Be prepared to be your own ‘pocket’ guide

The possible connection between gum disease and other health problems creates a new responsibility for consumers -- to learn the condition of their gums.

Gum disease is assessed by measuring the depth of “pockets,” areas of inflammation where the gums separate from the teeth. “When the hygienist is making the measurements, an aware consumer should ask, ‘What are my pocket depths?’ ” says Preston D. Miller Jr., president of the American Academy of Periodontology.

Pockets that are 1 to 2 millimeters deep with no bleeding are of little concern. But pockets of 3 and 4 millimeters may require more in-depth teeth cleaning, called scaling and root planing, or more frequent cleanings. Scaling and root planing involve removal of the plaque and tartar deposits on the tooth and root surfaces that can no longer be reached with brushing and flossing. This is a nonsurgical procedure performed in the dentist’s office.

Pockets of 5 millimeters are considered the “breaking point,” Miller says, raising danger of tooth loss. Deep pockets may have to be treated surgically. The dentist makes an incision and removes plaque and tartar deposits, inflamed tissues and damaged bone. The dentist may graft material into the area to help bone grow back. The surgery can reduce the amount of bacteria and inflammation present and also help save the tooth.

The severity of the pockets should also be considered along with your overall health. Bacteria in the gums creates more risk for people with other health problems. Someone with diabetes and pockets of 3s and 4s should be more concerned than a healthy person who has pockets of 3s and 4s, Miller says. A pregnant woman with 3s should ask whether additional dental care is prudent. But a healthy, nonpregnant woman with a few 3s probably need not worry.

Other tip-offs that your gums may be in bad shape include bleeding during brushing, swelling of the gums, bad breath and sensitive or loose teeth.

-- Shari Roan

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Help online

For more information on gum disease, check out:

* A special issue of Scientific American that explores the oral-systemic health link: www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asparticleid21 27

* The American Academy of Periodontology, which provides information on gum disease and how to find a periodontist: www.perio.org

* The National Institute of Dental and Craniofacial Research, which provides information on the causes, symptoms and treatment of gum disease: www.nidcr.nih.gov/HealthInformation/DiseasesAndConditions/GumPeriodon talDiseases/

* Two new studies on the link between gum health and other illnesses at www.joponline.org