Studies indicate that upwards of 75% of adults have some level of gum disease. Silent, like diabetes or high blood pressure, gum disease gradually erodes the bone that holds and supports your teeth in the jawbone. While it is possible to have no symptoms at all, there can be warning signs:
Gums that bleed easily
Red, swollen, tender gums
Gums that have pulled away from the teeth
Persistent bad breath or bad taste
Permanent teeth that are loose or separating
Any change in the way your teeth fit together when you bite
Any change in the fit of partial dentures
Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis. The degree and severity of the disease can be affected by many factors unrelated to just how well you brush. Some of these:
Tobacco smoking or chewing
Systemic diseases such as diabetes
Some types of medication such as steroids, anti-epilepsy drugs, cancer drugs, calcium channel blockers and oral contraceptives
Bridges that no longer fit properly
Crooked teeth
Fillings that have become defective
Pregnancy or use of oral contraceptives
Stages of Disease
HEALTH
Coral pink color
Gums hug teeth tightly
No bleeding
GINGIVITIS
Bleeding while brushing or during probing
Inflamed, sensitive gums
Possible bad breath or taste
MILD PERIODONTITIS
More pronounced gingival bleeding, swelling
Gums may begin to pull away from teeth
Bad breath or taste
Pockets 3-4 mm deep
MODERATE PERIODONTITIS
Teeth may look longer due to gum recession
Gum boils or abscesses may develop
Bad breath or taste
Teeth may begin to drift and show spaces
Pockets 4-6 mm deep
ADVANCED PERIODONTITIS
Teeth may become mobile or loose
Constant bad breath and bad taste
Teeth sensitive due to exposed roots
Pockets > 6mm deep
Some teeth may be extracted
Diagnosis
A diagnosis is confirmed or ruled out by using a panoramic or full series of radiographs and comparing them with periodontal pocket measurements. During your gum exam, we may use a tiny ruler to actually measure the depth of the pockets and, at the same time, note any abnormalities like bleeding, pus, gum recession or loose teeth.
Treatment
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The goal of treatment is to eliminate the bacteria causing the disease. We have a comprehensive program in place comprised of a full range of non-surgical options as the first line of treatment. Treatment is usually a combination of:
Scaling and root-planing - This is a detailed cleaning which removes tartar under the gumline and smooths the roots to keep them clean. Usually we will use local anesthetic to numb the areas that will be cleaned and it will take several visits to do a thorough job.
Antibiotics - We have many options available for agents that kill bacteria and assist your body in healing your gums and bone. From tiny local applications that are placed directly in the pocket where the infection hides to rinses and systemic options. Antibiotics have been shown to enhance the results of scaling.
Homecare - There is no cure for periodontal disease. Our goal is to stabilize it and prevent additional bone loss. If you rebuild the engine in your car, you will need to do regular maintenance in order to keep it running. In the same way, you will need to work hard at home to keep your teeth clean and come in for professional cleanings several times a year to keep gum disease from coming back.
If your disease is beyond the scope of nonsurgical care alone, we will most likely refer you to a gum-specialist called a periodontist.