Bleeding gums, or a “deep pocket” your hygienist mentioned in passing, are easy to shrug off. But gum disease doesn’t stay put. Left alone, it slowly breaks down the bone and tissue that hold your teeth in place, and it usually doesn’t hurt while it does it. By the time a tooth feels loose, a lot of that support is already gone.
So the goal is to find it early, figure out what’s driving it, and treat it while treatment still works well.
How we check for it
We screen for gum disease at every new patient exam. That means measuring the space between your gums and teeth, looking for bleeding and recession, and checking your X-rays for bone loss that isn’t visible in the mouth. It’s how we find gum disease before you’d ever notice it.
We also look for things other than plaque that can make gum problems worse, like a bite that overloads certain teeth, an old crown or filling that doesn’t fit well, or a habit like tongue thrust that keeps pushing on the teeth.
What we treat here, and what we refer
We’ll be straight with you about this, because it affects how your treatment goes.
- Mild to moderate gum disease: we treat it here. The main treatment is scaling and root planing, often called a deep cleaning. It removes the hardened buildup and bacteria from below the gumline and smooths the root surfaces so the gums can heal and tighten back up.
- Severe gum disease: we refer to a periodontist. A periodontist is a dentist with specialty training in gums and bone. When the disease has gone far enough that it needs surgery or more advanced treatment, they’re the right person to do it.
We treat the cases where we’re most likely to get a good result, and we refer the ones where a specialist will do better. We’d rather tell you that at the start than try something that doesn’t hold.
Either way, we stay involved. We keep an eye on your gums at your regular visits, and if the disease was part of a bigger problem, like missing or failing teeth, we plan and do the restorative work once your gums are healthy.
What a deep cleaning does, and doesn’t do
Scaling and root planing works, and the research is clear on that. An American Dental Association review of 72 studies found it improved the attachment between gums and teeth by about half a millimeter on average, with moderate certainty.
Smiley CJ, Tracy SL, Abt E, et al. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc. 2015;146(7):508-524. Randomized trials of at least 6 months. Some add-on treatments gave a little extra benefit, between 0.2 and 0.6 mm on average.
Half a millimeter sounds small, but gum disease is measured in millimeters, and stopping it from getting worse is the whole point. What a deep cleaning can’t do is grow back bone that’s already been lost. That’s why catching it early matters so much.
It also isn’t a one-time fix. Gum disease can come back, which is why what happens after treatment matters as much as the treatment itself.
How often you’ll come in afterward
There’s no single interval that fits everyone. How often we want to see you depends on how your gums are doing and how well plaque is being controlled at home. More bleeding and more buildup means we’ll want you back sooner. Healthy gums and good home care means we can space visits out.
If you’ve been treated for gum disease, we recommend a cleaning every 3 months. That’s the interval that keeps bacteria from building back up to the level that caused the damage in the first place.
Real cases
One patient’s front teeth had become loose. It turned out to be a combination of previously treated gum disease and a tongue thrust nobody had diagnosed, pushing on her teeth and gums all day. Treating the habit, not just the gums, is what let things settle for good.
See how we solved J.L.’s case →
Another patient’s gums and teeth weren’t where they needed to be for a new smile. Periodontal surgery repositioned the gum line first. It wasn’t a quick fix, but it made it possible to restore a brand-new smile afterward.
See how we solved P.P.’s case →
A third patient came to us unhappy with how his crowns and bridges from abroad looked. The real problem was that none of them fit, and the gum disease that followed had already cost him several back teeth. We referred him to a periodontist to treat the disease before rebuilding his bite with implants.
See how we solved S.V.’s case →
Signs worth a call
- Gums that bleed when you brush or floss
- Gums that look red, swollen or pulled back from the teeth
- Bad breath or a bad taste that doesn’t go away
- A tooth that feels loose, or a bite that feels different
- Food getting stuck in new places between your teeth
Gum disease is one of the few dental problems that gets much harder to treat the longer it waits. If any of this sounds familiar, call 702-734-0776 or tell us what’s going on.