One of the things your dentist does during a check-up is to examine your gums for periodontal disease. Periodontal disease is a condition in which bacteria attack the tissues that surround and support teeth. As it is often painless, you may not realize you have a problem until your gums and bones are damaged.
As I have discussed in previous columns, it is important to diagnose and treat periodontal disease as it can lead to tooth loss as well as contribute to vascular disease and low birth weight babies.
During your dental check-up your dentist will examine your gums with an instrument called a periodontal probe. He or she will measure and record the space between each tooth and the gum tissue that surround it. This space or sulcus is located at the very edge of the gumline where gum tissue is not attached to the teeth. The sulcus should be a very shallow v-shaped groove that measures three millimeters or less.
During a periodontal screening and recording your dentist moves the probe around your gumline to map out your pocket depths. This record will be used in conjunction with your dental x-rays to both diagnose and plan treatment as needed. It will also be used to compare your progress at later exams.
I have previously discussed a variety of options for preventing and treating periodontal disease. Today I would like to discuss scaling and root planing.
Scaling means removing the plaque and tartar that have accumulated under the gumline. It may require special instruments or an ultrasonic cleaner to remove it down to the bottom of each periodontal pocket. You may require it in one or more areas of your mouth and multiple visits may be necessary depending on the extent of the disease. A local anesthetic may also be necessary to assure your comfort.
Planing refers to smoothing off the root surfaces after they have been cleaned so that the gum tissue can heal and reattach to the tooth.
Once scaling and root planing have been completed you will be re-evaluated at a later appointment to see how well the gums have been able to heal and if the periodontal pockets have returned to their normal depths. When pockets greater than three millimeters remain after scaling and root planing, you will be evaluated for further treatment.