Gum disease, known in dentistry as periodontal disease, is an inflammatory condition of the tissues that surround and support the teeth. It develops gradually and, in its early stages, may cause few noticeable complaints. Periodontology is the branch of dentistry concerned with the diagnosis and treatment of these tissues.
What is gum disease?
Dental plaque is a soft layer of bacteria that forms continuously on tooth surfaces. When it is not removed by regular brushing and interdental cleaning, it hardens into calculus (tartar) and the surrounding gum tissue may react with inflammation.
Dentistry generally describes two stages. In gingivitis, inflammation is limited to the gum tissue itself. In periodontitis, the inflammation extends to the deeper tissues and the bone that supports the tooth. The distinction is made by the dentist after clinical examination and, where considered necessary, radiographic evaluation.
Findings that may be noticed
Some findings that patients report to their dentist include bleeding while brushing or flossing, redness or swelling of the gums, persistent bad taste or bad breath, gums that appear to have receded, sensitivity at the necks of the teeth, and a change in the way the teeth come together. These findings do not by themselves indicate a specific diagnosis; they are reasons to arrange an examination.
How the condition is evaluated
During the examination the dentist reviews the medical and dental history, inspects the gum tissue, and measures the depth of the gum pockets around each tooth with a periodontal probe. Radiographs may be taken where they are considered necessary in order to assess the level of the supporting bone. General health conditions and habits such as smoking are also discussed, because they can influence how the tissues respond.
Treatment approaches
The treatment plan is determined individually after examination. Approaches used in periodontology include:
- Removal of plaque and calculus. Deposits above and below the gum line are removed with hand instruments and ultrasonic devices.
- Root surface debridement. Where gum pockets have formed, the root surfaces within the pocket are cleaned and smoothed so that the tissue has the opportunity to reattach.
- Re-evaluation. After an interval determined by the dentist, pocket depths and tissue response are measured again.
- Surgical procedures. In cases where deeper pockets persist, procedures that allow access to the root surface or that address tissue and bone contours may be planned.
- Maintenance appointments. Recall visits at intervals set by the dentist allow the tissues to be monitored over time.
Local anaesthesia is used where the dentist considers it appropriate. The number of appointments varies according to the extent of the findings.
After treatment
Some sensitivity to hot and cold, and tenderness of the gums, may be experienced in the period following treatment. The dentist gives instructions specific to the procedure carried out, which usually cover brushing technique, interdental cleaning, and what to eat in the first days. Attending the review appointments that are arranged is part of the treatment itself, since periodontal conditions are managed over the long term rather than resolved in a single visit.
Daily care at home
Brushing twice a day, cleaning between the teeth with floss or interdental brushes, and attending routine dental examinations are the measures most often discussed. Where teeth have been lost, the remaining teeth carry additional load, which is one of the reasons the dentist may discuss options such as dental implants or implant-supported prostheses as part of the wider plan.
Where gingivitis ends and periodontitis begins
Inflammation limited to the gum is called gingivitis. At this stage the tissue is red and bleeds easily, but the bone holding the tooth is intact, and the picture can return to health with treatment and daily care. When inflammation reaches the supporting bone the condition is called periodontitis, and bone that has been lost does not grow back on its own. This is why the distinction is made at the first examination: it determines whether the aim is to reverse the condition or to stop it progressing.
Why bone loss changes the goal of treatment
Once supporting bone has been lost, treatment is directed at removing the cause, reducing pocket depth and keeping the remaining support stable. Teeth may feel looser or appear longer as the gum follows the bone. In selected sites regenerative procedures may be considered, but they are not applicable everywhere and depend on the shape of the defect. What is realistic for a particular mouth is explained after the periodontal measurements and radiographs are reviewed.
General health conditions that interact with gum health
Diabetes that is not well controlled, some medications and hormonal changes during pregnancy all affect how gum tissue responds to plaque. Certain medication groups can also cause the gum to enlarge, which makes cleaning harder and can create a cycle. This is why the medical history and current medication list are taken at the first visit and updated at review appointments; the treatment plan is built around them rather than applied uniformly.
Gum recession and sensitivity
When the gum margin moves back, root surface is exposed. Root surface is not covered by enamel, so it responds more sharply to cold and to brushing. Recession has several causes, including inflammation, a heavy brushing technique, the position of the tooth and clenching, and the approach differs according to the cause. Not every recession needs a surgical procedure; in many cases the first step is changing what is causing it and managing the sensitivity.
Maintenance after treatment
Periodontal treatment does not end when the initial appointments are finished. The tissues are reassessed after a healing period, and a recall interval is set from those findings rather than from a fixed rule. Patients who have had bone loss are usually seen more often than those who have not. These appointments exist because the bacteria that caused the condition return, and the interval is the point at which they are removed before the tissue reacts again.
Gum health around implants and restorations
Tissue around an implant can become inflamed in the same way as tissue around a natural tooth, and once it does, the process can progress quietly. A history of gum disease is therefore taken into account when implant treatment is planned. The same applies to the margins of crowns and veneers, which are areas where plaque gathers. Gum condition is reviewed before restorative work begins rather than treated as a separate matter.
Frequently asked questions
Is bleeding when I brush something I should mention?
Yes. Bleeding during brushing is a finding that is worth reporting at a dental examination so that its cause can be assessed.
If you have a question about this subject, you can reach our clinic.
How many appointments does periodontal treatment take?
This depends on the findings recorded at the examination. The dentist explains the planned number of appointments after the assessment has been completed.
Does the treatment hurt?
Local anaesthesia is used where the dentist considers it necessary. What is felt during and after a procedure differs from person to person, and your dentist will discuss this with you beforehand.
Can gum recession come back after treatment?
Periodontal tissues need continued care. Home cleaning and the recall appointments arranged by your dentist are the means by which the tissues are monitored over time.
Where can I arrange an examination?
You can reach our clinic through the contact page to arrange an appointment for an examination.
The information on this page is for general information purposes only and does not replace an examination by a dentist. Diagnosis and treatment planning are carried out by the dentist following an intraoral examination and, where considered necessary, radiographic evaluation.
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Related pages
- Our dental treatments — an overview of the treatments carried out at our clinic.
- Our dentists — the dentists working at our clinic.
- Contact us — appointment and directions.
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