You’ve probably heard about it before, whether from your dentist or in a toothpaste commercial: periodontal disease. It’s one of the most common chronic health problems in the world. It develops slowly and can stay under the radar until it’s done serious damage. In fact, many people don’t realize they’re living with it right now! What is periodontal disease, and what can you do about it?
WHAT IS PERIODONTAL DISEASE?
With about half of all adults in the US currently living with some form of gum disease, it’s incredibly common. However, not all cases of gum disease are equal! It’s a progressive inflammatory condition that, left untreated, usually gets worse over time. The term periodontal disease can technically refer to any form of gum disease, but it tends to be used more often when talking about the later, advanced stages.
In the beginning stages of gum disease, the tissue supporting your teeth may become red, swollen, tender, and may bleed when brushing or flossing. As inflammation gets worse and persists over time, it does damage deeper into the gums. This inflammation can compromise the ligament that holds teeth in their sockets (the periodontal ligament). Eventually, it will damage the bone supporting your teeth. While we can reverse inflammation in the gums to “repair” gingivitis, damage to the bone is permanent.
WHAT CAUSES PERIODONTAL DISEASE?
Much like gingivitis, periodontal disease starts with bacteria. Bacteria build up in sticky layers called biofilm, also known as plaque. Plaque then absorbs calcium and other minerals and salts from your saliva and hardens to become tartar (also known as calculus).
Tartar is very rough. When it builds up near or beneath the gums, it rubs on the gum tissue causing abrasions. It also leaves a great surface for more bacteria and plaque to build, continuing the cycle!
Oral bacteria release harmful substances as a byproduct of their digestion. Some release acid, which causes cavities. Others release compounds that can damage your gums and trigger inflammation. When your immune system responds to this threat, your white blood cells can end up causing even more damage. There is some evidence that this inflammatory process may even harm other organ systems in your body.
It’s the combination of buildup on the teeth, bacterial byproducts, and your own immune system that come together to create advanced periodontal disease. The longer this process progresses, the more unstable your oral health may become.
HOW DO WE DIAGNOSE PERIODONTAL DISEASE?
If periodontal disease is just an advanced stage of gum disease, how do we diagnose it? After all, gingivitis also causes red, puffy, bleeding gums, just like you’ll see in periodontal disease. So how do we draw the line?
Dr. Anderson and your dental health team here at Anderson Family Dental take diagnostics very seriously. We’ve invested in the best technology for thorough, accurate imaging so we know exactly what’s going on at all times. Just like diagnosing dental decay, periodontal disease has specific hallmarks we look for when evaluating your gum health.
First of all, we look for damage to the bone sockets that hold your teeth in place. When we take x-rays, we’re not just looking for cavities! We can also check the level of your bone and see if it sits nice and high on the teeth, or if it appears worn down. The bone should also have a continuous white line along its edge on an x-ray. If we see areas where that white line is broken or fuzzy, we know that the dense outer portion of your bone has become damaged.
Another key component of evaluating your gum health is called a periodontal chart. Your dental hygienist will periodically use a tiny dental ruler to measure your gums. If you’ve ever heard your dentist or hygienist calling out a bunch of secret code numbers like “3, 2, 3, 4, 2, 3,” and so on, that’s your perio chart! Your gum tissue is not connected to your teeth at the very edge. This cuff of unattached gums is called a sulcus or pocket. Ideally, that sulcus should be no deeper than 3 millimeters. If we see numbers over 5 millimeters, you may have periodontal disease
IS PERIODONTAL DISEASE TREATABLE?
As we said earlier, we can’t truly repair damage to the bone. However, that doesn’t mean all hope is lost! There are plenty of ways we can stabilize your oral health and stop the progress of periodontal disease.
First of all, we need to remove the triggers causing damage to the gums. That means removing all the calculus (tartar) from the teeth. Depending on how severe your buildup is, and how deep the pockets in your gums are, we may recommend splitting your cleaning up into sections. That way, we can numb one or two areas at a time and give you a thorough—and thoroughly painless—cleaning! In rare cases, more involved treatments including surgery may be necessary to ensure the complete removal of all buildup.
Once your teeth are as clean as possible, you’ll need to return every three months or so. Because the pockets will take time to heal, you’ll be more prone to buildup below your gums following your deep cleaning. We will need to take extra care to help the healing along.
TREATING AND PREVENTING GUM DISEASE STARTS AT HOME
The key to preventing and successfully treating gum disease is to keep your teeth as clean as possible. No surprises here! We recommend brushing well at least twice per day and flossing at least once per day. Some patients may benefit from an electric toothbrush or a water flosser as well! Using high quality fluoride toothpaste and other rinses or gels as recommended by your dental health team can also help.
Talk to your dental hygienist at your next cleaning about what you can do to ensure great oral health for your whole family. And don’t worry if it’s been a while since your last cleaning. We’re always here to help you get back on track! The best time to start fighting back against gum disease is now. Call us to schedule your next cleaning and dental health evaluation today!