Periodontal Treatment

Periodontal diseases are bacterial infections that attack the gums, the tissue and the bone holding your teeth in place. They can occur at any age, and several forms affect even teenagers, which is why children and adults alike need regular dental checkups.

Healthy gums

Plaque forms on teeth every day. Brushing twice daily and cleaning between the teeth daily with floss or another interdental cleaner removes it along with food particles, and that routine is the most effective thing you can do to prevent both tooth decay and periodontal disease. Left in place, plaque hardens into a rough, porous deposit called calculus, or tartar, which can only be removed when teeth are cleaned in the dental office. Tartar below the gumline is harder still to clean around and may interfere with the attachment of the teeth to the gums, creating the conditions that lead to chronic inflammation and infection.

Gingivitis

Gingivitis is the mildest and earliest form of periodontal disease. Plaque that is not removed irritates and inflames the gum tissue, making the gums red and swollen and causing them to bleed easily, particularly when teeth are brushed. There is usually little or no discomfort at this stage, which is why gums that bleed deserve attention rather than patience. Gingivitis is reversible with professional cleaning in the dental office and good oral care at home.

Periodontitis

If periodontal disease is left untreated, the gums may pull away from the teeth and form pockets between the teeth and gums that usually become infected. As the infection progresses, bone loss can occur and teeth may loosen, fall out or require extraction.

Chronic periodontitis is the most frequently occurring form, bringing progressive loss of tissue attachment and bone with pocket formation, recession of the gum tissue, or both. It is prevalent in adults but can occur at any age, and attachment loss usually advances slowly with occasional periods of rapid progression. Aggressive periodontitis is a highly destructive form that appears in patients who are otherwise clinically healthy, with rapid loss of attachment and destruction of bone in localized or generalized patterns. Periodontitis can also appear as a manifestation of a systemic disease such as diabetes, or alongside certain rare blood diseases and genetic disorders. Necrotizing periodontal diseases involve the death of gum tissue, periodontal ligament and bone, are commonly associated with pain, bleeding and a foul odor, and can be contributed to by emotional stress, tobacco use and HIV infection.

Periodontal disease is diagnosed at an examination, where the gums, the attachment around each tooth and what the x-rays show of the bone are read together. Scaling and root planing, a careful cleaning below the gumline that removes tartar and smooths the root surface so the tissue can reattach, is the treatment for most cases. Where a case calls for surgical treatment, that work is carried out by a periodontist and your care is coordinated with one.