Periodontal disease may be diagnosed by your dentist, or dental hygienist, during a periodontal examination. This type of exam will always be part of your regular dental checkup.
A periodontal probe (small dental instrument) is gently used to measure the pocket or space between the tooth and the gums. The depth of a healthy pocket or space measures three millimeters or less and does not bleed. The periodontal probe helps to indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets generally get deeper.
Signs and symptoms of periodontitis can include:
- Swollen gums
- Bright red or purplish gums
- Gums that feel tender when touched
- Gums that pull away from your teeth (recede), making your teeth look longer than normal
- New spaces developing between your teeth
- Pus between your teeth and gums
- Bad breath
- Bad taste in your mouth
- Loose teeth
- A change in the way your teeth fit together when you bite
Your dentist, or hygienist, use the pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into one of the categories below:
Gingivitis is the first stage of periodontal disease. Plaque, along with the toxin by-products, irritates the gums and makes them tender, inflamed, and more likely to bleed.
Your gums actually attach to the teeth at a lower point than the gum edges that we see. This forms a small space called a sulcus. Food can get trapped in this space and cause a gum infection or gingivitis.
Plaque is a thin film of bacteria. It constantly forms on the surface of your teeth. As plaque advances, it hardens and becomes tartar. You can develop an infection when plaque extends below the gum line.
Left unchecked, gingivitis can cause the gums to separate from the teeth. This can cause injury to the soft tissue and bone supporting the teeth. The tooth may become loose and unstable. If infection progresses, you may ultimately lose your tooth or need a dentist to remove it.
Gingivitis (gum inflammation) usually precedes periodontitis (gum disease). However, it is important to know that not all gingivitis progresses to periodontitis.
Plaque hardens into calculus or tartar. As calculus and plaque continue to build up, the gums begin to recede. Deeper pockets will form between the gums and teeth, which becomes filled with bacteria and pus. The gums will become very irritated, inflamed, and are likely to bleed easily. Also, slight to moderate bone loss may be present.
Periodontitis (per-e-o-don-TIE-tis) is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth. Periodontitis can cause tooth loss or worse, an increased risk of heart attack or stroke and other serious health problems.
Periodontitis is common but largely preventable. Periodontitis is usually the result of poor oral hygiene. Brushing at least twice a day, flossing daily and getting regular dental checkups can greatly reduce your chance of developing periodontitis.
The teeth lose support as the gums, bone, and periodontal ligament continue the destruction process. Unless treated, the affected teeth will become very loose and ultimately may be lost. It is likely that moderate to severe bone loss may be present if not treated.
The treatment you need depends on how serious your periodontitis is. Dentists classify the disease as mild, moderate or severe.
Mild periodontitis is treated with a cleaning called scaling and root planing. Scaling removes plaque and tartar from your teeth. Scaling cleans the teeth above and below the gum line. Root planing smooths the roots, making it harder for bacteria to stick there and grow. Combined with at-home brushing and flossing, this special cleaning often is enough to cure periodontitis.
Moderate periodontitis usually requires more than scaling and root planing. Surgery is sometimes suggested. Some surgeries reshape your gums to better fit your teeth. Others try to regrow bone that was destroyed.
Severe periodontitis traditionally requires surgery. Sometimes, you ma need antibiotics. Treatment may also include removal of teeth that can no longer be saved.