Gum Disease

Periodontal (gum) disease is a serious infection caused by degenerative bacterium.  Diseases of the mouth and gums are referred to as periodontal diseases, because they occur around (perio) the teeth (dontal).  Periodontal disease causes painful gum infections at a minor level, and in more severe stages can lead to bone resorption, tooth loss, and systemic health problems, including heart disease and diabetes.  Systemic infections are caused when the bacteria in the gums move through the rest of the body’s bloodstream.

There are two main stages of gum disease, gingivitis and periodontitis.  These are the early and relatively minor stage and the more severe stage of the disease, respectively.  As the disease progresses, periodontal treatment options become more complex, costly, and time-intensive.  It is important that you seek treatment from an experienced periodontist at the first signs of gum disease.


Gingivitis is the earliest and mildest form of periodontal disease.  It is characterized by swelling of the gums.  Patients with this stage of gum disease will often experience bleeding during normal brushing and flossing.

Gingivitis is reversible with professional periodontal treatment and consistent oral home care.

There are several stages to this advanced form of periodontal disease:

  • Aggressive Periodontitis – a form of gum disease found in patients who may otherwise have good oral health. Common symptoms of aggressive periodontitis include a rapid increase in the size of gum pockets around the teeth, which may lead to bone loss.
  • Chronic Periodontitis – this form of gum disease requires immediate intervention. If untreated, chronic periodontitis causes inflammation within the supporting tissue of the teeth, leading to progressive plaque attachment and rapid bone loss.  This is the most common form of gum disease and can be contracted at any age, though it is most prevalent in adults.  This form of gum disease will require gum surgery if left unchecked.
  • Periodontitis of a Systemic Disease – a form of gum disease that is often found at a young age, and associated with a pre-existing health condition or disorder, such as diabetes.
  • Necrotizing Periodontal Disease – this is one of the most dangerous forms of gum disease. Necrotizing periodontal disease is characterized by the necrosis, or death, of the gum tissues, periodontal ligament, and alveolar bone.  This form of gum disease is very aggressive, and often leaves gum surgery as the only treatment option.


Causes of Gum Disease

The main cause of periodontal disease is bacterial plaque.  This plaque is a highly adhesive, clear film that constantly forms on your teeth.  Other factors that contribute to the development of gum disease include:

  • Medications (such as oral contraceptives, anti-depressants, and certain heart medicines) – if you are taking any kind of medication, inform your dentist or periodontist of which medication you are using, and any changes you have noticed in your oral health since beginning treatment with that medication.
  • Smoking and tobacco use – recent studies have shown that tobacco use is one of the most significant risk factors in the development and advancement of periodontal disease, in addition to being a cause in a host of other health-related issues.
  • Genetics – genetics are responsible for nearly 30% of the patients who develop gum disease. Even with aggressive and consistent oral health care, these patients are up to 6 times more likely to develop periodontal disease.  We recommend that you visit a periodontist to determine if you are at higher risk, and if so, to begin and early intervention treatment.
  • Pregnancy – the hormonal changes that accompany pregnancy can lead to an increased susceptibility to gum disease.
  • Bruxism (grinding of teeth) – this creates an excess of force on the supporting tissues of the teeth, and can accelerate the rate at which gum disease destroys the sensitive support system of your mouth.
  • Diabetes – diabetes causes fluctuations and alterations in the levels of your blood sugar. These changes lead to a higher risk of developing sever periodontal disease.
  • Poor nutrition – poor nutrition causes a multitude of health-related complications, including gum disease. Compromising your immune system through a poor diet (or through any other method) will hinder your body’s ability to fight off gum disease, and may require you to seek professional periodontal treatment.

Symptoms of Gum Disease 
If you notice any symptoms of gum disease, schedule an appointment with your dentist or with a periodontist immediately.  An early diagnosis can make the difference between a non-surgical treatment and a surgical treatment.  Symptoms of periodontal disease include:

  • Mouth pain
  • Bleeding of the gums when you brush or floss
  • Increased space between the teeth
  • Gums that are swollen or tender
  • Gums that appear to be receding, making your teeth appear longer
  • Persistent bad breath
  • Pus between your teeth
  • Changes in your bite and the way your teeth fit together
  • Sores in your mouth

Periodontal Treatments 
gingivitisWhile gingivitis can be halted and reversed, the more severe stages of gum disease have no cure.  The main goal of treatment is to control the infection and help you manage your disease.  The type and number of treatments you receive will depend on the extent of your disease.  Any type of treatment requires that patients maintain good at home oral care, and may require the patient to modify certain behaviors to improve treatment outcome, such as quitting tobacco and eating unhealthy foods.

Common periodontal treatments include:

  • Scaling and Root Planing (Deep Cleaning) – Your dentist, periodontist, or dental hygienist will remove the plaque from your mouth using a deep-cleaning treatment. Scaling means scraping off the tartar from above and below the gum line.  Root planing gets rid of rough spots on the tooth where the germs gather, helping to remove bacteria that contribute to periodontal disease.
  • Surgery – Gum surgery, also called flap surgery, might be necessary if inflammation and deep pockets remain following treatment with medication and scaling and root planing. A periodontist performs this surgery to remove tartar deposits in deep pockets or to reduce the depth of the periodontal pocket, making it easier for the patient, dentist, and hygienist to keep clean.  This surgery involves lifting back the gums and removing the tartar.  The gums are then sutured back in place so that the tissue fits snugly around the tooth again.
  • Bone and Tissue Grafts – In addition to flap surgery, your periodontist may recommend a bone or tissue graft to replace or encourage new growth of bone or gum tissue destroyed by periodontitis. Bone grafting is also referred to as guided tissue regeneration, and involves placing a small, mesh-like piece of fabric between the bone and gum tissue to prevent the gum tissue from growing into areas where there should be bone, allowing the bone and connective tissue to regrow.

Each periodontal treatment is different, making it difficult to predict with certainty which treatment will be most successful in the long-term.  Treatment results depend on the severity of the disease, the patient’s ability to maintain good oral hygiene at home, and risk factors that may lower the chances of success, such as smoking.

How Can I Prevent Periodontal Disease? 
You can help prevent periodontal disease by brushing your teeth at least twice a day, or after every meal, flossing daily, visiting your dentist regularly for a professional cleaning and checkup, and eating a well-balanced diet.