Many people only visit the dentist when they feel pain or notice a problem, but routine check-ups are invaluable even when you feel fine.
Here’s why regular preventive care is so important.
Gum Treatments
Healthy gums are the foundation of a healthy smile. Periodontology is the branch of dentistry focused on preventing, diagnosing, and treating diseases of the gums and the supporting structures of the teeth. The most common gum issues are gingivitis (early gum inflammation) and periodontitis (advanced gum disease that can lead to bone loss and tooth loss). General services usually consist of periodontal evaluations and treatments ranging from deep cleanings to advanced gum therapies, with an emphasis on halting disease progression and restoring gum health.
What is Gum Disease (Gingivitis vs. Periodontitis)?
Gum disease is usually caused by plaque – a sticky film of bacteria – that accumulates on teeth and irritates the gums.
Gingivitis
This is the early stage of gum disease. The gums become red, swollen, and may bleed easily when brushing or flossing. Gingivitis is usually not painful, which is why it can be overlooked. The good news is that gingivitis is reversible – with proper brushing, flossing and a professional cleaning to remove any tartar, gums can return to health. No permanent damage has occurred at this stage (the bone and connective tissue are still intact).
Periodontitis
If gingivitis is left untreated, it can progress to periodontitis. In periodontitis, the plaque and tartar spread below the gum line and the toxins from bacteria trigger a chronic inflammatory response. This leads to the breakdown of the tissues and bone that support the teeth. Gums start to pull away from the teeth, forming “pockets” that trap more bacteria. Over time, these pockets deepen, more gum and bone are destroyed, and teeth can become loose and even fall out or require extraction. Periodontitis is the leading cause of tooth loss in adults. Unlike gingivitis, periodontitis causes irreversible changes.
Signs you might have periodontitis (beyond the bleeding gums of gingivitis) include persistent bad breath, receding gums (teeth look longer), gum abscesses, a change in your bite or how your teeth fit together, and any mobility of teeth. Some people also experience tender gums or a bad taste.
Risk factors for gum disease include smoking (huge risk factor), diabetes (uncontrolled blood sugar can worsen gum disease), genetic predisposition, hormonal changes (like in pregnancy, which can exaggerate response to plaque), certain medications, and of course poor oral hygiene.
Periodontal Evaluations
During a periodontal exam, dentists will tend to do the following:
Visual Exam
Look at the color and firmness of gums. Healthy gums are pink and firm, not red or spongy.
Periodontal Probing
Using a small measuring instrument (probe) to gently measure the depth of the sulcus (the gap between tooth and gum) around each tooth. In healthy gums, these pockets are usually 1-3 millimeters deep. Sometimes measuring deeper pockets (4mm and above) can indicate attachment loss due to periodontitis. These numbers are charted on a periodontal chart. This also helps the dentist know where the trouble spots are and how severe.
Bleeding on Probing
As your dentist probes, they’ll note if any sites bleed. Bleeding is a sign of inflammation. Even if pocket depth is not severe, bleeding points to gingivitis or active gum disease.
Mobility and Recession
A check if any teeth are loose (mobility) or if gums have receded significantly in areas (which can make pockets appear shallower than bone loss actually is). Your dentist might measure how much recession there is as well.
X-rays
Dental radiographs show the level of bone around teeth. To compare the bone height to where it ideally should be. In periodontitis, bone levels appear lower (bone resorption). X-rays also help detect tartar under the gums and any angular bone defects.
With this data, a diagnosis can be made to decide whether you have gingivitis, slight/moderate/severe periodontitis, etc. and which areas are most affected.
When you come in for a general dental check-up at Nuvodent, we carry out a thorough evaluation to get a complete picture of your oral health.
Gum Disease Treatments
If you’re diagnosed with gingivitis, often a thorough professional cleaning (prophylaxis) and improved home care will suffice to restore health. We’ll show you proper brushing/flossing techniques and perhaps recommend an antiseptic mouthwash or other adjuncts.
For periodontitis, treatment typically involves:
Scaling and Root Planing
(Deep Cleaning)
This is the first line of treatment for periodontitis. It’s essentially a careful, intensive cleaning of the tooth root surfaces below the gum line to remove plaque, tartar, and bacterial toxins from the pockets.
Usually, the dentist will numb the areas (often doing one quadrant or half the mouth at a time under local anesthesia) so they can comfortably clean deep under the gums.
They’ll use special instruments or ultrasonic scalers to scale (remove deposits) and plane (smooth) the root surfaces, because smooth surfaces are harder for bacteria to cling to. Sometimes antimicrobials (like chlorhexidine) or antibiotic gels are placed in pockets after cleaning. Scaling and root planing helps gums reattach to teeth somewhat as inflammation reduces, thus shrinking pocket depth.
Maintenance of Overall Health
We’ll also encourage controlling systemic factors: e.g., if you smoke, strongly advise quitting (some periodontal treatments won’t be as effective if smoking continues); if you’re diabetic, ensure good blood sugar control which will help gum healing.
Re-Evaluation
A few months after scaling and root planing, you may be asked to go see the dentist as they’ll often re-probe the gums to see how they’ve improved. Many pockets may reduce in depth and bleeding should significantly reduce if home care and maintenance have been good. If there are stubborn areas with deep pockets still (typically >5-6mm) or areas that bleed persistently, further treatment might be considered.
Periodontal Maintenance
After the deep cleaning, you will need more frequent cleanings – typically every 3 months – rather than the usual 6 months. These maintenance visits allow us to keep disease under control, cleaning in areas that you might have trouble reaching. Periodontal maintenance is critical to prevent recurrence; periodontitis can’t be cured per se, but it can be managed, like diabetes or hypertension, with ongoing care.
