Gum Disease

What are Gingivitis & Periodontitis?

There are two basic types of gum disease:

• Gingivitis is the earliest stage of gum disease, which involves inflammation or swelling of the gums.
• Periodontitis is a more advanced stage of gum disease, and involves infection of the gums with loss of the bone supporting the teeth.

Gingivitis and periodontitis are caused by bacteria around the teeth, either the day to day build up that can be brushed off (plaque) or the build up from not having your teeth cleaned in a period of time (calculus) that can’t be brushed off. Around 30% of the population is genetically more susceptible to periodontitis. People who are genetically susceptible to periodontitis can have bone loss even from small amounts of bacterial plaque. Smoking and diabetes make you much more likely to have periodontitis. It is not uncommon for periodontitis to cause loss of some or all your teeth. Periodontitis is the most common cause of tooth loss for adults in the United States today and is usually painless.

Diagnosis

Gingivitis can be diagnosed by redness of the gums, gums that bleed when brushed or flossed, periodontal pockets of 4 mm and no bone loss around the teeth on the x-rays.

Periodontitis can be diagnosed by redness of the gums, gums that bleed when brushed or flossed, periodontal pockets of 5 mm or deeper and bone loss around teeth on the x-rays. It is not uncommon with periodontal disease to have pus that comes from the pockets, offensive breath, gums that pull away from your teeth and loose teeth

Gingivitis & Periodontitis Treatment

The good news about gingivitis is that it is reversible. Getting your teeth cleaned regularly (at least every 6 months and possibly every 4 months) combined with thorough tooth brushing twice a day and flossing once a day will usually reverse gingivitis.

There is no cure for periodontal disease at this time, but we can help. Usually one of the first steps in treating periodontal disease is a deeper cleaning called “scaling and root planing”. Scaling and root planing goes below the gumline into the pockets to remove bacterial toxins and infection from the pockets and the root surface. This differs from a regular cleaning (adult prophylaxis) in that a regular cleaning is above the gumline or slightly below. Since with scaling and root planing we are working below the gumline, it is a slower process than a regular cleaning and may require just working on one 1/4 of the mouth per visit. After the intial scaling and root planing, a pocket check and deeper cleaning of the entire mouth, called a reevaluation, is next. Based on the healing at reevaluation, your gums will probably need to be maintained every 3-4 months. In certain cases of more severe periodontal disease, gum surgery may also be needed. As with gingivitis, brushing thoroughly twice a day and flossing once a day will make a big difference. The bone that is lost is gone forever. Our goal with periodontal treatment is to stop bone loss or dramatically slow it down to maintain your teeth as long as possible. Periodontal disease is progressive; if left untreated the condition will worsen.