Periodontal disease can be diagnosed by Dr. Espili during a periodontal examination. This type of exam is always part of your routine dental check-up.

The Periodontal Examination

During the periodontal exam, asmall dental instrument is used to gently measure the size of thepockets between the tooth and the gums. The depth of a normal, healthy pocket typically measures three millimeters or less and is not prone to bleeding. As periodontal disease advances, the pockets usually become deeper and inflamed.

Dr. Espiliwill use this measure of pocket depths,in addition to theamount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into one of the categories below:

• Gingivitis – Gingivitis is the first and earliest stage of periodontal disease. Built-up plaque and its toxic by-products irritate the gums, making them tender, inflamed, and likely to bleed.
• Periodontitis – Built-up plaque left untreated will eventually harden into calculus (commonly known as tartar). As hardened tartar and plaque continue to build up, the gums begin to recede from the teeth. As a result, deeper pockets form between the gums and teeth and can become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed more easily. Slight to moderate bone loss may also be present.
• Advanced Periodontitis – The teeth lose more support as the gums, bone, and periodontal ligament continues 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.

Periodontal Treatment

They type of periodontal treatment Dr. Espili uses will depend on the type and severity of the disease. Dr. Espili and the dental hygienist will evaluate the periodontal disease to recommend the best treatment.

• Treatment for Gingivitis – If the gum disease is diagnosed in its early stages of gingivitis, and has not yet caused damage to the gums and surrounding tissue, one or more routine dental cleanings may be sufficient treatment. During these appointments, Dr. Espili will also give you instructions on how to improve your oral hygiene habits in order to prevent reinfection.
• Treatment for Periodontitis – If the gum disease has progressed to a more advanced form, and has also begun to cause damage to the gums and surrounding tissue, a special periodontal deep cleaning known as scaling and root planing may be necessary.

Deep Cleaning for Periodontal Disease

The deep cleaning procedure involves numbing the gums and thoroughly cleaning the area by removing tartar, plaque, and other contaminants from above and below the gum line (scaling). Afterward, the remaining rough areas on the tooth root surfaces are smoothed out (planing). Through scaling and root planing, the affected gum tissues are better able to heal while the pockets shrink in size. Dr. Espili may prescribe medications and special mouth rinses to help with the healing process as well as control the infection.

If the pockets do not heal after cleanings and scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Dr. Espili may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

If you begin to notice any signs of periodontal disease, please book an appointment with our office so that Dr. Espili can provide you with immediate treatment.