Understanding Periodontal Disease

Your teeth are priceless! Your teeth are supported by bone and protected by gingiva. The time and effort you invest now to maintain them will reward you for a lifetime!

High levels of bacteria maintain a natural existence in your mouth. Your teeth are covered with plaque which is a clear, thin, sticky film that continually forms in your mouth. Bacteria in plaque produce toxins and enzymes that can inflame the gums and damage the attachment of the gums and bone to the tooth.

If this plaque is not removed on daily basis using a toothbrush and floss, it can harden into tartar also known as calculus. Tartar is a rough, porous surface which harbors more destructive bacteria furthering the process. The hardened tartar can no longer be brushed or flossed away. It can only be removed professionally by a dentist or hygienist.

Healthy gum tissue or gingiva is shaped like a collar around each tooth. Gingiva is tightly adapted to the tooth and bone, designed to be self-cleansing, is firm and resilient, is sculpted around each tooth with points extending between the teeth, and its colour ranges from pale pink to dark brown.

At the point where the gingiva meets the tooth is a naturally occurring space called the sulcus. The depth of this space measures from lmm to 3mm deep.

Plaque that is not removed daily collects around the tooth and in the sulcus. Inflammation causes the sulcus to deepen and it becomes a pocket. The deeper pocket is difficult to clean and becomes a haven for bacteria. This results in an ongoing process that inflames the gums and destroys the supporting bone of the teeth. This eventually leads to the loosening or loss of teeth. Bacteria associated with plaque also threatens to undermine your restorations and cosmetic work.

IMPORTANT TO REMEMBER - Bone that supports the teeth does not grow back. If you are of the belief that you can electively remove your periodontally involved teeth and replace them with a denture or implants, please remember that a significant amount of jawbone is still required to support both a denture or implants. Further, jaw bone exists to support teeth. Once teeth have been lost to disease, the jaw bone can continue to degenerate. The rate at which this happens varies among patients.

Stages of Periodontal Disease

Gingivitis

• Inflammation of the gums
  
• May appear bright red
  
• Bleed when brushed or probed
  
• 3-4mm pockets
  
• Minor accumulation of plaque and calculus - no loss of bone support
  

Early Periodontitis

• Greater inflammation of the gums
  
• Gums begin to separate from tooth
  
• Inflammation reaches bone - mild bone loss
  
• Up to 5mm pockets
  
• Unpleasant breath or taste
  
• Evident accumulation of plaque and calculus

Moderate Periodontitis

• A perio abscess may develop
  
• Gums recede - teeth appear longer
  
• Root surface exposed - sensitivity - root decay
  
• Possible furcation involvement
  
• Bad breath - difficult to clean - moderate plaque and calculus
  
• 5-6mm pockets
  
• Bone loss 20-50%

Advanced Periodontitis

• Loose or drifting teeth
  
• More than 50% bone loss *Significant plaque and calculus
  
• Leads to tooth loss or decision to remove teeth

How our treatment can help you

We believe that oral hygiene is the foundation of all dental health. One of the most effective ways to prevent the decline of your oral health is to have your teeth professionally cleaned by one of our Hygienists on a regular basis and practice effective home care.

Using the PSR method (periodontal screening and recording), we monitor the health of every patient at every hygiene visit as required. If indicated, a more in depth evaluation takes place. If further indicated, we may refer you to the periodontal care of a specialist.

Radiographs (x-rays) are important in the diagnosis and treatment of periodontal disease. They illustrate bone height, bone defects, infection, root involvement, tartar and decay. Radiographs are also beneficial in determining if the disease is progressing or if arrested.

Intra-oral cameras are used to show you any areas of concern - both periodontal and restorative. Computers are used to record our findings and compare results from one visit to the next. This way, we can confirm health or diagnose the progression of gum disease. When required, a personalized program of periodontal treatment is planned for you that is unique to your needs, abilities and values and will be thoroughly explained. For best long term results, you are advised to closely adhere to the recommended schedule of care.

In its simplest terms, treatment consists of gently removing the accumulation of plaque and tartar or calculus from above and below the gum line. This is known as debridement. How we do this depends on the stage of the disease and where the calculus exists. To be effective, sometimes surgery is recommended.