Periodontal diseases can be diagnosed by a periodontist such as Dr. FitzPatrick, or your family dentist during a periodontal examination. This type of exam should always be part of your regular dental check-up with your general dentist. Dental hygienists are trained to detect the various signs associated with health and disease, but they cannot, by law, make a clinical diagnosis. Only a periodontist or another licensed dentist is legally qualified to make a diagnosis.
A periodontal probe (small dental instrument) is gently used to measure the sulcus ( space) between the tooth and the gums. The depth of a healthy sulcus is relatively shallow, usually measuring about three millimeters or less, and does not bleed. As periodontal disease progresses, the supporting tissues around the teeth become inflamed or infected and the space deepens; now referred to as a pocket. Many studies have shown that as pockets get deeper, they reach a threshold where a patient can no longer maintain health, in spite of focussed efforts to carry out adequate plaque control.
Dr. FitzPatrick will use pocket measurement, presence or absence of bleeding and/or suppuration (pus) on probing, visual signs of inflammation, tooth mobility, interpretation of x-rays etc., to make a diagnosis that will fall into a category broadly reflected in the terms below:
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.
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 possibly pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss can be detected.
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. Moderate to severe bone loss may be present.
Areas of gum recession causing exposed roots can lead to sensitive teeth and decay. These conditions may be a result of disease, abnormal habits, genetics or anatomical considerations.
Excessive frenum pull on the gum margin may lead to recession or bone loss. High frenum attachemnt on the tongue side of the lower teeth ("tongue tied") can prevent normal speech development in children.