Gum disease begins with plaque on your teeth
Gum disease, also called periodontal disease, is an infection of the gums. Plaque and bacteria build up on your teeth over time and inflame the gums around them. As your gums become inflamed, they pull away from the teeth and form pockets where bacteria hide. Once those pockets form, brushing alone cannot clean them.
Gum disease is common. In a national study, about 42 percent of adults aged 30 and older with natural teeth had periodontitis, its more advanced form. Gum disease can be treated, and its earliest stage, gingivitis, can be reversed with professional treatment and good brushing and flossing at home. Left untreated, gum disease can lead to bone loss and tooth loss. If you have already lost a tooth, dental implants are one way to replace it.
When your gums bleed or pull back
Gum disease is often silent, and many people notice nothing until it is advanced. Tell us if you notice any of these:
- red, swollen or tender gums
- bleeding when you brush, floss or eat hard food
- gums pulling away from your teeth, so your teeth look longer than before
- bad breath that does not go away
- loose teeth, or teeth that are spreading apart
- a change in how your teeth fit together when you bite, or in how a partial denture fits
If you notice one of these, or it has been a while since your last cleaning, request an appointment and we will take a look.
A deep cleaning below your gums
When gum disease has formed pockets below the gumline, we recommend scaling and root planing, a deeper and more thorough cleaning than a routine one. It is the first nonsurgical treatment the American Dental Association recommends for chronic periodontitis.
- Scaling. We use a scaling instrument to remove plaque, bacteria and tartar from around the tooth and below the gumline, all the way to the bottom of each pocket.
- Root planing. We then smooth the surfaces of the tooth’s root. A smooth root gives plaque less to cling to, and it gives your gums a better chance to heal and reattach to the tooth.
After your deep cleaning
Some people feel mild discomfort during scaling and root planing and some sensitivity afterward. We plan your treatment with you, including how we will manage any discomfort.
Many people need no further active treatment, such as gum surgery, after scaling and root planing. Most do need regular maintenance visits afterward to keep their gums healthy.
Your care at home is part of the treatment
Removing tartar, also called calculus, is a large part of treating gum disease. What you do every day matters just as much. Good brushing and flossing after treatment helps keep gum disease from getting worse and helps you keep the results.
A gum graft covers an exposed root
When your gums have receded further than a cleaning can fix, a gum graft can repair the area. The graft covers the exposed root and gives you more gum along the tooth. That helps stop further gum loss, protects the root from decay and can make the tooth less sensitive to hot and cold.
There are three kinds of gum graft:
- Connective tissue graft. This is the most common kind. Healthy tissue from the roof of your mouth is stitched over the exposed root.
- Free gingival graft. Like a connective tissue graft, it uses tissue from the roof of your mouth.
- Pedicle graft. The tissue comes from the gum right next to the tooth that needs repair.
Healing after a gum graft
The area is numbed with a local anesthetic before the graft is placed. Afterward you may feel some soreness and slight discomfort. Rest, cold compresses and, if you need it, a prescription medication help ease it.
With good care, the graft protects the root that was exposed and gives you a healthier gumline.
Sources
- American Academy of Periodontology: Gum disease information
- American Academy of Periodontology: Non-surgical treatments
- American Dental Association: Nonsurgical treatment of chronic periodontitis guideline (2015)
- Eke PI and others. Periodontitis in US adults: NHANES 2009 to 2014. Journal of the American Dental Association, 2018
