Periodontal Disease 101

Periodontal Disease 101

Periodontal disease, also known as gum disease, begins with chronic bacterial growth in the mouth.  If left untreated, periodontal disease can eventually lead to tooth loss.

What are the Symptoms of Periodontal Disease?

Initially, bacteria build a home in the spaces between the tooth and the gum, called the periodontal pocket.  In the early stages, called gingivitis, the gums can become inflamed, red, sore, and can easily bleed when brushing or flossing.  Some people may even have persistent bad breath or a bad taste in their mouth.  If left untreated, inflamed and enlarged gums can even cause your teeth to shift and move.

Often this pain, inflammation and bleeding makes people want to brush and floss even less – exacerbating the problem.

Although the gums are inflamed and irritated, the tooth is still firmly rooted in the jaw bone.  However, as the bacterial infection grows, the bone tissue begins to be eaten away, like steel turning to rust.  When this happens, the teeth that were once anchored in the bone become loose and will eventually fall out.

Gum disease is the leading cause of tooth loss in adults, but unlike in children the tooth fairy can’t help you.

To stop the progression of this disease, it is important to see your periodontist for an accurate diagnosis and personalized treatment plan, which usually includes an initial deep cleaning followed by proper at home care and regular supportive periodontal therapy visits with your dental hygienist.

What causes Periodontal Disease?

Poor plaque control is the primary cause of periodontal disease.  Therefore, the first line of defence in reducing gum disease is at home care.

Other factors can make a person more susceptible to gum disease.  These factors include:

  • Family history of periodontal disease
  • Diabetic control
  • Heart disease
  • Medications – some medications have an effect on our oral health as they can increase or decrease saliva flow, which acts as a natural rinse in the mouth
  • Smoking status
  • Regular dental hygiene visits

How do I treat Periodontal Disease?

The first line of defence in reducing gum disease is at home care which includes;

  • brushing with a power toothbrush for 2 minutes twice daily
  • regular use of string floss to clean between the teeth
  • regular use of interdental brushes to clean between the teeth

To stop the progression of the disease, it is important to see your periodontist for an accurate diagnosis and personalized treatment plan, which usually includes an initial deep cleaning followed by proper at home care and regular supportive periodontal therapy visits with your dental hygienist.

What is my periodontist measuring?

What is my periodontist measuring?

Your periodontist and hygienist collect several values that give a good indication of your periodontal health and wellness at every appointment. 

To collect these values, a periodontal probe is used.  A probe is a very thin, small ruler.  The probe is gently inserted in the small space that exists between your tooth and your gum.  Some of the values that we are able to collect from this measurement are described below:

a. Bleeding on Probing – What percentage of sites bleed after gentle probing?  Bleeding indicates inflammation of the gums due to a bacterial infection.

b. Probing Depth – How deep is the pocket between the tooth and gum?  A healthy periodontal pocket is between 3 and 4mm.  A periodontal pocket deeper than 5mm requires deep cleaning.

c. Gingival Thickness – How thick or thin is the gum tissue surrounding the tooth rooth?  Just like Goldilocks, your periodontist and hygienist are measuring that your gums are not to thick and not to thin, but juuuust right.

d. Mobility – How loose are teeth?  The periodontal ligament around each tooth allows for some movement and mobility (think of the need for a skyscraper to have some room for movement in the wind), but the tooth should be snug in the bone and soft tissue.

e. Furcation Involvement – Has bone resorbed away from the tooth so much that the probe can fit between the roots of the teeth?

f. Plaque Score – How much visible plaque is on the tooth surface?

Like a report card, your periodontist and hygienist review these values at every appointment and look for areas of improvement as well as areas that require some more attention and focus.

Classifications of Periodontal Disease

Classifications of Periodontal Disease

Everyone lives with a small amount of inflammation and bacteria in their mouths, but it is when this bacterial infection in the gums proceeds to chew away at the bone that supports the tooth that we are diagnosed with periodontal disease.  Periodontal disease often goes undetected by the patient because there is no pain associated with the disease.  That is until teeth become loose, gums become red and inflammed and they begin to bleed when they are flossed or brushed.

In 2017, more than 170 clinicians and researchers came together to redefine the way that we classify periodontal disease.  Now, using language similar to that used in oncology (i.e., Stage 1 through 4) we are able to communicate the severity and rate of disease progression to patients and other clinicians better than ever before.

Your periodontist is a specialist in the gums and bone that support the teeth.  They collect information such as the depth of the pockets around your teeth, the amount of bone that’s been lost around the teeth (as seen on an x-ray), and the amount of bleeding and inflammation, and other factors like diabetes and smoking status to give an accurate diagnosis.  The diagnosis is made up of two factors, stage and grade.

First, a patients stage of disease is like the GPS of a car.  Stage describes the severity and complexity of the disease.  How straight of a path are we on from health to severe disease.  Staging of periodontal disease can rank from Stage 1, incipient periodontitis through to Stage 4, advanced periodontitis with extensive tooth loss.

Secondly, a patients grade of disease is like the speedometer of a care.  Grade describes how quickly the disease is progressing.  How fast are we moving from health to disease.  Grading of periodontal disease can rank from Grade A, slow rate through to Grade B, rapid rate.

Both smoking and diabetes status are known factors that can influence our Grade, how fast we are progressing from health to disease.  Being a non-smoker and having normal, controlled blood glucose levels slows the rate of progression.  Smoking more than 10 cigarettes per day and/or having an HbA1c greater than 7% rapidly increase the rate of disease progression.

Your periodontal diagnosis and classification should be updated every 5 years with a full mouth series of x-rays conducted at your periodontal office or general dentist.

The best way to prevent and to treat periodontal disease is by regular visits to your dental office as well as putting a high priority on oral hygiene at home.

A note to our community,

A note to our community,

We have made the decision to postpone the Paint a Paddle for ALS Canada Auction to November 2020 and to bring the Auction VIRTUAL.

We feel tremendous support from our community and know that an event held at a date to be determined will be a huge success for ALS Canada and a cause for celebration for the Niagara Region.

For those who still have unfinished paddles at home, we have extended the submission deadline.  Take this time to get creative with your family at home!  All paddles submitted after the original deadline of March 4 will not be considered for the grand prize at auction, but will still be included in the Virtual Auction in Fall 2020.

Stay close for updates to this unique event to be announced soon!

Last Updated: August 27, 2020

Remember there is no such thing as a small act of kindness. Every act creates a ripple with no logical end.”

– Scott Adams

Conventional Crown Lengthening

Conventional Crown Lengthening

First things first, what is crown lengthening?

 Often when a tooth fractures or has a very large filling and your dentist has recommended a crown to restore the tooth to its normal function and appearance, a crown lengthening procedure is required.

This procedure involves the removal and re-contouring of the gum and bone surrounding the tooth.  This provides your dentist with sufficient tooth area to work with in order to place the crown so that it will have the best chance of being retained on the tooth.  Having a proper fitting crown ensures the gum tissues remain as healthy and stable as possible.

Nearly everyone who has cracked or damaged a healthy tooth and is in general good health is a candidate for surgical crown lengthening.  However, if a tooth has been fractured beyond repair, extraction of the tooth and replacement with a dental implant may be another option for treatment.

To determine if you are a candidate for surgical crown lengthening, a consultation with your periodontist is needed to develop your individualized treatment plan of action.