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Clinical Examination

Periodontal disease is diagnosed during a comprehensive periodontal examination.

A comprehensive periodontal examination allows us to identify and assess periodontal concerns in our patients. Radiographic assessment of dental X-rays provides critical additional information to help us establish an accurate diagnosis.

Our primary goal is to asses the degree of tooth attachment loss.  In general, a healthy mouth has:

  • A space (2-3 mm deep) between the tooth and the gum (as space deepens, a pocket forms that accumulates bacteria).
  • A minimum amount of bacterial plaque build-up - improved oral hygiene techniques and home-care tools can significantly help patients with better plaque control.
  • An absence of recession - recession often occurs in areas with insufficient thickness of gum (called "attached gingiva") leading to increased sensitivity, poor esthetics.
  • An absence of gum inflammation and bleeding - inflammation is caused by a significant increase in accumulated number of bacteria that colonize below the gums.
  • An absence of mobility (looseness) - mobility occurs as the bacterial toxins deteriorate the jawbone support for the tooth.  This loss is generally irreversible.
  • An absence of furcation involvement - furcation involvement occurs when bone loss extends between the tooth roots and is a major risk factor for tooth loss.
  • A stable occlusion (bite) - excessive forces on teeth increase the risk of bone loss.

The goal of the clinical exam is to measure these important parameters:

  • Size of pocket depth
  • Amount of plaque build-up
  • Degree of recession
  • Degree of gum inflammation and bleeding
  • Degree of mobility
  • Level of furcation involvement
  • Stability of occlusion

 

We can assess the degree of periodontal disease that may be present in the mouth, as outlined below.

Gingivitis

Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis

Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.  Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed.  Unless treated, the affected teeth will become very loose and may be lost.  Generalized moderate to severe bone loss may be present.

If you have any questions or would like to schedule an appointment, please contact us today.


 

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