Periodontal Disease: What you should know

The two most common forms of periodontal disease are gingivitis and periodontitis which we are discussing here under the term gum or periodontal disease. It has been estimated that periodontal disease will affect 75% to 90% of adults. Periodontal disease is rarely painful. If any discomfort is noticed, it is often at a point where the periodontal disease has progressed to advanced stages. Even the common signs of periodontal disease are subtle. Many people are afflicted; however, without proper examination by a trained dental professional (knowledgeable and experienced in the diagnosis of periodontal disease), many cases go unnoticed and unrecognized until advanced stages. In its advanced stages, successful treatment of periodontal disease is less predictable, more involved, more costly, more time consuming and not as long lasting. Proper treatment of periodontal disease emphasizes early detection and early treatment intervention for the most long lasting, most predictable, and most successful treatment. Early treatment is generally less involved, less costly and more comfortable.

Periodontal (gum) disease will affect four out of five adults. In fact, it’s the leading cause of tooth loss in adults over age 35. Gum disease is the number one reason that most people lose their teeth. The sad thing is, gum disease is easy to treat, if detected early. Gum disease is caused by plaque, a colorless film of bacteria that constantly forms on the teeth. Plaque irritates the gums, causing them to become red, tender and swollen. If not removed, plaque eventually hardens to form calculus (tartar) around the necks of the teeth.

Periodontal disease is usually painless but progressive. Most adults with gum disease are unaware that they have it. If diagnosed early, however, most periodontally involved teeth can usually be saved.

Signs of Periodontal Disease

Unfortunately gum disease doesn't have many clues. People with periodontal disease often have advanced cases before it is discovered. Check for the warning signs listed below but remember, you may have periodontal disease and not have any of these signs or symptoms. Most people don't have any pain with periodontal disease. The only good way to detect periodontal disease is a proper examination by a properly trained and experienced dental professional. If you have noticed any of the following, you should seek professional advice:

The good news is that you can usually prevent tooth loss from gum disease through regular professional visits and good home care. If you are concerned you may have periodontal disease, you have any questions about preventing periodontal disease, or would like to schedule an appointment, call us today or contact us.

The Cause of Periodontal Disease

Essentially, common periodontal disease (gingivitis and periodontitis) is a chronic infection that occurs in the gum and bone surrounding the roots of teeth. The bacteria (plaque) that grows in all our mouths accumulates on all teeth, around the gum line and infects the cuff of gum tissue surrounding teeth. As the infection progresses, the actual "attachment" of the gum to the root is destroyed. Further progression actually breaks down and erodes the bone supporting the teeth. All of this usually takes place with no discomfort and few, if any, signs or symptoms.

If the gum disease remains untreated, it will typically progress with time. As more bone is lost around teeth, they will become loose. Eventually, when there is too little bone supporting a tooth, it will have to be extracted. The result of untreated gum disease is eventual loss of a tooth or teeth.

But remember: Gum disease is detectable (by a properly trained dental professional) in its early stages. The most successful treatment involves early detection and early treatment.

The Diagnosis of Gum Disease

The American Dental Association and American Academy of Periodontology recommend that examination for periodontal disease be part of every thorough dental exam. In addition, both organizations recommend that all people be examined for periodontal disease, as part of their routine dental care.

The examination for periodontal disease is simple, not time consuming and generally a comfortable procedure. A dental professional uses an instrument called a periodontal probe, which is like a small ruler. This ruler is used to measure the gum line around all teeth present in an individual's mouth. This simple examination will detect if common periodontal disease is present and give the dental professional a good idea of the severity. Usually, proper dental x-rays are also important to adequately diagnose a periodontal condition.. Other tests are available; however, they are used on an individual basis for specific concerns.

The Stages of Gum Disease

Common periodontal disease is caused by bacteria growing around teeth in the gum line. In many respects, periodontal disease is considered a chronic infection. As the infection of gum disease progresses, it destroys the attachment of gum tissue to the root of a tooth or teeth and destroys (erodes) the supporting bone. Gum disease is categorized based upon the amount of gum and bone destruction present at the time of examination and diagnosis. Different teeth within an individual's mouth can (and often do) have different stages of periodontal disease.

Healthy Gums
	» The probe will not measure beyond three millimeters. » There is no bleeding on probing. » There is no pus
Gingivitis
	» Gingivitis is a reversible early stage of gum disease. » There has not been any destruction of the gum attachment or bone surrounding the tooth. » Gingivitis is the first stage of gum disease. » Probing measurements usually three millimeters or less. » Some bleeding usually noted upon probing. » There may or may not be visible gum redness.
Early Periodontal Disease
	» This is the second stage of gum disease. » It involves some destruction of the gum attachment and bone around affected teeth. » This gum and bone loss is usually not reversible, but we can usually predictably treat the disease at this point. » Probing measurements are in the range of 4-5 mm in depth. » Gums will usually show some bleeding when probed.
Moderate Periodontal Disease
	» This is the third stage of periodontal disease. » It can be treated but not as easily as early periodontal disease. » This should be treated soon before further destruction of gum and bone take place. » Probing measurements are typically 5-7 mm. » Bleeding usually noted with probing measurements. » Bone loss around teeth is significant.
Advanced Periodontal Disease
	» This is the fourth and final stage of disease. » It is characterized by advanced gum and bone destruction. » Treatment is more difficult and less predictable than an earlier intervention. » Probing measurements are typically 7 mm or greater. » There may be noticeable tooth mobility. » Advanced bone loss.