Periodontal Disease

Examining Periodontal Disease

What is Periodontal Disease?

The word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that support the teeth. Your mouth is filled with bacteria. When bacteria are not disrupted on a regular basis, a plaque, or a sticky film of bacteria, debris and saliva form on the teeth and under the gum line. If plaque is not thoroughly removed each day, it becomes mineralized and turns into calculus (tartar). This build up on the tooth and root surface become rough and harbor the harmful bacteria of the mouth which begins to destroy the gums and bone. Once calculus has formed your toothbrush will not removed the hardened substance and a professional dental cleaning is required to remove the harmful build up.

Periodontal disease is characterized by red, swollen, and bleeding gums; although not all symptoms need to be present for a diagnosis of periodontal disease.

Four out of five people have some level periodontal disease and don’t know it! Most people are not aware of the condition because the disease is usually painless in the early stages. If your gums are bleeding, this is not normal and is a sign of disease in your mouth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease. As well as, genetics and your overall health can play a role in periodontal disease progression.

Signs and symptoms of Periodontal Disease:

  • Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss. Although bleeding gums are common, they are not healthy.
  • Loose teeth – Also caused by bone loss or weakened periodontal fibers, which are ligaments that support the tooth to the bone.
  • New spacing between teeth – Caused by bone loss.
  • Persistent bad breath – Caused by bacteria in the mouth. More than just morning breath.
  • Pus around the teeth and gums – Sign that there is an infection present.
  • Receding gums – Loss of gum around a tooth that can expose the roots of the teeth resulting in sensitivity.
  • Red and puffy gums – Gums should never be red or swollen. Medications, medical conditions and mouth breathing can also cause red and puffy gums. Only a dental professional can properly advise you of the condition of your gums supporting structures around your teeth.
  • Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth. They are irritants much like having a sliver in your finger. If you do not remove the sliver the tissue becomes sore and inflamed.


Gingivitis is the first stage of periodontal disease. Plaque and its toxic by-products irritate the gums, making them tender, inflamed, and likely to bleed. This stage of disease is reversible with proper professional treatment and your compliance at home. This stage affects the gum tissue only, but left untreated it will progress into the surrounding bone.


Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums and bone begin to recede from the teeth as a result of your own body attempting to fight off the bacterial byproducts associated with gum disease. Deeper pockets form between the gums and teeth and become filled with bacteria, fluid and sometimes pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss is present. This stage is often painless, therefore, it is easy to ignore.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and will likely be lost. Generalized moderate to severe bone loss may be present. Often this stage of gum disease can still have little pain to alert you of the progression and need for professional treatment.


Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment. Be sure you dental exam includes a full periodontal charting that is documented for your review annually.

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two visits with your dental hygienist for professional cleaning above and below the gum line with medications to reduce bacteria counts are commonly recommended. You will also be given instructions on improving your daily oral hygiene habits and require regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. This is a non-surgical procedure that can be done in the dentist office. One to three appointments will be needed to complete your treatment. Success of your treatment is largely dependent upon your compliance to homecare instructions.


It only takes 24 hours for plaque that is not removed from your teeth to begin emitting the harmful waste product that damages your tissues, teeth and bone. As well as it can turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention. Brushing alone does not properly cleanse all tooth surfaces. Additionally, you must follow the professional maintenance-cleaning schedule your dentist and hygienist recommend for you.

Your personal periodontal evaluation and teeth cleaning appointment will usually include:

  • Examination of diagnostic x-rays (radiographs): Essential for early detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
  • Examination of existing restorations and appliances: Check current fillings, crowns, dental implants, dentures, partial dentures, orthodontic retainers, night guards to prevent tooth grinding damage and bridges.
  • Examination of tooth decay: Check all tooth surfaces for decay.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer or abnormalities.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
  • Teeth cleaning: Removal stain and plaque, calculus, above the gum line. Polishing of the tooth surfaces with a fine polishing paste to smooth surfaces.
  • Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control.