Periodontal Disease

Periodontal Disease affects the structures in the mouth that support the teeth. It’s sometimes called “gum disease”, but it involves bone and other tissues too. This disease is often chronic (persists over time). The good news is that treatment can limit damage and help keep your mouth healthier.

Periodontists, including Dr. Chow, are trained to prevent, diagnose and treat periodontal disease, as well as place dental implants and perform cosmetic procedures to restore the look and function of the mouth. In addition to four years of dental school, they receive three years of formal education in periodontics and dental implant therapy. Because of their highly specialized background, periodontists are able to offer professional services beyond those of a traditional dentist.

What is periodontal disease?

Periodontal Disease is an infection of the tissues that support your teeth. It’s sometimes called “gum disease”. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal disease attacks just below the gum line in the sulcus, where they cause the attachment of the tooth and it’s supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket generally, the more severe the disease, the greater the depth of the pocket.

Do you have periodontal disease?

You may not even be aware that you have periodontal disease because often there is no pain. There are warning signs, however, and you should call your dentist if you experience any of the following:

  • gums that bleed during brushing or floss
  • red, swollen or tender gums
  • teeth that are oversensitive to hot and cold
  • gums that have pulled away from the teeth
  • persistent bad breath
  • pus between the teeth and gums
  • loose or separating teeth
  • a change in the way your teeth fit together when you bite
  • a change in the fit of partial dentures

The Stages of periodontal disease

Graphic showing healthy gum1. Healthy gums

Healthy teeth and gums are maintained by daily plaque removal from all surfaces of the tooth (through tooth brushing and inter dental cleaning)

  • Gums are firm; coral pink in color and do not bleed easily.
  • No gum recession is present.
  • Teeth are held firmly in place with no damage to supporting bone structure.
Graphic showing gingivitis2. Gingivitis

This is the mildest form of periodontal disease. The gum becomes inflamed. The space between gum and tooth deepens, forming a pocket. Gums may become red and swollen, or may bleed when probed. Or, there may be no symptoms. Gingivitis can often be reversed with dental cleanings and regular brushing and flossing. Left untreated, it can progress to periodontitis.

  • Gums appear red and swollen.
  • Bleeding may occur when gums are touched.
  • Teeth are still firmly in place with no damage to supporting bone structure.

Graphic showing periodontitis

3. Periodontitis

With periodontitis, infection and inflammation spread to the bone supporting the teeth. Ligaments break down and the gums may recede (shrink back). Pockets deepen and can be difficult to keep clean. Redness, swelling, and bleeding may develop or worsen. Bacteria multiply, and infection begins to destroy the bone. As bone is destroyed, teeth may start to feel loose.

  • Loss of gum/tooth attachment occurs.
  • Pockets form between teeth and gums.
  • Tissue that binds teeth to bone is inflamed.
  • Bone loss occurs.

Graphic showing advanced periodontal disease

4. Advanced Periodontitis

As periodontitis advances, pockets deepen even more and can fill with pus. Around the roots of the teeth, the gums may start to swell. Bone loss continues. The teeth may feel sensitive to heat or cold, and may hurt when brushed. Teeth loosen due to loss bone and ligament. In some cases, teeth may need to be removed to keep periodontal disease from spreading.

  • Gums recede dramatically from teeth.
  • Pockets deepen severely and may hold pus.
  • Teeth become extremely loose and may fall out or need to be extracted.
  • Severe bone loss occurs.

Don’t Ignore your Oral Health

If you value your oral as well as your overall health, a periodontal evaluation is a good idea. Sometimes the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation may be especially important if you:

  • Notice any symptoms of periodontal disease.
  • Have heart disease, diabetes, respiratory disease or osteoporosis.
  • Are thinking of becoming pregnant.
  • Have a family member with periodontal disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.
  • Have a sore or irritation in your mouth that does not get better within two weeks.