Periodontal disease is diagnosed by our dentists and hygienists during a periodontal examination. Because of the importance of periodontal disease to dental health and overall health a periodontal examination is included as part of regular dental check-ups at Bass Lake Dental. Using a standardized technique, a periodontal probe (small dental instrument) is gently used to measure the depth of the sulcus (pocket or space) between specific teeth and the gums. The depth of a healthy sulcus measures three millimeters or less. Deepening sulcus depths greater than three millimeters is indicative that bone and soft tissue is being destroyed by periodontal disease.
The clinical diagnosis of periodontal disease requires examination by a trained examiner who uses measurements of sulcus depths, amount of bleeding, inflammation, bone loss detected by radiography and tooth mobility to make a diagnosis that will fall into one of the categories listed below.
Long-term clinical studies has clearly demonstrated that regular and effective removal of bacterial biofilms (plaque) on the teeth can prevent periodontal disease. Effective removal of plaque requires excellent oral hygiene, including thorough cleaning between teeth, and periodic professional dental cleanings. Once periodontal disease has been diagnosed the method of treatment depends on the type and severity of the disease as outlined below.
Gingivitis is the earliest stage of periodontal disease where toxins produced by plaque bacteria irritate the gums making them tender, inflamed, and likely to bleed. At this stage of the disease there is no permanent damage to the gums or supporting bone.
Treatment: Gingivitis is easily reversible using a combination of home care (brushing and flossing) and professional dental cleanings.
In periodontitis dental plaque hardens into calculus (tartar) and the gums begin to recede. As calculus and plaque continue to build up, the gums begin to recede from the teeth, and sulcus depth increases. The deeper pockets between the gums and teeth and become filled with bacteria and pus and the gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
Treatment: For patients in which the disease has progressed to the stage of periodontitis, a special periodontal cleaning called scaling and root planing may be recommended. It is usually done one quadrant at a time while the area is numb. In this procedure plaque and calculus are removed from above and below the gum line (scaling) and rough spots on the root surfaces are smoothed (planing). At Bass Lake Dental Cavitron ultrasonic scalers are used in addition to the usual hand instruments to assure a thorough cleaning. This procedure helps the gum tissue to heal and the pockets to shrink. Antimicrobial treatments may also be recommended. A maintenance program of professional cleanings (usually four tomes per year) will also be recommended.
The advanced stage of periodontal disease is characterized by severe gum irritation and bleeding. In addition, there is a progressive loss of tooth support as the gums, bone, and periodontal ligament continue to be destroyed. Generalized moderate to severe bone loss may be present. If not treated the affected teeth will become very loose and may be lost.
Treatment: The treatment for advanced periodontitis are the same as those for periodontitis. If, however, the pockets do not heal after scaling and root planing, the patient may be referred to a specialist for pocket elimination surgery (also known as flap surgery). Alternatively, Bass Lake Dental is now offering the Laser Assisted New Attachment Procedure (LANAP). LANAP is an FDA approved procedure to treat moderate to severe periodontitis using the Periolase MVP-7, a pulsed fiberoptic delivered FR Nd:YAG laser.