Periodontal disease refers to inflammation of the gums and bone around teeth, leading to loss of the attachment of supporting gums or bone. This loss of attachment can be seen either as gum recession or deeping of the normal "sulcus", or cervice, where the gums attach to the teeth, or both. Periodontal disease is diagnosed by performing a detailed examination of the teeth and gums, and is part of the routine oral examination. Periodontal disease is very common, affecting to some degree 40% of all adults, and increasing with age. Untreated periodontal disease can result in tooth mobility and tooth loss.
A periodontal probe (essentially a small ruler) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper. We use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:
Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.