Gum disease, a very common problem, occurs when bacteria in dental plaque builds up and causes inflammation and infection of the gums and bone structures that support the teeth.
The early stage, called gingivitis, can progress to more serious periodontitis and eventual tooth loss if gum disease is left untreated. Thankfully, there are ways you can help prevent, control, and even reverse gum disease.
The main objective of treatment for periodontal disease is to control the infection. The number and types of treatment typically vary depending on the extent of the gum disease.
That said, any type of treatment requires that the patient maintain good daily oral care at home. The dentist may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome.
Causes and Risk Factors
Gum disease begins when plaque, a sticky film containing bacteria, accumulates on the teeth, usually due to inadequate brushing and flossing habits. buildup leads to gingivitis, which can develop into periodontitis. Risk factors include:
- Poor oral hygiene
- Smoking and tobacco use
- Diabetes and poorly controlled blood sugar
- Medications that cause dry mouth
- Genetic predisposition
- Stress
- Hormonal changes
- Other illnesses, such as cancer or HIV/AIDS
Signs of Gum Disease
Symptoms signaling gingivitis include:
- Red, swollen, tender gums
- Gums that bleed easily when brushing or flossing
- Bad breath
- Receding gums
- Spaces developing between teeth
With periodontitis, symptoms worsen:
- Pus discharge between teeth and gums
- Loose or shifting teeth
- Chronic bad breath
- Changes in bite alignment
- Tooth loss
Any of these symptoms may be a sign of a serious problem, which should be checked by a dentist. During your visit with a dentist or hygienist you can expect them to:
- Ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to gum disease.
- Examine your gums and note any signs of inflammation.
The dentist or hygienist may also:
- Take an x-ray to see whether there is any bone loss.
- Refer you to a periodontist (Periodontists are experts in the diagnosis and treatment of gum disease and may provide you with treatment options that are not offered by your dentist.)
How is gum disease treated?
As mentioned before, the primary goal of gum disease treatment is to control the infection. Depending on how much your case has advanced, your dentist or periodontist may recommend the following:
1. Deep cleaning (scaling and root planning)
This is the most common treatment for gum disease. It involves the dentist or hygienist carefully scraping away built-up tartar above and below the gumline to remove bacteria and smooth areas where plaque accumulates. A dental laser may sometimes be used to dislodge tartar and reduce swelling and discomfort compared to traditional deep cleaning methods.
2. Medications
Medications like antibiotics or antimicrobial rinses may be prescribed to support scaling and root planing treatment. However, medications alone cannot always take the place of necessary surgery for advanced cases.
| Medications | What is it? | Why is it used? | How is it used? |
|---|---|---|---|
| Prescription antimicrobial mouthrinse | A prescription mouthrinse containing an antimicrobial called chlorhexidine | To control bacteria when treating gingivitis and after gum surgery | It’s used like a regular mouthwash |
| Antiseptic chip | A tiny piece of gelatin filled with the medicine chlorhexidine | To control bacteria and reduce the size of periodontal pockets | After root planing, it’s placed in the pockets where the medicine is slowly released over time. |
| Antibiotic gel | A gel that contains the antibiotic doxycycline | To control bacteria and reduce the size of periodontal pockets | The periodontist puts it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days. |
| Antibiotic microspheres | Tiny, round particles that contain the antibiotic minocycline | To control bacteria and reduce the size of periodontal pockets | The periodontist puts the microspheres into the pockets after scaling and root planing. The particles release minocycline slowly over time. |
| Enzyme suppressant | A low dose of the medication doxycycline that keeps destructive enzymes in check | To hold back the body’s enzyme response — If not controlled, certain enzymes can break down gum tissue | This medication is in tablet form. It is used in combination with scaling and root planing. |
| Oral antibiotics | Antibiotic tablets or capsules | For the short term treatment of an acute or locally persistent periodontal infection | These come as tablets or capsules and are taken by mouth. |
3. Surgical treatments
If inflammation and deep pockets around teeth persist after deep cleaning and medication, surgery may be recommended:
a. Flap surgery
Flap surgery is a procedure to access and remove hidden tartar deposits in periodontal pockets, as well as reshape gum tissue for tighter fit around teeth. This can make plaque removal easier.
b. Bone and tissue grafting procedures
There are several procedures that may help regenerate lost bone and gum tissues damaged by periodontitis:
- Bone grafting involves the placement of natural or synthetic bone in the area of bone loss to help promote bone growth.
- Guided tissue regeneration involves inserting a mesh-like material between the bone and gum tissue to prevent the gum tissue from growing into the area where the bone should be. This allows the bone and connective tissue to regrow uninhibited following bone grafting.
- Growth factor proteins may also be used to stimulate the body’s natural bone regeneration as well.
- In the event of gum tissue loss, your periodontist may recommend soft tissue graft, in which synthetic material or tissue is taken from another area of your mouth and used to cover exposed tooth roots
Each case of gum disease treatment is different, so it is not possible to predict with certainty which grafts will be successful over the long-term. Regular dental visits for plaque removal combined with proper at-home care can help avoid the need for invasive surgical treatments.
Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success. You should discuss with your periodontist about the expected results with your specific treatment approach.
Final Thoughts
Keep in mind that adequate home care along with professional treatment is key to reversing gum disease and regaining healthy gums and teeth. Don’t delay in seeing your dentist if you notice any signs of gum inflammation or infection. Consistent oral hygiene habits combined with dental visits can help keep gum disease at bay.
