The wonderful thing about the advances in dentistry is that we are all able to keep our teeth for a lifetime.
Part of ensuring that your teeth are around when you need them is taking proper care of your gums. Without healthy gums, teeth get loose, you experience bleeding and bad breath, and you can notice effects on our health like heart disease and diabetes.
Our mouths are the entry point in our bodies to all the other systems. If you have infection in your mouth, the bacteria gets into the bloodstream and is constantly circulating throughout the body. There are many studies now correlating gum disease to complications with diabetes because bacteria get into already compromised blood vessels and circulation. Cardiac physicians are also paying more attention to the health of their patients’ mouths, because bacteria in the blood stream can cause serious cardiac issues.
Tooth brushes and floss manage plaque above the gums, but are only able to penetrate 1-3 mm below the gums to clean. Within 24 hours, any plaque left on your teeth turns into tartar (hard plaque) which can no longer be removed without help from your hygienist. Bacteria move into the tartar and act like barnacles on the side of a boat. They provide a surface that is irritating and rough to the gums. Gums swell and get inflamed and try to move away from the barnacle. This starts a retraction of the gum down the root. This is a major problem because exposed roots can be sensitive to temperature and touch, annoy us when we are trying to eat or drink, and are softer and more prone to decay and damage from tooth brushing. There is no enamel on roots!
It takes on average three months for the bacteria to produce enough toxic material around the tooth to start dissolving the bone. This is why, if you are diagnosed with periodontal disease, your hygienist will prescribe seeing you on a three month recare for periodontal therapy.
How do we decide whether you have periodontal disease?
There are a number of indicators of periodontal disease. When we examine you we are looking at the following things in terms of your gums:
How much plaque is present on your teeth?
The amount of plaque on your teeth gives us an idea of how much bacteria we are dealing with in your mouth.
How much bleeding is there when we touch your gums?
Healthy gums don’t bleed! Bleeding indicates that there are bad bacteria in the pockets around your teeth which can dissolve bone.
Are there pockets around your teeth and how deep are they?
Pockets are the spaces between your gums and your teeth. Normal pocket depths around teeth range from 1-3mm. Depending on the amount of bleeding, 4-5mm pockets would indicate early to moderate disease, and 6-7mm or greater pockets indicate advanced disease.
Are your teeth loose?
If bone is lost around a tooth due to gum disease it becomes mobile, like a fence post in a shallow hole. You may notice that mobility while chewing or pushing on the tooth. During the active disease process, the gums are boggy and inflamed and there is continual and gradual loss of bone support, eventually resulting in pain and tooth loss.
Do you have recession? If yes, how much bone has already been lost?
Recession can be a result of aggressive brushing, the result of active or healed gum disease or improperly aligned teeth. Our job is to figure out which it is. If it is due to brushing, we can teach you new, gentler brushing techniques. Active gum disease requires treatment planning and some time with your hygienist. You can’t clean into deep pockets at home. With periodontal scaling and root planing the roots become smooth and bacteria free, the gums get pink and healthy, and swollen gums shrink and heal. The result of this is that some recession may occur, but recession is better than having a pocket you can’t clean! With your help, we can maintain stable healthy gums for a lifetime.