Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.
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At Liv Hospital, we use a thorough and careful process to find out why your gums are bleeding. We look closely at the health of your gums and supporting tissues, not just the surface. Our goal is to find the exact cause, whether it is bacteria, your immune system, anatomy, or other health issues. This detailed approach helps us accurately diagnose and plan the best treatment for you.
The clinical periodontal examination is the most critical tool in diagnosing the cause of bleeding.
Periodontal Probing: Mapping the Disease
The periodontal probe is the “stethoscope” of the gum specialist. It is a slender, calibrated instrument with millimeter markings.
Probing depth alone can be misleading if there is gum swelling or recession. CAL is the accurate measure of periodontal support. It is calculated by measuring the distance from the Cemento-Enamel Junction (CEJ), a fixed anatomical landmark, to the base of the pocket. CAL provides the most accurate assessment of how much bone and ligament support has been destroyed over time.
In multi-rooted teeth (molars and premolars), the infection can destroy the bone between the roots, creating a “furcation defect.” A specialized probe (Nabers probe) is used to detect these defects. Furcation involvement complicates treatment because these areas are inaccessible to standard oral hygiene tools.
Imaging is mandatory to visualize the alveolar bone and verify clinical findings.
Crown-to-Root Ratio: Assessing the ratio of root embedded in bone to tooth exposed, crucial for determining prognosis.
Given the bi-directional link between oral and systemic health, the evaluation extends beyond the mouth.
In cases of refractory periodontitis (a disease that does not respond to standard therapy), identifying the specific bacteria is vital.
Antibiotic Sensitivity: This testing guides the prescription of systemic antibiotics, ensuring the chosen drug targets the patient’s specific bacterial profile.
The visual assessment records tissue quality.
The final diagnosis is categorized based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases.
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CT scans use X-rays to create detailed cross-sectional images and are excellent for visualizing kidney stones, detecting tumors, and evaluating traumatic injuries. They are fast and widely available. MRI uses strong magnetic fields and radio waves to produce detailed images of soft tissues, making it superior for staging prostate cancer, evaluating bladder wall invasion, and assessing pelvic floor disorders without ionizing radiation.
Contrast dye, usually iodine-based, is injected into a vein to highlight the blood vessels and urinary tract organs. As the kidneys filter the dye from the blood, it opacifies the urine. This allows the radiologist to see the internal structure of the kidneys, the ureters, and the bladder clearly, revealing blockages, tumors, or structural abnormalities that would be invisible on a non-contrast scan.
Multiparametric MRI is an advanced imaging technique that combines standard anatomical sequences with functional sequences like Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced imaging. This provides a comprehensive assessment of the prostate, allowing doctors to distinguish between benign conditions like BPH and significant prostate cancer, and to guide targeted biopsies.
CT scans do involve exposure to ionizing radiation, which carries a small theoretical risk of cellular damage over time. However, modern CT scanners use dose-modulation technology to minimize this exposure to the lowest level necessary for a diagnostic image. The benefit of an accurate and timely diagnosis for serious urological conditions typically far outweighs the minimal risk of radiation.
Many modern orthopedic implants are MRI-safe, although they may cause some image distortion. However, older pacemakers, defibrillators, and certain metal clips may be unsafe in the strong magnetic field. It is critical to inform the imaging team of any metallic implants so they can verify their safety compatibility or recommend an alternative test like a CT scan.
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