Your dentist will notice when you are in the first stage of periodontal disease. It is difficult to miss when the dental hygienist is cleaning your teeth or the dentist is doing some restoration on one or more of your teeth. He or she may watch this carefully while reminding you to brush. If it progresses, your dentist may refer you to a periodontist if your dentist does not have periodontal certification/licensing or does not work with a periodontistin the office. From there, you will work with a periodontist on halting and reversing periodontal disease. The periodontist has some means of correcting this very specific oral problem, which affects half of all Americans age 30 and above. Here are the four stages of this potentially menacing oral health problem, and how your periodontist can help, regardless of which stage you are experiencing.
First Stage: Bleeding Gums
The first stage of periodontal disease is, thankfully, the most easily reversed. If your dentist and periodontist catch it in this stage, you could easily reverse it in a month or two. In this stage, your gums are inflamed, reddish or darker in color, and there is blood in the sink and on your toothbrush when you brush. A thorough cleaning of your teeth and gums, followed by proper and regular brushing, will reverse this stage and stop the disease from progressing. Your periodontist will still want to keep an eye on the problem, to make sure it does not return.
Second Stage: Periodontitis
Periodontitis means that the disease has extended deep down inside the pockets of your gums, and that there is a slight amount of bone loss accompanying the deeper inflammation of your gums. Foul breath is common, as it is the result of the massive amounts of bacteria causing infections in the gums. It sounds scary, as it should, but at least there is still a way to turn this problem around.
Your periodontist will perform a deep cleaning and root planing, which helps remove a lot of the bacteria that causes the infection/disease from both the surfaces of your teeth and from the root pockets. You may be prescribed a mouthwash to use regularly to kill additional bacteria and prevent the disease from progressing. Consistent brushing with a recommended type of toothbrush may also be par for the treatment course.
Third Stage: Moderate Periodontitis
If you thought mild periodontitis was scary, you should see what happens when patients have moderate periodontitis. In this stage of the disease, teeth and gums are clearly rotting and the gums have shrunk away from the teeth. This reveals the roots of the teeth, exposing more of your teeth to cavities and other issues. Teeth may be a little loose, and bone loss in your jaw is more severe.
There are surgical procedures that can stop the disease from taking your teeth, but at this late stage, your periodontist cannot reverse the damage. He or she can only help you keep the teeth you have and help restore your mouth to a point where you experience less pain and bleeding. Ongoing monitoring and treatment is necessary.
Stage Four: Tooth Loss
This is the ugliest stage of the disease. Your gums have worn away, your teeth are falling out faster than those of a nuclear holocaust victim's, and there is no turning back. The biggest thing your periodontist can do is treat and/or prevent infections from going systemic (infections in the entire body stemming from your gums). With each tooth lost, the periodontist can flush the tooth pocket, sew it closed, and prescribe antibiotics to remove infection. Abscesses are also common, so your periodontist will drain the abscesses and flush them out before sewing up the gum tissue. Eventually, you will need dentures. (You are not a good candidate for implants because you have lost too much bone mass in your mouth.)