The most obvious symptom noted by the patient is bleeding from the gum during tooth brushing. The therapist notes the disease primarily by the bleeding that may follow a gentle touch with an instrument to the margin of the gum. Swelling of the gumline and a reddish color might also be present
The swelling is often notable between the teeth. Inflammation of the gums is a very common disease which almost all adults as well as children experience to a certain extent. Over time the disease may spread into the underlying attachment of the tooth as periodontitis develops. Untreated, the disease may cause deep periodontal pockets or retraction of the gumline and exposure of the root surface.
In regions where the teeth are crowded or mal-aligned the changes may be more pronounced. Sometimes the patient has a bad breath, in particular in the morning. However, by and large, the symptoms noted by the patient are rather few and, therefore, the first signs of the disease might be neglected. Longstanding periodontitis might result in discomfort and toothwandering and might also interfere with the general well being of the patient.
The disease in the gum is caused by products released from the accumulations of bacteria along the margin of the gumline. These bacteria cause an inflammation which, over time, may spread to the deeper portions of the tooth attachment. On occasion, the bacteria may enter the blood stream of the patient
The bacterial accumulations are difficult to observe and one has to stain them to make them visible. A staining solution is often used in the dental office to visualize the bacteria on the teeth. For home use the patient can find staining tablets in most drugstores. Click on the image to see the procedure in the dental office.
If no calculus has formed in the bacterial accumulations it is easy to remove the dental plaque with a polishing instrument. If the bacteria have entered the spaces between the teeth and the tissue, it might be necessary to use additional instruments. Oral rinsing solutions have a limited effect on the presence of accumulated bacteria.
Prior to professional cleaning this patient had inflammation in the gum around most of the teeth. Careful instruction in oral hygiene procedures and proper homecare cured the diseased gumline. The image to the right illustrates the condition in the tissues three years later.
Three years later. The gumline of the patient to the left is healthy, no bleeding during tooth brushing, and a fresh breath is the most significant immediate reward. Prevention of periodontitis development is the longterm reward in most patients who practice a regular efficient tooth cleaning.