Periodontal Care

Gum Disease Treatment & Maintenance

Personalized care for gingivitis and periodontitis -- from deep cleanings to long-term maintenance -- to protect your gums, bone, and natural teeth.

About Periodontal Care

Periodontal disease -- gum disease -- is one of the most common chronic conditions worldwide and the leading cause of tooth loss in adults. It is an infection of the supporting structures around the teeth, caused by bacterial plaque that the body responds to with chronic inflammation. The American Academy of Periodontology recognizes a spectrum from mild reversible gingivitis to advanced periodontitis with bone loss, and the right treatment depends on where on that spectrum you are.

Gingivitis is the earliest stage. Gums become red, swollen, and bleed easily when brushing or flossing. There is no permanent damage yet, and gingivitis is fully reversible with a professional cleaning and improved home care. Many adults experience gingivitis at some point. When it is caught early at a routine exam, treatment is typically straightforward: a thorough cleaning, focused brushing and flossing technique, and a recheck.

When gingivitis is not addressed, it can progress to periodontitis. The inflammatory response begins to break down the ligament and bone that hold teeth in place. The space between the gum and tooth -- the periodontal pocket -- deepens, and bacteria colonize areas that are now impossible to reach with a toothbrush. Pockets of 4 mm or more, bleeding on gentle probing, gum recession, sensitivity, bad breath, and tooth mobility are typical signs. X-rays show loss of supporting bone.

The foundational treatment for periodontitis is scaling and root planing (SRP), often called a "deep cleaning." Under local anesthesia for comfort, the dentist or hygienist uses specialized hand and ultrasonic instruments to remove plaque, tartar, and bacterial byproducts from the tooth surfaces above and below the gumline, then smooths the root surfaces so the gums can reattach. The procedure is usually completed over one or two visits and is far more thorough than a routine prophylactic cleaning. Most patients have some tenderness and gum sensitivity for several days, which is well managed with over-the-counter pain relief and a warm saltwater rinse.

After SRP, the tissue is re-evaluated, typically four to six weeks later. Most patients respond well: pocket depths shrink, bleeding decreases, and gum tissue becomes pink and firm. For sites that do not fully heal -- often deep pockets in molar regions -- additional treatment may be recommended, including localized antibiotic placement, laser-assisted therapy in some cases, or referral to a periodontist for surgical care.

Once active disease is under control, you move into periodontal maintenance. Unlike a routine prophylactic cleaning, periodontal maintenance combines a deeper cleaning of the periodontal pockets with continued monitoring and is typically performed every three to four months rather than every six. This shorter interval keeps the bacterial load below the threshold at which the disease tends to flare back up. Periodontal disease is a chronic condition, similar to high blood pressure: it is managed rather than cured, and maintenance is what keeps it stable for the long term.

Gum health is closely tied to overall health. Research consistently links periodontitis with diabetes, cardiovascular disease, certain pregnancy complications, and respiratory infections. The relationship with diabetes is particularly well established and goes both directions: poorly controlled diabetes makes gum disease harder to manage, and active gum disease makes blood sugar harder to control. Patients with diabetes, smokers, and patients on certain medications that reduce saliva flow generally need more frequent visits and a more intensive home care plan.

Home care is the single biggest determinant of long-term success. Twice-daily brushing with fluoride toothpaste, daily flossing or use of interdental brushes, and -- when recommended -- a water flosser or antimicrobial rinse keep bacteria from re-establishing themselves between visits. Your hygienist will show you specific techniques for your situation and the tools best suited to the spaces in your mouth. Small changes in technique often produce a meaningful improvement at the next visit.

If you are pregnant, planning to become pregnant, have diabetes, smoke, or are starting medications that affect immune response or bone density, it is worth scheduling a periodontal evaluation regardless of when you last had a cleaning. Our front desk can verify your insurance benefits, including periodontal maintenance coverage, before any treatment begins.

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