To understand the nature of periodontal disease you must first understand some basic anatomy. In health, the tooth is suspended in bone by a ligament called the periodontal ligament. The periodontal ligament is like the springs on a trampoline. Because of the periodontal ligament you know when you are biting on something (even something as small as a grain of salt).
Plaque, which is bacteria, tends to accumulate along the gumline because it is sheltered and difficult for you to keep clean. When you eat food, plaque eats the same food, only it’s byproducts are acids and toxins. These acids and toxins spill out onto and under your gums and cause them to become red, puffy, swollen, and inflamed. This is a condition known as Gingivitis. At this stage the infection is limited to the gums, and the bone is still intact. If the plaque is removed, the gums will return to a state of health.
If this condition is allowed to persist the plaque start to mineralize or calcify. This mineralized plaque is known as tartar or calculus. At this stage of the disease the gums are still red and inflamed, but now there is some bone loss as well. This is a condition known as Periodontitis. This bone loss is permanent.
If the plaque, tartar and calculus continues unchecked, there will be continuous bone loss, continued inflammation and now you will have receding gums. This is a condition known as Advanced Periodontitis. This bone loss is also permanent.
During your visit with the doctor you will have your pocket depths measured. You may have had this done in your general dental office as well. The number to keep in mind is 5mm. 5mm is the critical probing depth. When the pockets get above 5mm we, as dentists and hygienists with specialty instruments in our hands, are unable to completely clean all the way down into the base of the pocket. If we can’t get those deep pockets completely clean, it is impossible for you as a patient to properly keep them clean. The end goal of treatment is pockets that you can keep clean on your own, and pockets that you can maintain at home. That is the context of everything we do in Periodontics.