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Did you know?
     The ADA recommends all children have their first dental check up by age one:

Daily flossing can add five years to your life span:
            Your overall health is related to your dental health:

Periodontal Disease
What is it?
Periodontal means “around the tooth.” The disease attacks the gums and the bone that supports the teeth. If plaque and calculus are not removed they begin to destroy the gums and bone. Four out of five people have periodontal disease and don’t know it! Typically people are unaware of it because the disease is usually painless in the early stages.

Periodontal disease is the number one reason for tooth loss, and research shows there may be a link between this and other diseases including: stroke, pneumonia, diabetes, and cardiovascular disease.

You can reduce the risk of developing periodontal disease by having a balanced diet, regular dental visits and good oral hygiene. Some of the signs and symptoms of the disease includes:
**Bleeding gums- gums should never bleed!
**Loose teeth
**New spacing between teeth
**Persistent bad breath caused by bacteria in the mouth
**Pus around the teeth and gums- shows there is infection present
**Loss of gum around a tooth
**Gums should never be red or swollen
**Tenderness or discomfort

Periodontal disease is diagnosed by your dentist during your period exam. This type of exam should always be part of your regular check up.

A periodontal probe is used to measure the pockets or spaces between the tooth and gums. The probe helps indicate if the pockets are deeper than three millimeters. Three millimeters or less and no bleeding is a healthy reading. The pockets will get deeper as the disease progresses. Your dentist will use pocket depths, amount of bleeding, inflammation, and mobility to make a diagnosis of one of the following:
**Gingivitis- the first stage of periodontal disease. Plaque and its toxin by products irritate the gums, making them tender, inflamed and likely to bleed.
**Periodontitis- plaque hardens into calculus/tarter. As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets from between the gums and teeth may become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Also slight to moderate bone loss may be present.
**Advanced Periodontitis- the teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. The teeth that are affected will become very loose and may be lost unless treated. You may also have moderate to severe bone loss present.

The treatment depends on the type and severity of the disease. If the disease is caught in the early stages of gingivitis, and no damage has been done, one or two regular cleanings will be recommended. Your dentist will also give you instructions on improving your daily hygiene and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planning (deep cleaning) will be recommended. Typically its done one quadrant of the mouth at a time while the area is numb. In this procedure, tarter, plaque, and toxins are removed above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). The procedure will help gum tissue to heal and shrink the pockets.

If the pockets still do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist would refer you to a Periodontist for this surgery.

After your periodontal treatment has been completed, your dentist and hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings) usually four times a year. At these appointments, the pocket depths will be checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove will be removed from above and below the gum line. Your periodontal cleaning will also include a regular dental exam.

Every year, Dr. Sara goes to the area schools and preschools to promote dental education. Usually these visits are held every February in honor of dental health month. Dr. Sara discusses proper brushing and flossing and the importance of eating healthy foods. She usually shows an educational DVD, reads a book and gives a lesson. She enjoys her visits due to the enthusiasm of both the students and teachers regarding dental health.



Dr. Karl Koelling
Dr. Sara Koelling