Diagnosing Gum Disease and its Stages

 Periodontal disease is diagnosed by your dentist during a periodontal examination.  This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental instrument) 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.    As periodontal disease progresses, the pockets usually get deeper.

 

 

Your dentist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

 

 

Healthy Gums

 

 

 

Healthy gums are the foundation for your teeth and even your health.  Healthy gums protect the bone below which supports the tooth above.  Healthy gums measure 3 mm or less and do not bleed upon measurement.  To the untrained eye everything may seem fine, but there could be irrevesible damage going on to the bone below.  If you noticed bleeding of your gums during your routine home care flossing and brushing, you likely have gingivitis or periodontitis.  Make an appointment to see your dentist.

 

 

 

 

Healthy gums

• Are light pink in color (darker for people with darker complexions)
• Are stippled, much like the surface of an orange
• Are not tender or swollen
• Don't bleed when brushing or flossing

 

 

Gingivitis

 

Gingivitis is the first stage of periodontal disease.  Pocket depts are still 3 mm or less.  Gingivitis is the infection of the gums.   Plaque and their toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.    Your body tries to fight the intruder by releasing your immune cells into the site.   The vessels in the area are  engorge with blood and  they replicate, however, the bone below is still unaltered.  It is important to note that this stage of gum disease is fully reversable.  If you get rid of the bacteria the gums will return to their original healthy condition.    Symptoms include:

• Red gums
• Swollen gums
• Bleeding gums
• Tender gums
• Bad breath

 

 

Periodontitis

 

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.

• Plaque has spread to the roots of your teeth.
• Gums are red, swollen, bleeding, and tender.
• Infection continues to worsen.
• This infection has damaged the supporting bone and fibers that hold your teeth in place.
• Gums may have begun to pull away from your teeth forming a "pocket" below the gum line, which traps food, bacteria, plaque.
• Immediate treatment can stop further damage and tooth loss.
• Pus and bacteria are inside the gums which could damage other parts of the body.

 

Advanced Periodontitis

 

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.

• plaque has spread down to the apex of the root.
• The infection has damaged the majority of supporting bone and fibers that hold the teeth in place.
• Gums have receeded and pulled away from teeth.
• gums contain pus and bacteria that are getting into the blood stream and harming other parts of the body.
• Teeth are mobile.