What is periodontal disease?

Periodontal diseases are infections of the gums and the bone that surrounds the teeth. In advanced disease, the teeth themselves will be affected. The primary cause of these infections is the sticky accumulation of bacteria called plaque. Millions of people have some type of periodontal disease but are unaware that they have a problem. These diseases are almost always painless and may go completely unnoticed in their early stages.

There are two stages of periodontal disease:

Gingivitis - a superficial infection of the gum.

Periodontitis - a more advanced infection which involves the surrounding bone.

Plaque forms continuously, so it must be removed every day with regular brushing and flossing. If plaque is allowed to build up, tartar - or calculus - forms, which cannot be removed by brushing or flossing. The bacteria that cause periodontal disease thrive in these calculus deposits. The bacteria's waste products are toxic. The effects of these toxins and the body's own immune response to them, will begin to destroy the bone surrounding the teeth.

How to identify periodontal disease?

Gingivitis can sometimes be recognized by a redness and puffiness of the gums, bleeding of the gums when they're brushed, and sometimes a bad mouth odor, or halitosis. When the infection moves from the gum to the underlying bone, the problem is now periodontitis. In this stage, the bone that supports the teeth is lost and once this bone is lost it will not grow back.

Periodontitis can be characterized (in addition to the signs associated with gingivitis) by a receding of the gums, spaces opening between teeth, discomfort in the gums and loosening of the teeth. Gum recession is never normal and can expose the root, making it more vulnerable to decay. Loosening of one or more teeth is almost always a sign of severe bone loss. Spaces occur when the gums and underlying bone have receded and is typically a sign of an advanced problem.

Treatment

Normal tooth cleanings remove plaque and calculus deposits from above the gumline. When these deposits extend below the gumline, a procedure called root planing is necessary. Root planing is performed with the same tools as normal cleanings but the procedure is more aggressive and often requires more time than a regular cleaning . Often it is necessary to numb the affected area before the procedure. Once the accumulated plaque and calculus have been removed and a consistent routine of good oral hygiene is established at home, the gums will heal, tightening around the teeth. Depending upon the extent of disease found in the examination, root planing may be done over several office visits.