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Periodontal Diagnosis

Diagnosis :: Treatment :: Maintenance

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 (small dental instrument) is gently used to measure the sulcus (pocket or 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 get deeper.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category 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.

How can I tell if I have gingivitis or periodontitis (gum disease)?

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. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

  • Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
  • Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
  • Many medications – Steroids, cancer therapy drugs, blood pressure medications, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
  • Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
  • Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
  • Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

  • Red and puffy gums – Gums should never be red or swollen.
  • Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
  • Persistent bad breath – Caused by bacteria in the mouth.
  • New spacing between teeth – Caused by bone loss.
  • Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
  • Pus around the teeth and gums – Sign that there is an infection present.
  • Receding gums – Loss of gum around a tooth.
  • Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.