Periodontal Disease

What it is

Periodontal disease is a bacterial infection of the gum and the bone that hold your teeth in place. It is the leading cause of tooth loss in adults over 35, and in its early stages it is often painless — which is why it is frequently found by a dentist before the patient notices anything.

It begins with plaque, a colorless film that forms constantly at the gum line. Left in place, the bacteria in plaque inflame the gum: it reddens, swells, becomes tender, and bleeds easily. Over time the gum separates from the tooth and pockets form. Once plaque reaches into those pockets, the supporting tissue and jawbone begin to break down. That bone loss does not grow back on its own.

Signs to watch for

• Gums that bleed when you brush or floss
• Red, swollen, or tender gums
• Gums pulling back from the teeth
• Persistent bad breath or a bad taste
• Teeth that feel loose, or that have shifted position
• A change in how your teeth fit together when you bite

How it's treated

Treatment is non-surgical wherever possible. Most patients start with scaling and root planing — a deep clean below the gum line that removes bacterial deposits from the root surfaces. For many, that is the whole treatment.

Pockets are re-measured after healing to see what responded. Where deep pockets remain, surgical access allows the root surfaces to be cleaned properly and the bone reshaped so the gum can heal tightly against the tooth again.

What happens afterwards

Periodontal disease is managed rather than cured. Most patients move onto a maintenance schedule — usually every three to four months — often alternating between this office and their general dentist.

What raises your risk

Smoking is the single largest modifiable risk factor. Diabetes, certain medications, and a family history of periodontal disease all raise risk, as do pregnancy and conditions affecting the immune system. Tell us about all of these at your first visit — they change how treatment is planned.