Family Dentistry

Gum disease is an infection of the tissues and bones that surround and support the teeth. It is also called periodontal disease.  The two stages of gum disease are called gingivitis and periodontitis. Gingivitis is mild gum disease that affects only the gums, the tissue that surrounds the teeth. Periodontitis  is gum disease that gets worse and spreads below the gums to damage the tissues and bone that support the teeth.  Gingivitis causes red, swollen gums that bleed easily when the teeth are brushed. Because gingivitis usually doesn't cause pain, many people don't get the treatment they need.   Periodontitis develops if gum disease gets worse. The gums pull away from the teeth, leaving deep pockets where germs called bacteria can grow and damage the bone that supports the teeth. Gums can also shrink back from the teeth. This can make the teeth look longer. Teeth may become loose, fall out, or have to be pulled out by a dentist. 

Your mouth constantly makes a clear, sticky substance called plaque that contains bacteria. The bacteria in plaque make poisons, or toxins, that irritate the gums and cause the gum tissues to break down. If you don't do a good job of removing plaque from your teeth, it can spread below the gums and damage the bone that supports the teeth. With time, the plaque hardens into a substance called tartar that has to be removed by a dentist or dental hygienist.

It may be hard to tell if you have a mild case of gum disease. Healthy gums are pink and firm, fit snugly around the teeth, and do not bleed easily. But mild cases of gum disease (gingivitis) cause:

• Gums that are red, swollen, and tender.
• Gums that bleed easily during brushing or flossing.
• As gum disease gets worse (periodontitis), the symptoms are easier to see, such as:
• Gums that pull away or shrink from the teeth.
• Bad breath that won't go away.
• Pus coming from the gums.
• A change in how your teeth fit together when you bite.
• Loose teeth.

Early-stage gum disease causes:

• Red, swollen, tender gums.
• Gums that bleed easily when brushed or flossed. Healthy gums do not bleed with regular brushing and flossing.

Because gingivitis usually isn't painful, you may not notice the symptoms and may not get the treatment you need. If you don't get treated, the disease will progress.
Advanced gum disease causes more noticeable symptoms, such as:

• Gums that pull away or recede from the teeth.
• Persistent bad breath.
• Pus coming from the gums.
• A change in how your teeth fit together when you bite, or a change in the fit of partial dentures.
• Loose teeth.

If you use tobacco you have a higher risk of gum disease. Your gums may actually bleed less, even though they are unhealthy, and you may not realize it's a problem until its too late. If you use tobacco, you will need to see your dentist more often.

To find out if you have gum disease, your dentist will do an exam to look for:

• Bleeding gums.
• Hard buildups of plaque and tartar above and below the gums.
• Areas where your gums are pulling away or shrinking from your teeth.
• Pockets that have grown between your teeth and gums.

Your dentist or dental hygienist may take X-rays of your teeth to look for bone damage and other problems.
Your dentist or dental hygienist will examine your gums and teeth for gum disease during regular visits. Using a small mirror and a tool called a probe, your dentist will look for:
Bleeding gums. The more spots that bleed, the more likely it is that your gum disease is severe.

• Hard mineral deposits (tartar) above and below the gum line.
• Areas where your gums are pulling away from your teeth and pockets that have formed between your teeth and gums. Your dentist or dental hygienist will use the probe to measure the depth of the spaces between your teeth and gums to see how deep the pockets are.

The dentist or dental hygienist may take X-rays of your teeth to look for bone damage and other problems.

Your dentist or dental hygienist may take X-rays of your teeth to look for bone damage and other problems.  Your dentist or dental hygienist will examine your gums and teeth for gum disease during regular visits. Using a small mirror and a tool called a probe, your dentist will look for:

• Bleeding gums. The more spots that bleed, the more likely it is that your gum disease is severe.
• Hard mineral deposits (tartar) above and below the gum line.
• Areas where your gums are pulling away from your teeth and pockets that have formed between your teeth and gums.

If you have a mild case of gum disease, you will probably be able to take care of it by brushing and flossing your teeth every day and getting regular cleanings at your dentist's office. You may have to have teeth cleaned more than every 6 months.
If your gum disease has become worse and you have periodontitis, your dentist or dental hygienist will clean your teeth using a method called root planing and scaling. This removes the plaque and tartar buildup both above and below the gum line. You may also need to take antibiotics to help get rid of the infection in your mouth. If your gum disease is severe, you may need to have surgery.

Flap surgery/pocket reduction surgery. During this procedure the gums are lifted back and the tarter is removed. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. The gums are then placed so that the tissue fits snugly around the tooth. This method reduces the size of the space between the gum and tooth, thereby decreasing the areas where harmful bacteria can grow and decreasing the chance of serious health problems associated with periodontal disease. 
Bone grafts. Involves using fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by periodontal disease. The grafts serve as a platform for the regrowth of bone, which restores stability to teeth. New technology, called tissue engineering, encourages your own body to regenerate bone and tissue at an accelerated rate. 
Soft tissue grafts. This procedure reinforces thin gums or fills in places where gums have receded. Grafted tissue, most often taken from the roof of the mouth, is stitched in place, adding tissue to the affected area. 
Guided tissue regeneration. Performed when the bone supporting your teeth has been destroyed, this procedure stimulates bone and gum tissue growth. Done in combination with flap surgery, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow to better support the teeth. 
Bone surgery. Smoothes shallow craters in the bone due to moderate and advanced bone loss. Following flap surgery, the bone around the tooth is reshaped to decrease the craters. This makes it harder for bacteria to collect and grow.