Dr. Dana Rockey discusses the basics of periodontal health and dental hygiene. He explains the anatomy of the teeth and gums, and what it takes to have optimal oral health. Many of the questions Dr. Rockey and his staff receive are related to periodontal disease. Rockey also explains the process of periodontal probing, the process of measuring the pocket depths around a tooth in order to establish the state of health of the periodontium (specialized tissues that both surround and support the teeth).

Video Transcript:
Hi this is Dana Rockey. So many of our questions that we get here are related to periodontal disease. And as a wellness-based dental practice, really the cornerstone of that, or the foundation of the work that we do here is to make sure that your gums and surrounding tissues are healthy. Periodontal disease, the old term being pyorrhea. We want gums perfectly healthy; we do not want disease going on there; inflammation, bleeding and bone loss like that which are classic signs of gum disease. A lot of patients are confused about what is exactly happening there and what the architecture and what the relationship is. In this picture here I talk about the wall of the tooth, and the gum that’s laying against it. When you smile, and someone smiles brightly, and you see the gums scalloping along the teeth, just know, that they gum doesn’t attach to the tooth right there. You can see here that the gum attaches to it (the tooth) some distance below. So we have the wall of the tooth, the attachement of the gum, or skin, to the tooth, and we have the top of the gum, up in here, which we call the ‘crest’. Its important to use to use an instrument called the periodontal probe to actually measure the depth from the height of the tissue here, down to where it attaches. We assign a millimeter number to that; and of course, the deeper the number, is more the problem. We like to think that this number going from the top here to the attachment of the pocket at 3 MM of less being healthy and the reason for that is that generally with good brushing, good flossing you’re able to clean the bacteria out of there to keep the bacteria from growing extensively and the situation here developing into periodontal disease. If you’re at your dentist and they’re calling out numbers as they’re scalloping around the mouth, the ins and outs of the teeth and the upper and lower arches and you have numbers like 4a, 5s, 6s and beyond, that’s the sign of periodontal disease. If you’ve got measurements that are 3 milimeters or less in here, we generally think of that as a healthy (periodontal) pocket and your chances of having periodontal disease are very low. Another issue is when we have bleeding; so when we put the periodontal probe in here, we get bleeding there, we call that bleeding on probing, that’s also a sign of gingivitis or inflammation, irritation of the gum tissue on the inside wall of that pocket, and there’s really only one reason that you have inflammation and bleeding there, and that would be bacteria deposits inside here. So that’s the purpose of brushing and flossing is to keep the bacteria out of here and keep the bacteria colonies from growing in here, keep the numbers low, keep the attachment tight and reduce the inflammation and bleeding in the area. This is an illustration of course of a situation that’s pretty bad where you have heavy tartar deposits here, loads of bacteria teaming around here; you have the pocket depth growing as the bone is being lost and the attachment this (between the tooth and the gum) is beginning to drop, this number begins to increase here – so those are the signs of periodontal disease. With modern saliva testing techniques, we can actually culture the bacteria that’s in here and we learn that some are very bad and aggressive, and some are less aggressive. The whole point being is that great oral hygeine, great recall at the dental office (regular scheduled follow up appointments), to ideally keep the situation here where the tooth wall and the tissue adjacent to it, otherwise referred to as ‘the pocket’, is a healthy environment with minimal bacteria and minimal debris – that’s the goal. So anything beyond that we need to treat, and that will be a subject for another day. Thank you.

To learn more about Dr. Dana Rockey's wellness approach to dental care, his oral-systemic discipline and his focus on healthy nutrition, visit www.DanaRockey.com.

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