The word periodontal means “around the tooth”. Periodontal disease attacks the gums
and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria,
and saliva. If plaque is not removed, it turns into calculus or tartar. When plaque
and calculus are not removed, they begin to destroy the gums and bone. Periodontal
disease is characterized by red, swollen, and bleeding gums.
Four out of five people have periodontal disease and don’t know it! Most people
are not aware of it because the disease is usually painless in the early stages.
Not only is it the number one reason for tooth loss, research suggests that there
may be a link between periodontal disease and other diseases such as, stroke, bacterial
pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy.
Researchers are determining if inflammation and bacteria associated with periodontal
disease affects these systemic diseases and conditions. Smoking also increases the
risk of periodontal disease.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your
risk of developing periodontal disease.
Signs and symptoms of periodontal disease:
- Bleeding gums – Gums should never bleed, even when you brush or use dental floss.
- Loose teeth – Also caused by bone loss or weakened periodontal fibers that support
the tooth to the bone.
- New spacing between teeth – Caused by bone loss.
- Persistent bad breath – Caused by bacteria in the mouth.
- Pus around the teeth and gums – Sign that there is an infection present.
- Receding gums – Loss of gum around a tooth.
- Red and puffy gums – Gums should never be red or swollen.
- Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and
Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal
examination. This type of exam should always be part of your regular dental check-up.
A periodontal probe is gently used to measure the sulcus or pocket space between
the tooth and the gums. The depth of a healthy sulcus measures three millimeters
or less and does not bleed. The periodontal probe helps indicate if pockets are
deeper than three millimeters. As periodontal disease progresses, the pockets usually
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation,
and tooth mobility to make a diagnosis that will fall into a category below:
- Gingivitis - Gingivitis is the first stage of periodontal disease. Plaque irritates
the gums, making them tender, inflamed, and likely to bleed.
- Periodontitis - Plaque hardens into calculus or tartar. As calculus and plaque continue
to build, the gums begin to recede from the teeth. Deeper pockets form between the
gums and teeth filling with bacteria and pus. The gums become 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.
If the disease is caught in the early stages of gigivitis, and no damage has been
done, one to two regular cleanings will be recommended. You will also be given instructions
on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning
called scaling and root planing or deep scalings will be recommended. In this procedure,
tartar, plaque, and toxins are removed from above and below the gum line and rough
spots on root surfaces are made smooth. This procedure helps gum tissue to heal
and pockets to shrink. Medications, special medicated mouth rinses, and an electric
tooth brush may be recommended to help control infection and 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. Your dentist
may also recommend that you see a Periodontist, a specialist of the gums and supporting
It only takes twenty four hours for plaque that is not removed from your teeth to
turn into tartar! Daily home cleaning helps control plaque and tartar formation,
but those hard to reach areas will always need special attention. Once your periodontal
treatment has been completed, your dentist and dental hygienist will recommend that
you have regular maintenance cleanings, usually four times a year. At these cleaning
appointments, the pocket depths will be carefully checked to ensure that they are
healthy. 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
- Examination of diagnostic x-rays which are essential for detection of decay, tumors,
cysts, and bone loss. Examination of existing teeth and restorations for tooth decay.
- Oral cancer screening of the neck, lips, tongue, throat, gums and all oral tissues.
- Oral hygiene recommendations reviewing and recommending oral hygiene aids such as
electric toothbrushes, special periodontal brushes, fluorides, and mouth rinses.
- Teeth polishing to remove stain and plaque not removed during tooth brushing and
- Good oral hygiene practices and periodontal cleanings are essential in maintaining
dental health and keeping periodontal disease under control!