There seems to be no stop to the litany of products we are bombarded with that supposedly can help us achieve a leaner trimmer physique. Of course no one ever mentions that lean, strong and toned gums are also important to your overall health and longevity. At every dental appointment we evaluate your gum health. Have you ever listened to us recite a series of numbers as they gently probe your gum line? That’s the sound of us carefully measuring (in six places) the exact depth of the “turtleneck collar” of gum tissue surrounding each tooth and root with a calibrated flexible plastic dental tool.
The gap or “cuff” between a tooth and its surrounding gums is called a sulcus or a pocket. The depth of the pocket is one of the indicators of overall gum and tooth health. The measurement is calculated in millimeters on a scale starting at 1. Any number 4 or less mm is generally (but not always) an indicator of healthy gums. Any number higher than a 4 can indicate that the gum tissue may be swollen or infected or loosing bony support and needs a closer look. Overall, we look for pocket depth to be between 1 and 3 mm with 4 being an indicator or a gentle warning that the tooth or gum tissue surrounding the tooth may need some special attention.
What if the gum space or pocket depth is higher than a 5 or 6 mm?
Good question. When pocket depths are recorded at or above 5 or 6 mm a deeper periodontal cleaning may be needed. This deep cleaning is often called scaling and root planing. This treatment is quite simple, patients can return to their normally scheduled activities the same day. Using a gentle local anesthetic we rely on special instruments and ultrasonics to smooth the root, remove contaminated cementum (the outside layer of the root – the part that attaches the tooth to you), and deep clean the entire pocket to its full depth well below the gum line. The object is to remove the bacteria and infected accretions from the pocket as best we can in order to restore gum health. Sometimes we will combine scaling with antibiotics delivered systemically and locally, usually with a form of a tetracycline put directly in to the pocket. In addition, the latest research out of University of Michigan indicates that seeing us for periodontal maintenance cleanings every three months after your scaling is the best way to conservatively (and nonsurgically) treat periodontal (gum) disease.
Gum Surgery in Rare Cases
In the event we record higher numbers and it is evident that the loss of bone and attachment is advanced we generally need to provide better access for cleaning and will also try to repair some of the damage to the bone and gums surgically. This is typically done after patients have already completed a course of scaling and root planning, antibiotics may already have been used, and the periodontal damage is just too advanced to treat simply by cleaning the tooth and pocket. These teeth are in danger of being lost. Many times bony defects can be grafted, gums can be reshaped, pockets can be made shallower, and recession of the gums can be corrected. The goal, of course, is to enable people to keep their teeth their entire life and restore oral and systemic health, one of many things which help to prevent the numerous entities like cardiovascular events, stroke, etc. Of course, comfort, a pleasant appearance and sweet breath will come along for the ride!
At home, we prevent high pocket depth numbers by keeping the gumlines of our teeth free of bacteria and dental plaque (bacterial colonies and debris) by brushing the front and backs of the teeth and by flossing the sides of the teeth. Between the two, we are attempting to remove accumulated plaque 360 degrees around each tooth. In addition, attempts are made to clean slightly below the gumline by proper angulation of the brush and slowing down, almost lingering at each tooth so the bristles have a chance slide into the pocket bit. Flossing can be awkward and is sometimes a difficult habit to start, but tools like floss holders or small disposable individual floss holders (we strongly recommend Glide Floss Picks ) make the process easier. Please know that my excellent staff and I are always ready and willing to “coach” you in quick, effective techniques regardless of your experience or skill level with flossing.
At Dr. Mark W Langberg, DDS, MAGD PC we believe the details are important and understand it’s the little things that make a difference. Regardless of how busy your schedule is or where you find yourself in the battle against oral disease, we are always available for gentle, compassionate nonjudgmental help. Our purpose is to serve, so if you haven’t done so already, give us a call at 248-356-8790 and schedule a dental examination or just a complimentary consultation appointment. We look forward to meeting you as well as introducing you to the best in modern dental care!
Until Next Time,
Mark W Langberg, DDS, MAGD
Your Southfield Family Dentist
Tel: (248) 356-8790