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Charting and Diagnostic Services

Co-Diagnosis

The diagnoses of periodontal disease and cavities are two important parts of a dental examination.

Since you may have periodontal disease, yet have none of the symptoms, your dentist will perform a thorough examination using x-rays and a periodontal probe to measure bone levels around the teeth.

When bone levels fall, the gums pull away from the tooth, forming a pocket. Your dentist will measure the depth of this pocket with 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.

Healthy gums are tight against the teeth, and there aren’t any pockets. Early periodontal disease will cause pockets to form. In general, the deeper the pockets, the greater the spread of periodontal disease.

Bleeding is a sign of infection—healthy gums don’t bleed! Your dentist also will examine the color and shape of your gums. Healthy gums are pink and have a lightly stippled appearance similar to the surface of an orange. In a case of moderate periodontal disease, there is a red and swollen infection of the gums. The stippling disappears when gums become swollen.

X-rays tell us a lot about periodontal disease. In a healthy mouth, the bone comes up high around the necks of the teeth and it’s even throughout the mouth. In advanced periodontal disease, the bone level is much lower than in the healthy mouth.

So now you know how your dentist diagnoses periodontal disease:

  • probe readings greater than three millimeters
  • bleeding upon probing
  • swollen and red gums, especially between the teeth
  • bone loss or tartar on the x-rays

You also know what causes periodontal disease: the accumulation of plaque. The bacteria in plaque also produce acid. This acid destroys the enamel of your teeth and produces cavities.

Finding cavities is sometimes easy, but it can be difficult. For hard-to-find cavities, your dentist uses a dental explorer and x-rays. Your dentist also checks the tops and sides of your tooth with a dental explorer. X-rays are used to look for cavities between teeth. Metal fillings and crowns show up as bright white; cavities look like dark spots.

It’s far better to catch and restore cavities while they’re still small and in the enamel layer of the tooth. Once they’re in the softer dentin layer, they grow very quickly. If they make it to the pulp chamber, the decay can progress to a whole new set of problems: root canals.

The dental profession has assigned each tooth a number and every surface of a tooth a letter. If your dentist finds cavities in your teeth, you’ll hear them call out the numbers and letters for each one. Of course, if you keep the plaque off your teeth, you’ll never need to know about these numbers and letters!

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