Periodontal disease affects more than 80% of Americans by the age of 45
Signs and symptoms of periodontal disease include the following:
- Tender, red or swollen gums that bleed easily, especially during brushing and flossing
- Gums have begun to pull away from teeth
- Persistent bad breath
- Discharge between the teeth and gums
- Loose, separating, or moving teeth
- If you have experienced any of these symptoms we recommend a full periodontal evaluation with a periodontist.
Certain factors contribute to the progression of periodontal disease:
Links between certain conditions and periodontal disease progression have been found in various studies. Diabetes, heart disease, respiratory disease, osteoporosis, HIV, arthritis, numerous genetic inflammatory & immune disorders and other systemic factors may contribute to the severity of periodontal disease.
Tobacco use, certain medications, emotional stress and tooth grinding on infected teeth have been linked to the progression of periodontal disease.
Research suggests that the bacteria in saliva may be passed from person to person; therefore, people with family members who have periodontal infection may be at risk of contracting periodontal disease.
For further information on how periodontal disease affects overall health we suggest visiting the American Academy of Periodontology website.
Non periodontal symptoms that periodontists treat:
- Perception that teeth are too short or that one has a “gummy” smile.
- Dental bridge or dentures may be unsatisfactory necessitating placement of dental implants.
- Surgical therapy in conjunction with orthodontics such as frenectomy, gingivectomy, impacted tooth exposure and placement of orthodontic anchorage devices such as mini-screws.
- Root coverage for recession areas
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Diagnosing Periodontal Disease
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 care at least twice a year.
X-rays are used to diagnose bone loss surrounding the roots of the teeth. If evidence of bone loss is seen on x-rays periodontal treatment is mandatory. If left untreated the likelihood of tooth-loss is high.
A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket) 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 get deeper. Your dentist or hygienist will use pocket depths, amount of bleeding, and tooth mobility to make a diagnosis that will fall into a category below:
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.
Mild to Moderate Periodontal Disease
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up below the gum line, 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.
Severe Periodontal Disease
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed by tartar and bacteria. Unless treated, the affected teeth will become very loose and may be lost.
Treating and Preventing Periodontal Disease
Most often, non-surgical therapy precedes surgical treatment for periodontal disease. Scaling, root planing and bite adjustment can improve the health of tissue, often being curative themselves. Greater tissue health improves the effectiveness of surgical therapies by reducing infection and promoting healing.
Daily brushing and flossing removes plaque from teeth and gums and helps reduce tartar deposits. Regular visits to the dentist are necessary to eliminate tartar where bacteria can grow and to clean in places that are difficult to reach.
There are other factors that a patient can control which directly correlate with the success of any periodontal treatment. Quitting the use of tobacco will improve oral health and reduce the risk of periodontal disease. Severity of periodontal infection is greater in diabetics. Maintaining control of blood sugar levels will decrease chance of infections.
Periodontal disease is more easily treatable in its early stages. Regular maintenance visits are important for successful periodontal therapy especially for individuals who are susceptible to the disease.
During your visit we will review effective brushing and flossing techniques.
The tooth brush technique that we recommend requires placement of the toothbrush pointed towards the gum line at a 45 degree angle. Gentle circular strokes are used to massage the tooth surface along the gum-line. If possible, we recommend using an electric toothbrush such as a Phillips Sonicare which is designed to push fluid between teeth and under gums. If you purchase a Sonicare toothbrush, please bring it to our office and we are happy to show you how to use it properly.
A Proxi Brush is used to clean between teeth after periodontal surgery has been performed. The brush removes plaque more efficiently than floss.
Thick floss such as Ultrafloss is recommended because it absorbs and grabs plaque as it runs between the teeth. We recommend wrapping the floss around the tooth and moving it up and down along the side to dislodge food and plaque.
Colgate Total Toothpaste has an antimicrobial component that inhibits plaque formation even after you brush.
Q: What is the best toothbrush to use?
A: There are a lot of options out there when it comes to toothbrushes, but making the right choice is actually fairly simple. You need a soft-bristle brush that is the right size for your mouth. Typically, adults need a toothbrush with a head that is half an inch across and an inch long, but this can vary based on the size of your mouth. Look for a toothbrush that provides adequate coverage to the surface of your teeth, but is not so big that you have difficulty reaching the back of your mouth.Beyond size and bristle firmness, everything else is a matter of personal preference. So find a toothbrush you like and that keeps your teeth and gums clean, and go with it.