Gum Disease Treatment in Johns Creek, GA
Gum disease is the main reason adults lose teeth, and most people who have it don't know it. It rarely hurts in the early stages. The good news is that it's easy to catch at a regular checkup. The early stage, gingivitis, can usually be reversed; the later stage, periodontitis, can be controlled with treatment and maintenance. This page explains what we're looking for, how we treat it, and why your doctor cares about your gums too.
What is periodontal disease?
"Periodontal" means around the tooth. The disease is an infection of the gums and, later, the bone that holds your teeth in place. It starts with plaque, the sticky film of bacteria that forms on teeth every day. Plaque you don't brush away hardens into tartar within about a day, and tartar can only be removed with dental instruments. The bacteria in plaque and tartar release toxins that irritate the gums.
The first stage is gingivitis: red, puffy gums that bleed when you brush or floss. No bone has been lost yet, and it's fully reversible with a good cleaning and better home care. If it's ignored, the gums pull away from the teeth and form pockets, the infection moves below the gumline, and the body's own inflammatory response starts destroying bone. That's periodontitis. As it advances, teeth loosen, shift and eventually fall out or have to be removed.
What are the warning signs?
- Gums that bleed when you brush or floss. Healthy gums don't bleed.
- Red, swollen or tender gums
- Gums that have receded, making teeth look longer
- Bad breath that doesn't go away
- Pus between the teeth and gums
- Loose teeth, or new gaps opening between teeth
- A change in how your teeth fit together when you bite
Smoking raises your risk considerably, as do diabetes, some medications and hormonal changes during pregnancy and menopause.
How is it diagnosed?
At every checkup, your hygienist measures the pocket between the gum and each tooth with a small probe. A healthy pocket is three millimeters or less and doesn't bleed. Deeper pockets, bleeding, inflammation and loose teeth tell us how far things have progressed, and X-rays show whether bone has been lost. From that we classify it as gingivitis, periodontitis or advanced periodontitis, and plan treatment to match.
How is gum disease treated?
Gingivitis. One or two regular cleanings, plus some coaching on brushing and flossing, usually clears it up.
Periodontitis. The standard treatment is scaling and root planing, often called a deep cleaning. We numb the area and work one section of the mouth at a time. Scaling removes plaque and tartar from the tooth and root surfaces above and below the gumline, usually with an ultrasonic instrument and hand scalers. Root planing smooths the root surfaces so the gum can reattach and bacteria have a harder time settling back in. We may place an antibiotic in the pockets, and we'll often send you home with a prescription mouth rinse.
A few weeks later we measure the pockets again. Most shrink. If some don't, the next steps can include periodontal surgery to reduce pocket depth, grafting to regrow lost bone and gum tissue, or a referral to a periodontist, a specialist in the gums and supporting bone. Teeth lost to gum disease can be replaced with dental implants once the infection is controlled and the bone is rebuilt.
What is periodontal maintenance?
After treatment, you're not back on a six-month schedule. Pockets that have been deep once can refill with bacteria quickly, so we see periodontal patients about every three months. At those visits we re-measure the pockets, clean above and below the gumline, check your X-rays and existing fillings and crowns, do an oral cancer screening, and adjust your home-care tools, which might mean an electric toothbrush, small interdental brushes or a prescription fluoride. Regular maintenance and good home care are what keep the disease controlled and the bone you still have in place.
Why does gum disease matter for the rest of my body?
The mouth isn't sealed off from everything else. Research keeps turning up links between periodontal disease and several chronic conditions. We're not claiming treating your gums will cure any of them, but the connections are strong enough that your physician may ask about your gums.
Diabetes. This one runs in both directions. Diabetes makes gum infections more likely and harder to fight, and active gum disease pushes blood sugar up and makes it harder to control. Treating periodontitis has been shown to improve A1c readings in some patients. If you're diabetic, twice-yearly checkups are the minimum.
Heart disease and stroke. People with gum disease are more likely to have coronary heart disease. The association is well documented, though it hasn't been shown that gum disease causes heart disease or that treating your gums prevents a heart attack. The leading explanations are that oral bacteria enter the bloodstream and attach to arterial plaque, and that chronic gum inflammation raises inflammatory markers that are tied to heart disease.
Pregnancy. Gum disease during pregnancy is associated with preeclampsia, premature labor and low birth weight. Hormonal changes also make gums more reactive to plaque during pregnancy, so it's a good time to be extra careful, not less.
Lung disease. Bacteria from infected gums can be inhaled into the lungs and have been linked to pneumonia and flare-ups of COPD.
Worried about your gums?
If they bleed when you brush, that's reason enough to come in. Call (770) 609-1281 or text us. We're on Medlock Bridge Road in Johns Creek, next to Starbucks. We're in network with several PPO plans; see our insurance page for details.