Periodontitis – Diagnosis and Treatment
Gum disease, or periodontal disease, messes with the tissues that support and surround your teeth. It’s surprisingly common and can cause swollen or bleeding gums.
If you don’t treat it, things can get worse—damage to the gums and even the bone holding your teeth in place.
Taking care of your mouth really matters when it comes to stopping gum disease before it starts. Catching problems early and treating them quickly helps keep your teeth and gums safe.
Diagnosis
Dentists follow a few steps to spot gum problems like periodontitis. They start by asking about your medical history—stuff like smoking or medications that dry out your mouth can make things worse.
| What is Checked | Why It Matters |
|---|---|
| Bleeding Gums | Sign of inflammation or infection |
| Plaque and Tartar | Cause bacteria and gum inflammation |
| Periodontal Pockets | Show how far disease has progressed |
| Bone Loss (X-rays) | Indicates advanced periodontitis |
| Gum Recession | Reveals gum and tooth support problems |
Next, dentists check your mouth for yellowish plaque, hard tartar (calculus), and gums that look red, puffy, or bleed easily. Those are the classic signs of gum disease or gingivitis.
They use a special tool called a periodontal probe to gently measure the depth of the spaces (pockets) between your teeth and gums.
Healthy gums usually have pocket depths between 1–3 mm. If the pockets measure 4 mm or more, there’s likely inflammation or infection.
When pockets go deeper than 5 mm, you really can’t clean out the infection with floss or a toothbrush alone.
Dentists also take X-rays to spot bone loss around your teeth. If they see bone loss, the disease has probably advanced. They look for receding gums, tartar, bad breath, and tooth decay too.
Once they gather all this info, periodontics experts figure out how serious things are and set up a treatment plan.
Treatment
Approaches Without Surgery
Most treatments start with nonsurgical options, especially if dentists catch gum disease early. Professional cleaning is a big deal here.
| Treatment | Purpose | Notes |
|---|---|---|
| Scaling | Removes tartar and plaque | Reduces risk of further damage |
| Root planing | Smooths root surface, helps gum reattachment | Supports healing and resists bacteria |
| Antibiotics | Controls infection | May be topical or oral |
| Professional cleaning | Maintains gum health | May be needed regularly |
Dentists or periodontists (sometimes with a dental hygienist) use special tools to get rid of sticky plaque and hard tartar above and below the gumline. This is called scaling.
Scaling removes buildup that hurts your gums and bone. Sometimes, they’ll do a deep cleaning called root planing. They smooth out rough spots on the tooth root, which helps keep bacteria and tartar from sticking.
It gives your gums a better shot at healing and reattaching to your teeth.
Your dentist might also suggest antibiotic treatments to target bacteria. These come as special rinses, gels for your gums, or pills. They help cut down infection and swelling.
Good home habits—brushing, flossing, using a medicated rinse, and not smoking—make a huge difference in how well treatment works.
Surgical Options
Sometimes, cleaning and antibiotics just aren’t enough. If things get serious, surgical procedures can help fix or even undo some of the damage.
| Procedure | What It Does | Benefits |
|---|---|---|
| Gum flap (flap surgery) | Opens gums for deeper cleaning, reshapes bone | Easier cleaning, less infection |
| Gum grafting | Covers exposed roots, restores gumline | Lowers sensitivity, protects roots |
| Bone grafting | Adds bone if lost, supports tooth stability | Prevents tooth loss |
| Tissue regeneration | Encourages new bone, keeps gum from invading | Restores support for teeth |
| Protein gels | Boosts growth of bone and tissue | Promotes faster healing |
One common surgery is the gum flap procedure (or pocket reduction). The dentist makes small cuts in your gums to lift the tissue, giving better access to roots and deep tartar.
After they clean everything out, they might reshape the bone to get rid of places where germs hide. Then, they stitch the gum back in place, making it easier for you to keep things clean.
Gum tissue sometimes shrinks because of disease, exposing the roots. In that case, gum grafting can help.
The dentist attaches a small piece of healthy tissue—usually from the roof of your mouth or a donor—to the area. This protects exposed roots and can make your gums look better too.
If you’ve lost bone, bone grafting might be the next step. The dentist adds small amounts of bone (from you, a donor, or artificial material) around the tooth root. This can help save teeth and encourage new, stronger bone to grow.
Other advanced techniques include:
- Guided Tissue Regeneration: The dentist places a thin fabric between the bone and gum to help bone regrow without interference.
- Special Protein Gels: Sometimes, a protein-rich gel goes on the root to help new bone and tissue grow.
If a tooth can’t be saved, dentists may use dental implants to replace it after treating the gum disease.
At-Home and Daily Management Tips
Keeping up with good oral hygiene is huge for managing and preventing periodontitis.
| Oral Hygiene Steps | Description |
|---|---|
| Brushing | Twice daily, with soft or electric toothbrush |
| Flossing | Once daily or using alternatives |
| Mouth rinse | Use as recommended by a dentist |
| Professional cleaning | Follow dentist’s maintenance schedule |
Brush your teeth twice a day, or after eating if you can. Using a soft-bristled or ultrasonic toothbrush helps, and swapping out your toothbrush every three months keeps things effective.
Floss every day, or use tools like interdental brushes or water flossers to get between teeth. Mouth rinses can help too, but only use them if your dentist recommends it.
Avoiding smoking and chewing tobacco drops your risk for gum disease. If you have ongoing health issues like diabetes, keep them under control—they affect your gums, too.
Getting Ready for Your Visit
Getting organized before seeing your dentist or periodontist makes things go smoother. Make a list of any gum problems you’ve noticed—bleeding when brushing, swollen gums, or bad breath. Jot down when these symptoms started and if they’ve changed.
Gather info about your medical history. Note any health conditions that might affect dental care, like diabetes or heart issues. Bring a list of all medicines, vitamins, over-the-counter drugs, and supplements you use, along with the amounts.
Having questions ready helps you get more out of the visit. You might want to ask:
- What could be causing my gum problems?
- What dental x-rays or tests should I expect?
- Are there different treatment options for my situation?
- Will insurance cover this?
- Are there things I should do at home to help my gums?
- Any restrictions after treatment?
Bring paper and a pen, or just use your phone to take notes. It’s easy to forget what the dentist says otherwise. Take your insurance card and any old dental records if you have them.
Unless your dentist says otherwise, it’s fine to eat a light meal before your appointment. Brush and floss as usual. Good oral hygiene before your visit helps the dentist see what’s really going on.
Here’s a quick checklist for your appointment:
| Item | Bring to Appointment? |
|---|---|
| List of symptoms | ✔ |
| Timeline of symptoms | ✔ |
| List of medicines and supplements | ✔ |
| Medical and personal health details | ✔ |
| Insurance information | ✔ |
| Past dental records (if possible) | ✔ |
| Written questions for the dentist | ✔ |
| Notepad or phone for notes | ✔ |
Thinking through these things ahead of time can really lower your stress and help you get more out of your dental checkup.
What the Dental Team May Ask and Do During Your Visit
The dentist or periodontist will ask about your gum symptoms. They’ll probably want to know:
- When did you first notice gum pain, bleeding, or swelling?
- Do the problems happen all the time, or just sometimes?
- How often do you brush and floss?
- When was your last dental checkup or cleaning?
- Any medical conditions?
- What medicines are you taking?
- Do you smoke or use tobacco?
Being ready with answers helps the exam move along. If things look more severe, your regular dentist might send you to a periodontist. These specialists focus on gum disease and can handle more complicated treatments.
