An important aspect of the dental exam is the periodontal probing.
It is an examination that allows the dentist to evaluate the health of the gums and the bone supporting the foundation around the tooth.
A tooth consists of a crown (visible part) and the root (not visible part) which is anchored in the bone. In a healthy state, the whole root should be covered with bone. Sometimes, an accumulation of tartar/calculus causes the bone to dissolve away. In fact, calculus is not only ugly but it also contains bacteria which are quite harmful to your gums and the bone supporting your teeth. The loss of supporting bone structure and the infectious process associated with it is called periodontal disease. This condition can lead to tooth mobility, bleeding, infection, sensitivity and in extreme cases the loss of a tooth.
Often patients cannot tell they are losing bone support around their teeth other than their gums possibly bleeding or looking red or puffy. Unfortunately, periodontal disease is a silent one. Hence the importance of regular dental check-ups and the periodontal exam!
During a periodontal probing, the dentist uses a probe; which is a special small ruler. The probe is used to measure the tooth’s sulcus or “pocket” by sliding it into a space between the tooth and the gums. In a healthy state, this measurement is around 1-3 mm deep. A higher measurement like 4-5 mm would indicate a degree of bone loss. A measurement over 6 mm can indicate a more advanced state of bone loss. If bleeding occurs when the gums are probed, it is an indication that the area is inflamed. This means your body is fighting the bacteria and the calculus that are irritating your gums.
Bleeding and redness of the gums is also called gingivitis which is an infection of the gums only. However, these symptoms can also accompany periodontal disease.
Now! What do we do about all this?!
If your dentist evaluates that you have gingivitis, a cleaning, as well as better brushing and flossing, are the way to go. Your dentist or your hygienist will be glad to show you the best techniques and tips for your needs.
If you have periodontal disease, your dentist will fill a document called a periodontal chart. This chart will allow the dentist to record the “pocket” measurements of all your teeth and other valuable information. It will be a great aid in helping the patient and the dentist in visualizing the affected areas and evaluate the progression of the disease.
To treat periodontal disease, patients usually require periodontal scaling or “deep cleaning”. Its goal is to remove the build-up of calculus and bacteria present in the deeper pockets. This will allow the gums and the bone to heal in a clean environment. Cleaning those deep areas can be sensitive. This is why the gums are numbed for this special procedure. “Deep cleanings” take more time and sometimes need to be completed over several visits. This is because we spend more time per tooth and perform a more detailed job in cleaning those affected areas. This is not a surgical procedure. We work with the same instruments used during a cleaning, simply in deeper areas.
After the deep cleanings are completed. The dentist will see you after several weeks to complete the periodontal chart once again. You will be informed of the progress made and if some areas need more work. Once all areas are stable, a maintenance therapy is usually recommended to keep and teeth and your smile healthy for years to come!
Cheers,
Dr. John
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