Treat
Periodontal disease
Periodontal disease affects the gums and the structures that support your teeth. It is the leading cause of tooth loss in adults, affecting more than 75% of all people regardless of race, nationality or income — and nearly half of all twenty-year-olds already have at least one periodontal pocket.
The important part: the earlier it is detected, the more successful the treatment results. It is also largely silent, which is why it is usually a general dentist who spots it first and refers the patient here.
The one thing to know
You may have periodontal disease and experience none of the symptoms.
It is silent and chronic, rarely giving advance warning that tissue destruction is taking place. That is why regular dental checkups matter more than how your mouth happens to feel.
How it progresses
From reversible to irreversible
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01 · Plaque
Bacteria trapped in a sticky film adhere to the teeth. Plaque cannot be rinsed off — it has to be mechanically removed, and it begins reforming within minutes to hours of removal.
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02 · Gingivitis
The rim of gum next to the teeth becomes red, swollen and bleeds easily when touched. Most often there is no discomfort at this stage. Gingivitis is reversible with improved oral hygiene and a professional cleaning.
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03 · Periodontitis
Bone and the tissues supporting the teeth are destroyed — and an individual may still be unaware. The gum attachment separates from the teeth, creating pockets that harbour millions of bacteria. This stage is not reversible; it is managed.
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04 · Tooth loss
Teeth loosen, spaces open, the bite changes. Where teeth are lost, dental implants can still be placed — most patients have adequate bone, and where they do not, it can be grafted and regenerated.
Some people are more prone to periodontal disease than others, and some get a mild form while others get a severe case. A genetic predisposition is the single biggest determinant of how serious an individual case becomes.
Warning signs
What to look for
If you recognise several of these, book a consultation rather than waiting for your next routine cleaning.
And if you recognise none of them, that is not evidence of health — see the note above.
- Gums bleeding when you brush
- Red, swollen or tender gums
- Gums pulling away from the teeth, exposing roots and creating recession
- Pus between the teeth and gums
- Sudden swellings that are painful to the touch
- Loose teeth, or spaces suddenly appearing between teeth
- Teeth beginning to flare out
- A change in the way your teeth fit together — a different bite
- Chronic bad breath
What makes it worse
Once periodontal disease is diagnosed, several factors affect it
Smoking — the worst offender
Study after study shows that with an established periodontal condition, smokers have worse gums: deeper pockets, more bone loss, and poorer healing than non-smokers. This matters particularly for implants — smokers can successfully have them, but they tend to heal slowly, have more infections and experience more problems.
Diabetes and other conditions
Many disease states affect the gums, the most notable being diabetes. Diabetic patients are prone to more infections and greater problems than non-diabetics, and need to take particular care of their teeth and gums.
Medications
Calcium channel-blockers — Cardizem, Procardia, Verapamil and others, used for certain heart conditions — sometimes cause the gums to swell between the teeth, making brushing and flossing difficult. Occasionally the swelling can only be managed surgically. Dry mouth, a common side effect of many medications, also increases decay and inflammation.
Diet
To a lesser extent, what you eat affects the gums. High carbohydrate intake — especially candies, cakes and sugared drinks — and constant sucking on cough drops or hard candies help bacteria metabolise faster and in greater numbers, raising the risk of decay and inflaming the gums.
Treatment
Active treatment, then maintenance for life
Periodontal disease is a chronic condition, like diabetes. Treatment has two halves: bringing the disease under control, then holding the ground you gained.
Even with excellent flossing and brushing, plaque continues to mature in hard-to-reach places — and it can do so within 8 to 12 weeks. That is why patients completing periodontal treatment are often placed on a three-month maintenance interval.
Maintenance intervals range from two to six times a year, and are decided between you, your dentist and your periodontist. Where there is a significant amount of disease, we recommend quarterly visits.
Treatment options here
- LANAP laser gum treatment →
- Gum grafting for recession →
- Bone grafting and regeneration →
- Implants where teeth are lost →
- Sedation, if you are anxious →
Your general dentist remains responsible for your overall dental health. Periodontal maintenance does not replace your regular checkups — how the two fit together.
Caught early, this is far easier to treat.
Bleeding gums are worth a consultation. So is a referral from your dentist that you have been putting off.