How does Gum Disease
Progress?
Pockets
Plaque and tartar can be seen on the surfaces
of teeth when we look in the mouth. However they can also be found
below the gumline in pockets.
A pocket is a small space between the gum and tooth. Pockets are
present in healthy gums- even those without gum disease. When plaque,
tartar and bacteria get below the gum line in pockets, they become
harder to clean out.
Healthy Gums
 In
health, pockets tend to be between 0-3 mm deep. Pockets between
0-3 mm can be cleaned out easily at home with a toothbrush, dental
floss and by dental cleanings. When pockets are between 0-3 mm,
the bacteria in them are exposed to a lot of oxygen and are not
very destructive.
Early
gum disease and gingivitis
 When
plaque, tartar and bacteria collect in a pocket and are there for
too long, or when our ability to fight the infection is decreased,
gum disease can start. There is a change in the types of bacteria
that infect the pocket and inflammation starts. When the gums get
inflamed, they will start to swell, turn red and bleed when brushed
or flossed. This is gingivitis. During gingivitis, or early periodontitis,
the pockets tend to get a little deeper due to the swollen tissues.
Bacteria, plaque and tartar collect where they cannot be accessed
to clean them out. Pockets tend to be between 3-5 mm
Moderate to advanced
periodontitis
When the bacteria are left undisturbed in the
pocket for longer periods of time, or when our body’s resistance
is lowered, the bacterial colonies change even more and the bacteria
become more destructive. As well, our body responds to this and
sends more blood cells to fight the infection. The combination of
the bacterial infection and our immune response results in a loss
of the bone supporting the tooth and a deepening of the pocket.
This makes it impossible to clean down the root of the tooth even
with dental instruments.
Dentists and hygienists can clean the upper surface of the root
– but not deeper down where the bone loss is occurring. As
the condition progresses the pockets get deeper (over 5 mm) and
more bone loss occurs. Over time bone is worn away, the pockets
can get deeper, the teeth get loose and abscesses can start to develop.
Signs and Symptoms:
Often gum disease, like many other serious conditions
has no signs or symptoms until it is advanced and often the patient
does not know they have a problem.
Over time, however, certain signs and symptoms may be noticed by
either the person with gum disease or those around them. These possible
warning signs include:
- Red swollen gums
- Bleeding when flossing or brushing (may not
happen in smokers)
- Bad breath or taste in the mouth
- Receding gums
- Loose teeth
- Change in tooth position or an increase in
the spaces between teeth
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