The New York
Patient’s Guide to Periodontal Disease

What is Gum Disease?

Periodontal (gum) disease is an infection that develops in the gums due to bacteria produced by plaque, or an opaque film on the teeth that hardens to form tartar. As tartar accumulates, it houses bacteria that attack the soft tissue around the gums.

Diagnosis

During your regular dental check-up, your dentist or hygienist will use a small dental instrument called a probe to measure the pocket or space (sulcus) between the tooth and gums.

The depth of a healthy sulcus measures three millimeters or less and doesn’t bleed. The periodontal probe helps indicate if pockets are deeper than three milliliters. As periodontal disease progresses, the pockets usually get deeper.

Stages of Periodontal Disease

We’ll use the pocket depths, amount of bleeding, inflammation, tooth mobility, and more to provide a diagnosis that’ll fall into one of three categories:

1. Gingivitis — In the first stage, plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.
2. Periodontitis — During this stage, plaque hardens into calculus (tartar) and the gums begin to recede from the teeth. The gums become very irritated, inflamed, and bleed easily, while the bone loss may occur as well.
3. Advanced periodontitis — When gum disease is completely ignored, the teeth lose more support as the gums, bone, and periodontal ligament continues to be destroyed. The affected teeth will become very loose and may eventually be lost.

Treatment

The type of periodontal treatment you need depends on the severity of your condition. At your appointment, your dentist and hygienist will evaluate for periodontal disease and recommend the most effective treatment for you. This may include:

• Regular cleanings — If caught early on, one to two cleanings will be recommended. You’ll also be given instructions on improving your daily oral hygiene habits and visiting us for regular dental cleanings.
• Scaling and root planing — For patients suffering from mild to moderate cases, we’ll remove hardened plaque and bacteria from under the gumline. We’ll also smooth out the roots to prevent bacteria from settling into the cleaned area.
• Periodontal surgery — If pockets don’t heal after scaling and root planing, surgery may be needed to reduce pocket depths, making your teeth easier to clean. We may also recommend that you see a periodontist or specialist of the gums and supporting bones.

Maintenance

Once your treatment has been completed, your dentist and hygienist will recommend that you have regular maintenance cleanings, usually four times a year. Uring these visits, we’ll carefully check the pocket depths to ensure they’re healthy.

In addition to your cleaning and evaluation, your appointment will usually include:

• Examination of diagnostic X-rays — Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
• Examination of existing restorations — Check current fillings, crowns, and more.
• Examination of tooth decay — Check all tooth surfaces for decay.
• Oral cancer screening — Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
• Oral hygiene recommendations — Review and recommend oral hygiene aids as needed.
• Teeth polishing — Remove stains and plaque that aren’t otherwise removed during tooth brushing and scaling.

Frequently Asked Questions