Among the causes for periodontal (gum) disease are genetic susceptibility, smoking, and other illnesses like diabetes. Periodontal maintenance involves removing plaque and calculus from above and below the gum line. Most gum diseases are preventable with proper oral hygiene. However, what can start out as gingivitis (inflamed or bleeding gums) can quickly turn into periodontitis. In such cases, gums pull away from the tooth to create “pockets,” thereby exposing a dental root to infection. It can also lead to prolonged bad breath, loose teeth, painful chewing and other complications.
Diagnosing Gum Disease
The best way to determine if gingivitis is present is by the use of a perio probe. This instrument goes beneath the gum line between the tissue and the tooth and measurements are recorded in millimeters. The deeper the pocket, the greater the chance for food/debris/bacteria to escape and flourish in an area that is difficult if not impossible for the patient to clean. If the gums bleed when brushing or after using the perio probe, the diagnosis would be gingivitis. This is caused by chronic plaque build-up that has resulted in the gums being inflamed. Periodontal disease is diagnosed by bone loss and deep pockets as determined by the perio probe.
When patients have periodontal disease that is uncontrolled or has not been treated, we may have to do a procedure known as scaling and root planing. This is different from a typical cleaning because we go below the gum line to clean and remove plaque/calculus in those areas that are impossible for patients to clean with at-home oral hygiene devices. When we do this procedure, the patient is anesthetized to provide comfort and typically one side of the mouth is done at each appointment.