At each visit to your oral health care provider, a dentist or licensed hygienist will likely conduct a brief procedure called periodontal charting. While it may be confusing to patients, this assessment is a valuable tool that helps dental professionals to identify and prevent periodontal disease. A probe is used to measure the depths of six areas of each tooth where the gingival sulcus is located (this is the potential space between the gingival or gum tissue and the tooth), and the readings are recorded onto a chart. At each subsequent visit, the measurements are re-taken in order to provide comparative data and to gain a picture of any changes in an individual mouth.
What the Sulcus Depths Can Reveal About the Entire Mouth
The “sulci” are the spaces between the free gingiva, part of the gum tissue, and the teeth. This section of gum tissue often covers the junction of the crown and the root, and is also where floss can be inserted to clean the proximal (in between) and facial or lingual (the lateral sides) of the teeth. Because the sulcus offers a safe, dark reservoir for bacteria, plaque, and food debris to deposit, cleaning these areas is an essential part of maintaining healthy teeth and gums. Whether or not the sulcus depths are deep or shallow is indicative of whether or not there is significant bone loss and, similarly, periodontal disease.
Healthy Probing Depths
In a healthy mouth, probing depths are between zero and three millimeters. Often, a periodontal probe cannot be inserted into a sulcus, because the gum tissue is snug against the teeth. Occasionally, if gingivitis is present, the gum tissue begins to stretch, and a condition called “pseudo pocketing” can occur. This means that there are 3 to 4 millimeter pockets present in some areas (especially in between the teeth where flossing is not always performed). However, with proper home care, gingivitis is reversible, and pockets can shrink within weeks.
Unhealthy Probing Depths: a Diseased State
Probing depths above three millimeters are associated with the beginning and progression of periodontal infections in the mouth. Periodontal disease is characterized by the atrophy of the alveolar bone, which hugs the teeth on both the upper and lower dental arches. If higher sulcus depths are prevalent in a patient, radiographs may need to be taken to confirm and measure the extent of bone loss. Unfortunately, periodontal disease, once diagnosed and confirmed by a dentist, cannot completely be reversed. The best approach to treatment of periodontal disease is to cultivate and implement proper brushing and flossing techniques and by seeing a dental health professional every three to four months for maintenance appointments. When under control, periodontal disease does not have to be a condition that continues to break down the teeth and surrounding structures.
Ways to Prevent or Control Periodontal Disease
There are several ways to prevent periodontal disease including brushing and flossing twice daily. However, if periodontal disease is diagnosed using probing depths, radiographs, and a clinical exam, other methods of treatment may be administered to control infection or reduce bone loss. Gross scaling (or the removal of mineralized plaque from the tooth surfaces) and root planing (the process of smoothing root surfaces so that it becomes difficult for bacteria to attach) may significantly lower the amount of infection in the mouth and periodically restore the tissues to health. Regardless of the presence of absence of periodontal disease, measuring the probing depths of the free gingiva will provide you and your dental health professionals with clues as to the state of the oral cavity and what can be done to maintain health or promote improvement.
For more information, contact Dr. Hawkins and his team at Hawkins Family Dentistry in Midlothian, VA today!