Your Initial Exam
Diagnosing periodontal disease — You may have periodontal (gum) disease and not even realize it. That's because periodontal disease is usually not painful, especially in its early stages. To check for signs and symptoms of perio
dontal disease, we perform a thorough periodontal examination.
Periodontal disease is an infection in the gums, caused by the bacteria in plaque. When your gums are healthy, they fit tightly against your teeth. If you have periodontal disease, your gums pull away from your teeth in response to the infection.
In a healthy mouth, the space between your teeth and gums (called a sulcus) is one to two millimeters deep. When you have periodontal disease, the sulcus deepens and eventually exceeds three millimeters; it's then called a pocket. In general, the deep
er the pockets, the greater the spread of periodontal disease. During your examination, we use a special instrument with millimeter markings (called a periodontal probe) to measure the sulcus or pocket depths around your teeth.
We also carefully note any bleeding as we take your periodontal measurements. Bleeding gums upon probing (as well as when you brush and floss) are another sign of periodontal disease; healthy gums don't bleed. We'll also note the color and texture of
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our gums; healthy gums are pink, and have a "stippled" appearance, similar to the skin of an orange. Swollen gums lose this stippled appearance. Finally, we'll take X-rays of your mouth to establish whether there has been bone loss around your t
eeth - another indicator of periodontal disease. If your mouth is healthy, the bone comes up high around the necks of your teeth. With periodontal disease, bone is lost. The longer it goes untreated, the more bone is lost. Once bone is lost, it never grow
s back. That's why it's critical to diagnose and treat periodontal disease early - to prevent continued bone loss and the eventual loss of teeth.
Diagnosing decay (cavities) — The two main ways we diagnose cavities are through the use of X-rays and an instrument called a dental explorer. We systematically and thoroughly check every surface of your teeth with the dental ex
plorer; it will catch or stick in the spots created by cavities. X-rays are used to find cavities between the teeth where the explorer can't reach. Cavities show up as small dark spots on X-rays.
It's far better to catch and restore cavities while they're still small and in the outer enamel layer of the tooth. Once they're in the softer dentin layer, they grow much more rapidly. If they make it to the pulp chamber, we will have a new, more com
plicated set of problems and restorations to discuss.
