Periodontal (gum) Disease is a condition in which bacteria attack the tissues that surround and support teeth. Simply put, it is an infection that can result in tooth loss if not treated. Because it's often painless, you may not be aware that you have a problem until your gums and bone are seriously affected. The good news is that periodontal diseases often can be treated in the early stages with a treatment called scaling and root planning.

If you schedule regular dental checkups your dentist can detect developing periodontal disease before the gums and the bone supporting your teeth are irreversibly damaged.

Periodontal diseases are progressive - Left untreated the condition will worsen.

Diagnosing Periodontal Disease During a checkup, Dr. Ostroth examines your gums for periodontal problems. An instrument called a periodontal probe is used to gently detect "pockets" between your gums and teeth.

Periodontal Probe showing healthy gums Periodontal Probe showing un-healthy gums

At the very edge of the gumline, gum tissue is not attached to each tooth. Instead, there is a very shallow, v-shaped groove called the sulcus between the tooth and gums. The normal space between healthy teeth and gums is three millimeters or less. With periodontal diseases, this tiny space develops into a pocket that collects more plaque bacteria and is difficult to keep clean.

If gum disease is diagnosed, Dr. Ostroth, and his staff of dental hygienists may provide treatment, or you may be referred to a periodontist, a dentist specializing in the diagnosis, prevention and treatment of periodontal diseases. Treating the disease depend on how far the treatment has progressed.

Gingivitis is the earliest stage of gum disease. The gums become red, swollen and they bleed easily. At this stage the infection is still reversible. If not treated, it may lead to a more severe condition called, periodontitis.

Healthy gingiva (gum tissue) and bone anchor teeth firmly in place			Advanced periodontitis is present when the teeth continue to lose their attachment and the supporting bone is destroyed. Unless treated, the affected teeth frequently become loose and may fall out or require removal by Dr. Ostroth

Periodontitis is the more advanced stage of periodontal disease. At this stage, the disease may require more complex treatment to prevent tooth loss. The gums, bone and other structures that support teeth are damaged. Teeth can become loose and fall out - or they may have to be removed.

Prevention and Treatment
The first line of defense is prevention. This includes a good oral hygiene routine at home. Brushing twice a day and cleaning between the teeth once a day with floss or an interdental cleaner helps prevent plaque from accumulating. Dr. Ostroth or his dental hygienists may provide instructions on additional cleaning methods or oral hygiene products to use at home.

Regular dental checkups and cleanings are important in preventing periodontal diseases. If these measures are not taken, the likelihood of disease increases. In some cases, even with these measures, a certain percentage of patients experience some form of periodontal disease that must be treated.

When Dr. Ostroth diagnoses periodontal disease, one of the first treatments is scaling and root planning. Depending on the extent of the disease, Dr. Ostroth may recommend to the patient that one or more sections (quadrants) of the mouth be treated by his hygienist. Treatment may require one or more visits.

Scaling is used to remove plaque and calculus below the gumline. A local anesthetic may be administered to reduce any discomfort. Using a small scaler or ultrasonic instrument, plaque and calculus are carefully removed down to the bottom of each periodontal pocket. The tooth's root surfaces are then smoothed or planed to allow the gum tissue to heal and re-attach to the tooth.

Subgingival Scaling Cleaning the tooth below the gum	Root Planing smoothing the tooth root.

Once the scaling and root planning is complete, another appointment will be made so that Dr. Ostroth can check to see how your gums have healed, and how the periodontal pockets have decreased. When pockets deeper than three millimeters persist after root planning and scaling Dr. Ostroth may recommend further treatment with chemothereputic agents, more frequent preventative visits or a referral to a Periodontist.