Periodontal Therapy
Periodontal Therapy & Gum Disease Treatment
Gum disease is more common than most people realize. It’s usually painless in the early stages, and so most don’t know they have it until it’s already progressed.
At Triangle Family Dentistry, we check for signs of periodontal disease at every visit and provide complete treatment in-house, so you never have to wonder about the health of your gums.
We serve communities across central North Carolina, with locations in Apex, Cary, Morrisville, Wake Forest, Fuquay-Varina, Holly Springs, and more. We’re also in Summerville, SC. Find your nearest office and schedule your next visit today.
What is Periodontal Disease?
The word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.
Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages.
Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Signs & symptoms of periodontal disease
Because periodontal disease is usually painless in the early stages, regular dental exams are the most reliable way to catch it. However, there are warning signs to watch for:
- Bleeding gums — Gums should never bleed, even when you brush vigorously or floss
- Red or puffy gums — Healthy gums are firm and pink, not swollen or inflamed
- Receding gums — Loss of gum tissue around a tooth, making teeth appear longer
- Loose teeth — Caused by bone loss or weakening of the fibers that anchor teeth to bone
- New spacing between teeth — A sign of bone loss
- Persistent bad breath — Caused by bacteria in the mouth
- Pus around the teeth and gums — Indicates active infection
- Tenderness or discomfort — Plaque, calculus, and bacteria irritate the gums and teeth
If you are experiencing any of these symptoms, we recommend scheduling an appointment as soon as possible. Early treatment is significantly more effective and less involved than treating advanced disease.
How Is Periodontal Disease Diagnosed?
Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.
A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:
- Gingivitis: Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.
- Periodontitis: Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
- Advanced Periodontitis: The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.
Periodontal Treatment
Treatment depends on the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate course of care.
Early-Stage Disease — Gingivitis
If gum disease is caught in the early stages (gingivitis) and no permanent damage has been done to the supporting bone, one to two regular professional cleanings are typically recommended. Your dental team will also provide personalized guidance on improving your daily oral hygiene routine to prevent the disease from progressing.
Advanced Disease — Scaling and Root Planing
If the disease has progressed beyond gingivitis, a specialized deep cleaning called scaling and root planing will be recommended. This procedure is typically performed one quadrant of the mouth at a time, with the area numbed for your comfort. During scaling and root planing:
- Scaling removes tartar, plaque, and bacterial toxins from above and below the gum line
- Root planing smooths the rough surfaces of the tooth roots, removing contaminated tissue and making it more difficult for bacteria to re-attach
When Additional Treatment Is Needed
If the gum pockets do not heal adequately after scaling and root planing, periodontal surgery may be recommended to reduce pocket depth and make the teeth easier to clean. In some cases, your dentist may also recommend a referral to a periodontist, a specialist in the gums and supporting bone, for advanced care.
Periodontal Maintenance
Once your periodontal treatment is complete, ongoing maintenance is essential to keep the disease under control. Periodontal disease cannot be cured, but it can be managed effectively with consistent care.
Your dental team will recommend periodontal maintenance cleanings, typically four times per year. At these appointments, your hygienist will:
- Check pocket depths to ensure gum tissue is remaining healthy
- Remove plaque and calculus from above and below the gum line in areas that are difficult to manage at home
- Review your X-rays for any signs of bone changes
- Check existing restorations and screen for oral cancer
- Provide updated oral hygiene recommendations as needed
Good oral hygiene habits at home, combined with regular periodontal maintenance visits, are the most effective way to preserve your dental health long-term.
Periodontal Membership
Guests diagnosed with periodontal disease may be eligible to upgrade to our Periodontal Membership through the Dental Access Plan — an affordable way to cover the cost of your ongoing maintenance care. Learn more about the Dental Access Membership.
More Cleaning & Prevention Services
Frequently Asked Questions
A regular cleaning maintains healthy gums. A deep cleaning (scaling and root planing) is a treatment. If your hygienist finds signs of gum disease during your exam, they’ll explain why a deeper level of care is needed and what it involves.
Scaling and root planing is performed with local anesthesia, so the area is numb during the procedure. Some tenderness and sensitivity in the days following treatment is normal and typically resolves within a week.
For most guests, scaling and root planing is completed over two to four appointments, treating one quadrant of the mouth at a time. The exact number depends on the extent of the disease. Your dental team will outline a treatment plan at your evaluation.
Gingivitis, the earliest stage, is reversible with professional cleaning and improved home care. More advanced periodontal disease is not reversible, but it can be effectively managed and stabilized with treatment and ongoing maintenance to prevent further progression.
For most cases of gum disease, your general dentist and dental hygienist can provide effective treatment including scaling and root planing and ongoing maintenance. If your case is more advanced or does not respond to initial treatment, a referral to a periodontist may be recommended.
Periodontal disease will continue to progress without treatment. Over time it causes irreversible bone loss, loosening of the teeth, and ultimately tooth loss. Research also associates untreated gum disease with systemic health conditions including cardiovascular disease and diabetes.
Most guests with a history of periodontal disease are recommended to come in for maintenance cleanings four times per year rather than the standard twice-yearly schedule. This frequency keeps the disease under control and protects the progress made during treatment. If you suspect you have gum disease, scheduling an evaluation is the first step toward getting your oral health back on track.