Signs of Periodontal Disease:
Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
New spacing between teeth – Caused by bone loss.
Persistent bad breath – Caused by bacteria in the mouth.
Pus around the teeth and gums – Sign that there is an infection present.
Receding gums – Loss of gum around a tooth.
Red and puffy gums – Gums should never be red or swollen.
Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.
Diagnosis
Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up. A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category 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.
Types of Periodontitis
When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line. When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.
Here are some of the most common types of periodontal disease:
Systemic
This form of gum disease often begins at an early age. Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.
Chronic
Inflammation within supporting tissues cause deep pockets and gum recession. It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding. This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
Aggressive
This form of gum disease occurs in an otherwise clinically healthy individual. It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
Necrotizing
This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition. Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.