Gum Disease / Periodontics

Understanding Gum Disease (Periodontitis)

Periodontal disease (gum disease) is a serious infection of the gums and other tissues surrounding the teeth. Millions of Americans have periodontal disease. If left untreated, it can lead to bone and tooth loss. The symptoms of periodontal disease are often painless, so you may not be aware you have it until severe damage has occurred.


Gingivitis is the early stage of gum disease and is characterized by red, swollen gums which may bleed easily when you brush or floss. Nearly all people who do not maintain good daily oral hygiene will develop gingivitis. Gingivitis is reversible with thorough brushing and flossing, and regular professional dental cleanings. If it is not treated, gingivitis can lead to a more serious condition called periodontitis.


As gingivitis progresses, it advances to periodontitis. Periodontitis causes the gums to swell further and pull away from the teeth, forming pockets that become infected with plaque and bacteria. Over time, the plaque hardens and forms tartar which increases the inflammation. As your body fights the infection, the bacterial toxins degrade the gums, teeth, and supporting structures, eventually leading to tooth loss and bone loss

Systemic Link

Decades worth of research has shown links between oral health and overall health, including links between periodontal disease and the following health conditions:

  • Heart disease
  • Diabetes
  • Stroke
  • Respiratory problems
  • Head and neck cancer
  • Alzheimer’s Disease and dementia
  • Erectile dysfunction
  • Pregnancy risks


Because of this oral-systemic link, it is essential to understand the importance of oral hygiene care and combating periodontal disease.


Prevalence of Gum Disease in the US

According to recent findings from the CDC, half of Americans aged 30 or older have periodontitis. This equals approximately 64.7 million Americans.

Warning Signs of Gum Disease

Because periodontitis is a degenerative disease, it is common to have periodontitis with no obvious symptoms, especially if you are a smoker (nicotine reduces blood supply, preventing bleeding and swelling of the gum tissues). However, it is very easy to spot the warning signs before the condition advances. These are some important things to look for:

  • Bleeding gums — Some people think that when their gums bleed, it simply means they’re brushing too hard. While brushing too hard is bad for the gums, it should not cause bleeding. Any bleeding of the gums should be considered a warning sign of gum disease.
  • Bad breath — It’s very easy for plaque to collect in the spaces between the teeth, creating the perfect living conditions for bacteria that produce odorous, sulfur-containing compounds, resulting in bad breath.
  • Redness or swelling of the gums — Inflammation of the gums is usually the first visible sign of periodontal disease.
  • Receding gums — If you notice that your teeth look longer than they used to, it may be that your gum tissue has receded (away from the enamel), exposing some of your tooth roots.
  • Sensitivity — If there is gum recession, the exposed roots may become sensitive to hot or cold.
  • Periodontal abscess — Bacteria can become enclosed in a periodontal pocket and the area will fill with pus, becoming swollen and painful.
  • Loose teeth — When periodontal disease results in bone loss, teeth can become loose or migrate. Tooth loss can result and may be accelerated if you are applying excessive biting forces from clenching or grinding your teeth.

Screening for Gum Disease

You will be screened for gum disease at your initial exam and all routine examinations thereafter. Dr. Toland and her hygienist use dental x-rays, visual observations, and gum measurements to determine if signs of periodontitis are present. As part of our effort to provide comprehensive gum disease treatments, you will receive a general cleaning, as well as a deep scaling, if needed, to allow the gums to adhere back onto the clean tooth surface. Antibiotics and/or laser therapy may be prescribed to combat any infection.

Like all oral diseases, periodontal disease is easier to treat the earlier it is discovered. If you visit our practice at least twice a year as recommended by the American Dental Association, Dr. Toland will be able to diagnose and provide effective gum disease treatments before you face more severe problems.

Treatment Options

Periodontitis can do lasting damage to the gums, bones, and other structures that support the teeth. There is no cure for periodontitis, but it can be controlled with appropriate treatment and diligent home care. At more advanced stages, more complex treatment may be required to prevent tooth loss. In the worst case, teeth can become loose and infected and need to be pulled.

The first step to treating periodontal disease usually involves a special cleaning, called scaling and root planing. In this treatment, plaque and tartar (calculus) are carefully removed down to the bottom of each periodontal pocket. This treatment may be done over several visits and with anesthetic, depending on your needs. The root surfaces of the teeth are smoothed, or planed, to allow the gum tissue to heal and reattach to the teeth. This is sometimes called “periodontal cleaning” or “deep cleaning”.

Medications may also be recommended to help control the infection and aid in healing. These could include a pill, mouthrinse, or a substance that the dentist places directly into the periodontal pocket after scaling and root planing. Laser therapy can also be used to aid in decontaminating and healing the periodontal pockets.

Once the scaling and root planing is complete, another appointment will be made within a couple of weeks. At this appointment, the Dr. Toland or her hygienist will check to see how the gums have healed and to see if further therapy is necessary. If the disease continues to advance, more treatment including surgery and removal of teeth may be necessary.

Caring for your gums

The best way to prevent periodontal disease is to brush and floss your teeth effectively every day. Regular dental checkups and professional cleanings every 3, 4, or 6 months are also an important part of maintaining periodontal health, as we can reach into areas that your toothbrush and floss can’t.

People are more likely to develop periodontitis in their 30s and 40s, but even teenagers can develop gingivitis, therefore men and women of all ages should pay particular attention to their oral care routine. Some medications and habits, such as smoking, can increase the risk for periodontal disease. Hormonal changes, particularly in girls and women, can make the gums more sensitive, allowing inflammation to develop easily.

Additionally, eating right, reducing stresses in your life, and giving up unhealthy habits like smoking will help ensure that you keep your teeth for a lifetime.

Proper brushing technique

Proper flossing technique

Learn more about periodontal disease

Regular brushing and flossing paired with routine visits to our La Mesa dental office can help to ensure that you never develop periodontitis. Don’t delay – schedule your routine oral exam today!

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