Our restorative dentistry gives periodontal examinations to assess the health of your gums and teeth. It helps our dental specialists diagnose for major dental problems such as gum disease, gingivitis, and periodontitis. It also can reveal receding gums, exposed roots, tooth grinding (bruxism) and other problems. During the examination, our dentists will take measurements of the spaces between your teeth and gums.
Here's what we will evaluate during a periodontal examination:
Lumps or Abnormal Areas
These may include changes in the color of the gums, inner cheeks or tongue. Changes could have several causes, including:
- Oral cancer
- Any condition that could lead to cancer
- Any infections
Missing or Loose Teeth
Loose teeth can be a sign of periodontal disease. Other possible causes include a problem with your bite (the way your teeth come together) or tooth grinding (bruxism)
Color, Texture, Size, and Shape of Gums
Healthy gums are firm and pink. Diseased gums may be:
- Reddish or bluish-red
- Puffy or spongy
- Enlarged or swollen
- Shaped differently than normal
This includes fillings, crowns, bridges, dentures or implants.
This is a coating on the teeth that contains large numbers of bacteria. These bacteria can cause decay and periodontal disease. The amount of plaque gives your dentist an idea of how well you brush and floss your teeth.
Space Between Teeth and Gums
This space is known as the sulcus. It is the spot where the gum attaches to the tooth. When the gums are healthy, the sulcus is usually about 4 millimeters deep. If it is deeper than this, it is called a pocket.
A pocket (a sulcus deeper than 4 millimeters) indicates that you have gum disease. This may be either due to gingivitis (the early stage) or periodontitis (more advanced disease). To measure these spaces, the dentist uses a periodontal probe. This is a tiny millimeter ruler with a blunt tip.
Your dentist slides the probe between the tooth and gums at various places around each tooth. Healthy gums cling tightly to the tooth. Diseased gums tend to swell and detach from the tooth. Pockets become deeper.
In advanced forms of periodontitis, the pocket can be more than 10 millimeters deep. The probe measuring the pocket may reach all the way to the tip of the tooth's root. If a pocket is this deep, it means that much of the soft tissue and bone that anchor the tooth in place have been lost.
Perhaps seeing diagrams will explain it better.
Healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a slight v-shaped crevice called a sulcus. In healthy teeth, this space is usually three millimeters or less.
Periodontal diseases are infections that affect the tissues and bone that support teeth. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. Generally, the more severe the disease, the greater the pocket depth and bone loss.
Bleeding after probing is an indicator of inflammation and gum disease.
Normally, the roots of your teeth are covered by gum tissue. Many factors, however, may cause the gums to recede. These include inflammation, badly positioned teeth and hard brushing. Teeth with exposed roots can have several problems:
- Sensitivity to changes in temperature
- Increased risk of decay
- Unattractive appearance
Dentists use periodontal probes to measure how far gums have receded. They do this by measuring the distance between the crown of the tooth and the edge of the gum.
How your teeth come together when you bite
This is also called the bite, or "occlusion." If teeth meet with too much force, it can affect your teeth and gums. Excess force can result from the way your teeth come together when you bite, or from habits such as grinding and clenching your teeth. Your dentist will notice some problems simply by looking at your teeth. That's because excessive force can cause tooth wear.
Besides the examination, you also may need X-rays of your teeth. A periapical X-ray helps to show the extent and pattern of bone loss around each tooth. These X-rays show the entire tooth, from the crown (top) to the end of the root, which anchors the tooth in your jaw. You also may need an X-ray of your entire mouth. This is called a panoramic radiograph. This type of image shows other important structures in your skull. They include the maxillary sinuses and jaw joints.
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