Periodontal disease is an infection of the teeth, gums, and the bone that surrounds the teeth. Most people who have periodontal disease aren't even aware of it, because it's rarely painful, especially in the early stages.

The main cause of periodontal disease is the accumulation of plaque. Plaque is the sticky film of food and bacteria that forms constantly on your teeth. If all of the plaque isn't removed each day, it builds up and mineralizes to become tartar, also called calculus.

If tartar isn't removed, it begins to accumulate on the root surfaces. Bacteria that cause periodontal disease thrive in tartar. These bacteria produce toxins, and it's these toxins, combined with your body's response to them, that destroy bone around your teeth. Professional help is required to remove tartar, because there's no way to remove it at home. A toothbrush or floss won't even budge it.

Since you may have periodontal disease without experiencing symptoms, we perform a thorough examination using X-rays and a periodontal probe.

The crevice between a tooth and the surrounding gum is called a sulcus. A healthy sulcus is two to three millimeters deep. When plaque and tartar invade a sulcus and it becomes deeper than three millimeters, it is called a pocket. We measure the depth of all pockets using a periodontal probe. The measurement is from the bottom of the pocket, where the gum is attached to the tooth, to the top of the gums. In general, the deeper the pockets, the greater the extent of periodontal disease.

We also examine the color, shape, and overall condition of the gums. Bleeding is a sign of infection; healthy gums don't bleed. Healthy gums are firm and lightly stippled. In moderate cases of periodontal disease, we see swollen gums.

X-rays also tell us a lot about periodontal disease, because they allow us to monitor your bone levels. In a healthy mouth, the bone comes up high around the necks of the teeth, and the bone level is even throughout the mouth. With advanced periodontal disease, the bone levels are much lower and are uneven.