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PERIODONTAL

Gum (periodontal) disease is usually caused by plaque, a sticky film of bacteria that constantly forms on teeth. If plaque is not removed with thorough daily brushing and cleaning between teeth, gums become irritated, inflamed, and bleed easily. The irritated gum tissue can separate from the teeth and form spaces called pockets. Bacteria move into the pockets where they continue to promote irritation. Left untreated, the process can continue until the bone and other tooth-supporting tissues are destroyed. The affected teeth may become loose and may be lost. Smoking is a major risk factor for periodontal disease.

Diagnosis

Periodontal disease is diagnosed by your dentist and dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-ups.

A periodontal probe is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The periodontal probe helps indicate if pockets are deeper than the ideal 3 millimeters or less. As periodontal disease progresses, the pockets usually get deeper.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis.

Treatment

Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric toothbrush may be recommended to help control infection and healing.

If the deep pockets do not resolve after scaling and root planing, periodontal surgery may be needed.

Maintenance

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.

Examination of existing restorations: Check status of fillings, crowns, etc.

Examination of tooth decay: Check all tooth surfaces for decay.

Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.

Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)

Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

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