Periodontal disease, also known as gum disease, is an infection that affects the gums, and the bone surrounding the teeth. Interestingly, a significant number of individuals with periodontal disease are often unaware of its presence, particularly in its early stages when it tends to be relatively painless.
The primary reason behind periodontal disease is the long-term existence of plaque buildup, a sticky film composed of food particles and bacteria that constantly forms on the teeth after consumption of either solid food or liquid. Although plaque is not easily visible, its presence becomes obvious when stained with red dye.
Regular removal of plaque is crucial to prevent its accumulation. By absorbing calcium plaque subsequently hardens into tartar, also known as calculus. Tartar formation requires professional assistance for removal since regular brushing or flossing is not sufficient in its elimination. If left untreated, tartar starts to increase in size and consequently affect the root surfaces of teeth, When the tartar is dense enough it starts appearing as small white bumps attached to the tooth on X-rays.
The bacteria responsible for periodontal disease succeed in this environment, producing toxins that, in conjunction with the body's immune system respond to them, result in the destruction of the bone surrounding the teeth.
Several warning signs indicate the presence of periodontal disease, including
- Constant bad breath,
- Bleeding from the gums when brushing and flossing, - Edematous or swollen gums, - Gum recession - Tooth mobility, and - Alterations in the spaces between the teeth, reflecting changes in the underlying bone.
Remarkably, an individual can have periodontal disease without experiencing any of these warning signs.
In an individual with good oral health, teeth roots are supported by the jawbone, where the bone typically should cover the whole root of the teeth to the teeth's necks where the root connects to the crown of the tooth. This bone support is even throughout the mouth when everything is in good health. A sulcus refers to the cleft between the tooth and the gums, with a healthy gum, the sulcus measuring two to three millimeters in depth. When plaque and tartar build up extends into the sulcus, causing the gum to separate from the tooth and create a cleft measuring more than three millimeters in depth, the sulcus transforms into a pocket.
In the presence of the tartar build-up and pocket deeper than 3 millimeters, the infection and inflammation of the gum can release body enzymes that resorb the bone surrounding the root. Regrettably, once bone is lost, it cannot regenerate itself. Excessive bone loss weakens tooth support, leading to loosening and eventual removal of the tooth.
Diagnosis:
Periodontal disease typically initiates between the teeth, taking X-rays as an informative tool is important to identify potential periodontal disease, even in the absence of visible symptoms, a thorough examination involving X-rays and a periodontal probe, to measure bone levels around the teeth is conducted. The existence of tartar on X-rays serves as a strong indicator of periodontal disease.
As it is explained previously, when tartar builds up under the gum, gums pull away from the teeth, forming pockets. The depth of these pockets is measured using a periodontal probe, from the pocket bottom where the gum attaches to the tooth to the top of the gums.
In a healthy gum, it tightly adheres to the teeth, lacking any pockets ( 0- 2mm ). Conversely, early periodontal disease manifests with deeper pockets, indicating a more widespread issue. Bleeding during probing serves as a sign of infection, which is absent in healthy gums. Moderate periodontal disease presents with red, swollen gums, particularly between the teeth.
Classification of the gum health and treatment.
- Gingivitis: First stage of gum disease, which is reversible with good oral home care. There is no pocket depth of more than 3 millimeters.
- Early periodontitis: Early stage of gum disease, X-ray shows starting minor bone loss and the patient starts seeing more blood when flossing and brushing. The prognosis in being able to control the bone loss is good with good home care and 3-4 months of recall cleaning
- Moderate periodontist: Bone loss is visible in the X-ray and clinical visit. bleeding is present and the patient has a bad taste in the mouth. The prognosis is fair with meticulous home care regular deep curettage every 3 months, and possible gum surgery required to maintain the bone level.
- Advanced periodontitis: Sever bone loss, the patient can see the spacing and feel tooth mobility, Prognosis is poor, and the patient needs to plan for alternative treatments to replace the missing teeth in the near future.
If you have any questions or concerns about the health of your gum, our Dentists at Ace Dental locations in Vancouver and Coquitlam are ready to help.
Give us a call and schedule your appointment for a comprehensive evaluation of your oral health at Ace Dental Locations and the lower mainland.