Advanced Treatments
Areas that do not respond completely to initial therapy, or for certain cases of advanced disease, may need to refer to a periodontist (gum specialist) or perform further interventions such as:
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Periodontal Surgery: This can include flap surgery where gums are gently reflected (lifted) to allow direct access to deep tartar for removal and then repositioning the gum, sometimes a bit lower to reduce pocket depth. It could also involve bone grafts or guided tissue regeneration if trying to regenerate some lost bone in specific defects.
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Laser Therapy: Some practices use lasers as an adjunct to help disinfect pockets and potentially aid in reducing bacteria and contaminated tissue.
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Local Antibiotic Delivery: In isolated sites, dentists can place tiny antibiotic chips or gels (like doxycycline gel or chlorhexidine chip) into a deep pocket after cleaning, which releases medication over time to kill bacteria.
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Extractions: If a tooth is so compromised by periodontal disease (very loose, hardly any bone support, causing repeated infection), it may be better to extract it. This can also help protect neighboring teeth from ongoing infection. Extractions are last-resort when a tooth can’t be saved.
Benefits of Treating Gum Disease
Treating gum disease has many benefits
Prevent Tooth Loss
The number one cause of adult tooth loss is periodontitis. By treating it, you significantly reduce the risk of losing teeth. Keeping your natural teeth is not only beneficial for function but also avoids the need and cost of replacements like implants or dentures.
Reduce Infection and Inflammation
Active gum disease means chronic infection in your mouth. Treating it eliminates that source of bleeding and pus. Your breath often improves dramatically (since gum disease is a major cause of persistent bad breath). You’ll also likely experience less gum soreness and see less bleeding when you brush or floss, which is encouraging feedback that your mouth is healthier.
Overall Health Links
Gum health is increasingly linked to overall health. Studies have shown associations between untreated periodontal disease and heart disease, stroke, poorly controlled diabetes, adverse pregnancy outcomes, and other conditions. While more research is sorting out these links, it’s clear that reducing chronic inflammation in your mouth can positively impact your general health. For instance, diabetics often find their blood sugar is easier to control once their gum infection is addressed; pregnant women reduce risk of preterm birth by managing gum health.
Preserve Your Smile and Chewing Ability
Gum disease often leads to receding gums and shifting teeth (teeth can splay out or create spaces). By treating it, you can maintain a more aesthetic smile line and keep teeth in their proper position. You also ensure you can continue to chew properly; severe gum disease sufferers often have difficulty eating certain foods because of loose teeth or discomfort.
Fresher Breath and Taste:
Chronic periodontitis can dull taste (due to coating on teeth and generally unhealthy mouth environment) and cause bad breath. Patients frequently notice their mouth feels “fresher” and food tastes better when their gum health is restored.
Prevention and Home Care for Healthy Gums
Tips for prevention of gum disease and its recurrence
Brushing
It’s recommended to use a soft-bristled brush angled 45 degrees at the gum line, using gentle circular or jiggle motions to disrupt plaque at and below the gum line. Brushing twice daily is important, especially along the gum margins. Power toothbrushes can be very effective for many people, as they can remove plaque efficiently with less technique sensitivity.
Flossing/Interdental Cleaning
Floss daily to clean between teeth and under the gumline where brushes can’t reach. If you have trouble with floss or large spaces. For some with dexterity issues, water flossers (oral irrigators) are a beneficial tool to flush out bacteria from pockets. The key is you need to consistently clean between every tooth – find the tool that you’ll actually use daily.
Antimicrobial Rinses
A chlorhexidine mouthwash could be prescribed for short-term use if gum disease is moderate to severe, to reduce bacterial load during initial therapy. Long-term, some over-the-counter antiseptic rinses or natural antimicrobial agents can be adjuncts, but they are not substitutes for mechanical cleaning.
Lifestyle
As mentioned, quitting smoking is perhaps the best thing you can do for your gum health aside from oral hygiene. Also, a healthy diet helps – deficiency in vitamin C, for instance, can worsen gum issues (scurvy is an extreme example). Eat a balanced diet with plenty of nutrients to support healing.
Stress Management
Interestingly, stress can affect gum disease (likely because it impairs immune response and might correlate with neglect of oral care). Managing stress through exercise, etc., can indirectly benefit your oral health as well.
Regular Dental Visits
Even after stabilizing gum health, don’t slack on your dental visits. Tartar can form even with good home care (especially in hard-to-reach spots). Professional cleanings ensure that buildup is removed before it triggers new inflammation. And periodic exams catch any relapse early.
We are here to help.
At Nuvodent, your oral health is our top priority, and we want to work with you to keep your smile healthy and radiant for a lifetime.
Cost of Periodontal Treatments
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The cost for gum disease treatment varies with severity. A simple case of gingivitis may just need a routine cleaning and some focused instruction, which is relatively low cost and often covered well by insurance (most insurances cover cleanings). Scaling and root planing is more involved; typically it’s billed per quadrant of the mouth. Insurance often covers a portion of this under periodontal benefits, but there might be co-pays. Periodontal maintenance visits also usually have coverage on a more frequent schedule but can have co-pays each time.
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Advanced periodontal therapy (like surgeries or bone grafts) might require referral to a specialist (periodontist), and those costs are higher per site. However, consider that saving your teeth through periodontal treatment is usually more cost-effective in the long run than losing teeth and needing replacements like implants or dentures.