Periodontal Disease

Diagnosis:

Periodontal (gum) disease is diagnosed by Dr. Wong or the Hygiene team during a periodontal examination. This type of exam is always a part of your regular dental check up at our office.

A periodontal instrument (ruler) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. Keep in mind there is a natural space between the tooth and gums but the depth is normally less than 3 mm and does not bleed. This instrument helps indicate if pockets are deeper than 3 mm. As periodontal disease progresses, the pockets will get deeper.

Dr. Wong and the Hygiene team will use pocket depths, amount of bleeding, inflammation, tooth mobility, gum recession etc. to make a diagnosis that will fall into one of the categories below:

Gingivitis
Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.

Advanced Periodontitis
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.

Treatment:

Periodontal treatment methods depend on the type and severity of the disease. Dr. Wong and the Hygiene team will evaluate your condition for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, tartar and pus, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth. In addition, new medical research indicates there is a link between periodontal disease and heart disease, premature birth and low birth weight!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two hygiene appointments will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings (recare appointments).

If the disease has progressed to more advance stages, a special periodontal cleaning called scaling and root planning (deep cleaning) will be recommended. It is usually done on one section of the mouth at a time wile the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). The planning helps enable the gums to heal back and attach to the root of the tooth thereby causing the pocket to shrink. Medications, special prescription strength mouth rinses and the Rotadent electric toothbrush may be recommended to help control infection and promote healing.

If the pockets do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Dr. Wong may also recommend that you consult with a periodontist (gum and bone specialist) in order to help you fight the disease.

Maintenance:

It only takes twenty minutes for plaque to reform on the teeth after a cleaning and in twenty-four hours, if left undisturbed, this plaque will turn into calculus (tartar)! Daily home care helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, Dr. Wong and the Hygiene team will recommend that you have regular recare visits (periodontal cleanings), usually four times a year. At these recare appointments, the pocket depths will be carefully checked to ensure that they have healed and are disease-free. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

Examination of diagnostic radiographs (x-rays): This is vital to detect evidence of decay, tumors, cysts and bone loss. X-rays also help determine tooth and root positions so the dental team and help you with home care.
Examination of existing restorations: Check current fillings, crowns, etc.
Examination of tooth decay: Check all tooth surfaces for decay.
Oral cancer screening: Check the face, neck, lips, tongue, cheek, gums and throat for any abnormalities and signs of cancer.
Oral hygiene instructions: Review and recommend oral hygiene aids as needed, such as Rotadent electric toothbrushes, irrigation devices, special brushes, and other medications or rinses.
Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Good oral hygiene habits and periodontal cleanings are essential in maintaining optimal dental health and keeping periodontal disease under control.