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Diagnosis
We
will first take a medical history to reveal any past or
present periodontal problems, any underlying diseases that
might be contributing to the problem, and any medications you
are presently taking.
We use these elements
to examine for periodontal disease:
1. A comprehensive
or recare exam is crucial in
diagnosing periodontal disease. It is an easy, simple and painless
exam.
2. X-rays will be taken to determine
bone loss levels:
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3. Your gum tissue will be measured around
every tooth with a ruler to measure the periodontal destruction. This
fine instrument calibrated in
millimeters, will be used to measure pocket depth. It is
held along the length of the tooth with the tip placed in
the pocket. At the very edge of the gumline, healthy
gum tissue forms a very shallow V shaped grooves (sulcus)
between the tooth and gums. The normal depth of the sulcus
should be three millimeters or less. We will measure six points on each tooth --
three on the check side and three on the tongue sides. The
tip of the probe will then touch the point where the
connective tissue attaches to the tooth. These measurements
enable us to determine the condition of the connective
tissue and amount of gingival overgrowth or recession. Pocket
depths greater than 3 millimeters indicate disease and
infection. The deeper the pockets the great extent
plaque bacteria collects and infection and gum disease
develop because this area is more difficult to keep clean. .
Redness, puffiness, and bleeding
upon probing indicate inflammation and INFECTION. If the gum formation
between teeth is blunt and not pointed, acute necrotizing
ulcerative gingivitis (ANUG) may be indicated.
Tooth mobility is determined by pushing
each tooth between two instrument handles and observing any
movement. Mobility is a strong indicator of bone support
loss.
After noting the general state of oral
hygiene, we will ask about the quality of home dental
care. Please note that aspirin intake of 325 mg daily
for 7 days moderately increased the appearance of bleeding
on probing . [J Periodontol
2002;73:871-876]
Gum Ruler to measure pocket depth
4. Co-diagnosis where we involve you by
showing you the conditions in your mouth with an intraoral camera,
Warning Signs, mirror and calling out probing numbers.
Your gum tissue chart will be printed out and provided to you upon
request.
It is normal
for the depth of the space to be 1-3mm.
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5. All the results of this exam are placed into a detailed perio
chart which is a
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bleeding sites
which is a good indicator that you have ACTIVE disease |
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swellings
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pus
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color, contour and texture of
gingiva
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status of margins
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presence of inflammation
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recession
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mobility of teeth
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presence and degree of plaque and
calculus
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6.
In-dental-office
screening for diabetes mellitus
Diabetes
mellitus (DM) is undiagnosed in
approximately half of the patients
actually suffering from the disease. In
addition, the prevalence of DM is
more than twice as high in patients with
periodontitis. Thus, a high
number of patients with periodontitis
may have undiagnosed DM.
During routine periodontal examination
bleeding gums is a sign
of periodontitis. This blood may
be used for diabetes mellitus screening in a dental office setting. We
will ask you if you would like this
done.
7. We use plaque finding to
help us help you by using Plaque Finder 
| Selective differential staining permits
distinction between older and recent
plaque deposits
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| Fades quickly from teeth, restorations
and tissues with simple water rinses and brushing
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| Allows you to visualize plaque and
identify areas in need of more thorough daily plaque
removal
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| Plaque is a bio film that
Actinobacillus
actinomycetemcomitans and Porphyromonas gingivalis
that cause periodontal infections. |
8.
Juvenile periodontitis is now called
aggressive
periodontitis.
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Periodontitis will not go away by
itself. Left untreated, surgery
may be needed to save affected teeth.
Preventing and treating the disease in
the early stages are the best ways to
keep your smile healthy
Goal
of Treatment
Once
periodontal disease has been identified,
the goal of treatment is:
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to arrest and
control the progress of the disease. |
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to leave the
periodontal tissues in an easily maintainable state. |
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to restore the supporting structures, which
include bone, gum tissue, and ligaments. |
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Benefits of Treatment:
| Keeps dental costs down by
preventing future problems.
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| Research links periodontal infection to
more serious health problems,
such as cardiovascular
disease, stroke, diabetes, respiratory problems
and pre-term, low weight babies. |
| Prevent surgical intervention. |
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Updates
A BLOOD TEST MAY REVEAL SYSTEMIC FACTORS
THAT RELATE TO PERIODONTAL DISEASE, ESPECIALLY IN MEN
This study reported that a
blood test may reveal indicators of periodontal diseases.
Researchers examined and measured the oral health of 7,452 men
and women, and tested their blood for 37 items used in general
blood tests. Some of the items tested for in the blood
include cholesterol and C-reactive protein, commonly linked to
heart disease; and diabetes. The results of the blood
tests were compared against the oral health scores of the
participants. In this study they found that generally if the
blood was “healthy,” the oral health was also healthy.
Conversely, if the blood test detected certain “red flags,”
the person also had serious symptoms of periodontal diseases They
also found that males were reported to have more serious
symptoms of periodontal diseases than females of the same age
group. These findings mean that in the future when patients
visit their medical doctors for a routine check-up and annual
blood work, they may also be referred to their dentist. A
specific reason could not be pinpointed as to why men were
reported to have more serious symptoms of periodontal diseases
than women. One reason could be that men and women have
different endocrine situations, and periodontal diseases are
influenced by endocrine conditions. Since
the treatment of periodontitis in this study appears to be
effective in reducing levels of CRP, patients at risk for
coronary heart disease may want to visit a dentist to control
their periodontitis. Blood Test &
Periodontitis Journal of
Periodontology as reported by Jill Rethman, RDH, BA 2/04
*Pictures courtesy
of Periowise.
Comprehensive Periodontal Exam Perio.org
What is Gum
Disease?
Dentistry Today pg 36,
September 2002
Parameter of Care for Periodontal Disease, Perio.org Up
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