Periodontics
Periodontics is the dental specialty focused on the prevention, diagnosis, and treatment of periodontal disease affecting the gums and jawbone. Gum tissue surrounds and supports the teeth, and the underlying jawbone anchors teeth firmly in place. Periodontists have additional training focused on maintaining the function, health, and aesthetics of the jawbone and supporting tissues.
Periodontal disease is progressive. It commonly begins as gingivitis (mild inflammation) and can advance into deeper infection, gum recession, bone loss, and tooth mobility if not treated.
Reasons for Periodontal Treatment
Periodontal disease (gum disease) is typically signified by red, swollen, painful, or bleeding gums—though it can also progress with little or no noticeable symptoms. The disease often begins when bacteria in plaque cause infection in the tissues around teeth. Over time, the infection can cause gum and jawbone recession, loosening teeth.
- Moderate/advanced gum disease: bleeding, red/swollen gums around many teeth + jawbone recession.
- Localized gum recession: may begin in one area; can also be caused by over-brushing with a hard bristle brush or tooth positioning issues.
- Before crown lengthening: soft tissue removal to provide more tooth exposure when needed.
- Ridge augmentation/recontouring: may be needed to correct uneven gum line after infection is addressed.
For mild/moderate problems, care focuses on stopping the bacterial infection and improving home care. In advanced cases, deeper cleaning and additional procedures may be recommended.
Understanding Gum Disease
“Periodontal” means “around the tooth.” Periodontal disease (also called periodontitis or gum disease) is an inflammatory condition affecting the tissues supporting teeth, and in advanced stages it affects the jawbone. It is commonly preceded by gingivitis—bacterial irritation from plaque toxins.
How it progresses
As bacteria colonize, pockets between the teeth and gums deepen, making infection harder to remove and treat. Over time, connective tissue and jawbone can be destroyed.
Why early care matters
In the earliest stage (gingivitis), gum disease can often be reversed with professional care and strong home hygiene. Advanced disease requires ongoing treatment to stabilize.
Common Signs & Symptoms
Periodontal disease can progress without pain, which is why regular checkups are important. If you notice any of the following, seek evaluation promptly.
- Unexplained bleeding: bleeding while brushing, flossing, or eating.
- Pain, redness, or swelling: swollen, red, or painful gums for no apparent reason.
- “Longer-looking” teeth: gum recession can make teeth appear longer.
- Bad breath/halitosis: deeper pockets can trap debris and bacteria, contributing to odor.
- Loose, shifting, or wobbly teeth: can occur as supporting tissues and bone are compromised.
Periodontal Disease Self-Evaluation
Many people don’t realize they have periodontal disease until it reaches advanced stages. This quick self-check is not a substitute for an exam, but it can help you recognize risk factors and seek evaluation.
Risk notes
In general, women may have increased risk due to hormonal changes (puberty, pregnancy, menopause). Risk can increase with age. Smoking may contribute to deeper pockets, faster bone loss, and slower healing.
Self-check prompts
Do your gums bleed when brushing/flossing? Do you have loose teeth? Are teeth looking longer (recession)? Do you have other health conditions that may be linked?
Common Causes & Risk Factors
Gum disease begins with inflammation from plaque toxins and ongoing bacterial infection. If treated early, gingivitis effects can be reversible. If infection progresses, gums and jawbone can be destroyed and bacteria may enter the bloodstream.
Poor oral hygiene
If bacteria and calculus (tartar) are not removed, gums and bone are affected by bacterial toxins—leading to gingivitis and periodontitis over time.
Tobacco use
Smoking and tobacco use are significant factors in the development and progression of gum disease.
Diagnosis & Stages
Periodontal disease is diagnosed during a periodontal examination. A periodontal probe measures sulcus (pocket) depth around teeth. Healthy pockets are typically 3mm or less and do not bleed; deeper pockets often indicate disease progression.
Types of Periodontal Disease
There are many types and patterns of periodontal disease. All require prompt care to halt progression and preserve gum tissue and bone.
Gingivitis
Mildest and most common form; often reversible with strong home care and professional cleaning, sometimes deep scaling/root planing and antimicrobial support.
Chronic periodontitis
Most common form in adults; progressive tissue/bone destruction. Cannot always be “cured,” but progression can often be halted with scaling/root planing, antimicrobial therapy, and sometimes surgery/grafting.
Aggressive periodontitis
Rapid loss of attachment and bone; family history and smoking can increase risk. Often more likely to require surgical intervention.
Systemic/necrotizing forms
May be associated with systemic conditions (e.g., diabetes/heart/respiratory), or rarely immunosuppression/stress/malnutrition. Treatment can include deep cleaning, antimicrobial therapy, and physician coordination when needed.
Treatment Options
Treatment depends on severity. In early gingivitis without damage, one to two regular cleanings plus improved home care may be recommended. In more advanced cases, scaling and root planing (deep cleaning) is commonly recommended—usually one quadrant at a time while numb.
Scaling & root planing
Removes plaque/tartar/toxins above and below the gumline; smooths rough root surfaces to help gums heal and pockets shrink. Medicated rinses/antibiotics and electric brushes may be recommended.
Tissue regeneration
When bone and gum tissues have been destroyed, regrowth can be encouraged via grafting procedures; membranes may be used to assist regeneration.
Pocket reduction (flap) surgery
Can reduce pocket size between teeth and gums to make cleaning more manageable and limit bacterial buildup.
Adjuncts + supportive care
Antimicrobial therapy and medicated mouthwash may be used; in advanced cases, loose teeth that cannot be saved may be removed and replacement options discussed.
Periodontists are also trained in dental implant procedures, which can restore function after teeth are affected by periodontitis.
Maintenance
After periodontal treatment, maintenance visits are often recommended to keep bacteria under control and monitor pocket depths. Many patients benefit from periodontal maintenance cleanings about four times per year (your hygienist will tailor this to your case).
Mouth–Body Connection
Research cited on the site notes associations between periodontal disease and chronic conditions such as diabetes, heart disease/stroke, pregnancy complications, osteoporosis, and respiratory disease. Maintaining periodontal health and excellent oral hygiene may help reduce risk factors and inflammation.
Diabetes
Diabetes can increase infection susceptibility; periodontal disease may worsen blood sugar control, and diabetes can create conditions that promote bacterial growth in the mouth.
Heart disease & stroke
Site notes research suggesting gum disease sufferers are nearly twice as likely to have coronary heart disease, and oral infection has been described as a stroke risk factor.
Pregnancy
Hormonal changes can increase gingivitis/gum disease risk; site notes links in studies to outcomes like preeclampsia, low birth weight, and premature birth.
Osteoporosis & respiratory disease
Site notes studies exploring links between bone density and periodontal disease; also describes pathways where oral bacteria may be inhaled into lungs and worsen conditions like COPD/bronchitis/pneumonia.
Periodontics FAQs
Can gum disease be reversed?
How is periodontal disease diagnosed?
What is scaling and root planing?
How often is periodontal maintenance recommended?
What signs should I watch for?
We’ll evaluate your gums, explain findings clearly, and map out the right treatment and maintenance plan.
Credible Sources
• ADA/MouthHealthy – Gum disease: mouthhealthy.org
• NIH MedlinePlus – Periodontitis: medlineplus.gov