Periodontal disease is an infection of the teeth, gums, and the bone that surround the teeth. Most people who have periodontal disease aren’t even aware of it, because it’s rarely painful, especially in the early stages.
The main cause of periodontal disease is the accumulation of plaque. Plaque is the sticky film of food and bacteria that forms constantly on your teeth. If all of the plaque isn’t removed each day, it builds up and mineralizes to become tarter, also called calculus.
If tarter isn’t removed, it begins to accumulate on the root surfaces. Bacteria that cause periodontal disease thrive in tartar. These bacteria produce toxins, and it’s these toxins, combined with your body’s response to them, that destroy bone around your teeth. Professional help is required to remove tartar, because there’s no way to remove it at home. A toothbrush or floss won’t even budge it.
Since you may have periodontal disease without experiencing symptoms, we perform a thorough examination using X-rays and a periodontal probe.
The crevice between a tooth and the surrounding gum is called sulcus. A healthy sulcus is two to three millimeters deep. When plaque and tartar invade a sulcus and it becomes deeper than three millimeters, it is called a pocket. We measure the depth of all pockets using a periodontal probe. The measurement is from the bottom of the pocket, where the gum is attached to the tooth, to the top of the gums. In general, the deeper the pockets, the greater the extent of periodontal disease.
We also examine the color, shape, and overall condition of the gums. Bleeding is a sign of infection; healthy gums don’t bleed. Healthy gums are firm and lightly stippled. In moderate cases of periodontal disease, we see swollen gums.
X-rays also tell us a lot about periodontal disease, because they allow us to monitor your bone levels. In a healthy mouth, the bone comes up high around the necks of the teeth, and the bone level is even throughout the mouth. With advanced periodontal disease, the bone levels are much lower and are uneven.
Treatment and Maintenance
Routine cleanings in our office remove plaque and tartar that exist on your teeth above the gum line, but sometimes, especially if you don’t floss regularly, plaque, tartar and bacterial toxins can develop below the gum line. The goal of scaling and root planning is to remove this source of periodontal infection from below the gum line on the surface of the roots.
Normally, we’ll spread scaling and root planning over two appointments. This will maximize your comfort and allows us to check the healing and help you fine-tune your homecare efforts.
To keep you comfortable, we may give you local anesthetic before the procedure begins. Then we’ll use either a small scaling instrument or an ultrasonic scaler to carefully and meticulously remove plaque and tartar from the top of your tooth all the way down to the bottom of the pocket.
Then, we’ll plane- or smooth- the root surfaces so your gums can heal and reattach to your teeth. If it appears to be necessary, an antibiotic or alternative medication will be placed in the pocket after it’s been scaled and planed to control infection and promote healing. Oral antibiotics might also be prescribed to further combat again tighten around your teeth.
Scaling & Root Planing Procedure
Homecare is the key to continuing the healing process. Since brushing and flossing only removes plaque about three millimeters below the gum line, you’ll need special tools to clean the affected areas. As part of your treatment, we’ll provide you with the tools and techniques you’ll need to thoroughly clean and maintain these areas.
After this disease process in under control, a regular cleaning is not appropriate anymore. Instead, you will require special on-going gum and bone care procedures, also known as periodontal maintenance to keep your mouth healthy.