Periodontal (Gum) Disease

Periodontal disease is a general term. It refers to a number of conditions, but it always inflammation of the gums and bone around teeth. It may lead to loss of the attachment of gums to the teeth or the loss of the bone that supports the teeth. The loss of attachment can be seen either as gum recession or deepening of the cuff of tissue around the tooth and tis is called developing pockets. What is a constant in all periodontal disease is inflammation. This is frequently recognized as a generalized or localized redness of the gums, frequently bleeding develops when the gums are touched, even while brushing and flossing! There are many causes of gum disease, some are under your control, some are not. The accumulation of plaque (soft debris accumulating on the gums) that cause the body to react to the irritation with a series of destructive reactions can be controlled by adequate brushing and flossing…we will teach you how to clean your teeth to prevent and control periodontal disease. When calculus (tartar) accumulates on your teeth, it allows irritants to cause inflammation of the tissue. Tartar can only be removed by the dentist or hygienist. Sometimes if it is deep in the pockets around the teeth, we need to numb the area to keep the gums comfortable while we clean them! Smoking tobacco has been shown to increase the risk of developing gum disease. We can help you quit or refer you to people who can help you quit. Uncontrolled diabetes causes the gums, along with other systems of the body, to break down more easily. We can help make referrals to healthcare providers who can help bring your diabetes under control. Family history of gum disease…we can not escape our family history but we can control the other factors that make it more likely to develop gum disease. Untreated periodontal disease can result in tooth mobility and tooth loss.

Periodontal disease is diagnosed by performing a detailed examination of the teeth and gums, and is part of the routine oral examination. The periodontal probe is a small ruler that is gently placed in the sulcus (the space between the tooth and the gums) to measure the depth of the sulcus. The depth of a healthy sulcus measures three millimeters or less and does not bleed. If the pockets are deeper than three millimeters or if the pockets are bleed, there are varied levels of disease. As periodontal disease progresses, the pockets usually get deeper. We use pocket depths, amount of bleeding, inflammation, tooth mobility and x-ray evidence of bone destruction etc., to make a diagnosis that will fall into a category below:

Gingivitis

An early stage of periodontal disease that generally involves irritated gums generally caused by plaque and its toxin by-products. The gums become tender, inflamed, and likely to bleed.

Periodontitis

The attachment of the gums to the teeth begin to break down. 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.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and attachment break down. Untreated, the affected teeth become very loose and may be lost. Generalized moderate to severe bone loss may be present.

Dr. Wolff and his team have significant experience in managing patients with Periodontal Disease. He has published multiple papers on the factors influencing periodontal disease and products designed to mediate the severity and extent of the disease.