Understanding Periodontal Diseases: Diagnosis & Treatment

Periodontal disease starts as a mild infection, but can advance to a more serious condition if it’s not treated early. Read ahead to learn how periodontal disease can impact one’s oral health and appearance, why it’s so important to reverse the effects of the disease, and the gum disease treatments that are available as it progresses.

Why are Periodontal Diseases so Harmful?

Periodontal disease treatment

Most people probably don’t give much thought to their gums until they begin to experience soreness, see redness and puffiness, or find blood in the sink after they brush their teeth. Healthy gums fit snugly around the teeth and act as barriers to the types of bad bacteria that can cause infection and degenerate gum and bone tissue.

But poor oral hygiene, certain underlying medical conditions, smoking, and even heredity can play a role in the onset of gum disease, and it can affect patients of all ages.

The sticky film known as plaque contains harmful bacteria and it produces toxins that cause the gums to be inflamed. Plaque becomes a more serious threat as it hardens and is exceedingly difficult to remove without a professional deep cleaning. As the gum tissue begins to deteriorate, the snug “collars” that surround the teeth loosen and form periodontal pockets that serve as breeding grounds for further bacterial growth.

As periodontal disease progresses, individuals are at risk for losing their teeth. Gum disease can be prevented by brushing and flossing daily and visiting a dentist regularly. Regular visits also allow dentists to identify the early stages of gum disease and recommend minimally invasive treatments that can reverse it.

Periodontal Disease Stages

When diagnosing periodontal disease, a dentist will:

  • Review a patient’s medical history to learn about underlying conditions
  • Examine the patient’s mouth for visible signs of redness, inflammation, and tartar (what happens when plaque calcifies and hardens)
  • Use an instrument to measure the depth of periodontal pockets
  • Take X-rays to determine whether bone loss has already occurred

Whether the patient presents as having a Stage 1 mild infection (gingivitis) or a more advanced stage of the disease (periodontitis, Stages 2-4) has to do with the depth of the periodontal pockets, degree of bone loss, and the rate of the disease’s progression.

Periodontal Disease Treatments for Mild Gum Disease

If diagnosed early, gum disease can be treated using non-surgical procedures.

Scaling and Root Planing

Scaling and root planing are two separate non-surgical treatments that require dental instruments to remove the plaque and tartar that’s causing infection. Using either a manual tool or ultrasonic instrument, dentists use scaling to remove deposits on the teeth and up to the gum line. Root planing then cleans beneath the gum line and smooths the tooth root.  Smoothing the root reduces gum tissue inflammation and makes it easier for the gum to reattach properly to the teeth.


Patients can be made more comfortable during the procedures with the use of local anesthetics. 


Medications are often prescribed to control infection and heal tissue. They can be used instead of scaling and root planing or as a follow-up to those procedures.  Since antibiotics and antimicrobials can also destroy good bacteria in the mouth, dentists and periodontists will want to limit the use of these medications and recommend that patients stop using them once the area has healed.

Occlusal Adjustment

When upper and lower teeth are not aligned properly, problems with the patient’s “bite” can lead to a number of dental issues, including the worsening of periodontal disease. A dentist or periodontist can correct an abnormal bite (called malocclusion) with a procedure known as occlusal adjustment. The dental professional will usually make a mold of the teeth to find the areas of concern, use drilling and filing to reshape the teeth, and often recommend a nightguard to prevent teeth grinding.

Periodontal Disease Treatment for Advanced Stages of Gum Disease (Periodontitis)

Gum Disease Illustration

Advanced stages of periodontal disease show that bacteria continues to grow beneath the gum line. At this point, teeth are loose and may require extraction because the gum and bone tissues are so damaged. When the disease has progressed this far, surgery is likely needed to reduce the depth of periodontal pockets, regenerate bone and gum tissues, or replace lost gum tissue with material from other locations in the mouth.

Pocket Depth Reduction

When gums fit snugly around the teeth, they form a support structure that helps prevent infection and bone loss. Once those tissues begin to move away from the teeth, not only is the support structure damaged, but the pockets provide a place for bacteria to grow.

Periodontists can reduce the depths of those pockets by suturing them to the teeth after performing a thorough cleaning.

Gum and Bone Tissue Regeneration

When the gums surrounding the teeth are so damaged that a simple cleaning and suturing cannot repair them, there are options for generating new material to support your teeth and prevent them from falling out.

Gum Tissue Regeneration

Periodontists perform gum grafting surgery by taking gum tissue from other areas of the mouth and applying them to the damaged site. A membrane that promotes tissue regeneration will also be placed at the site, and then then the periodontist will use sutures to close off the exposed area.

Bone Regeneration

If periodontal disease has moved to an advanced stage where a tooth must be extracted, periodontists will only be able to place a dental implant at the spot if the bone is sufficient to support the implant. If not, bone from either a different location in the patient’s body or from a bone bank will be grafted to the site. The periodontist will need to cut an opening in the jawbone and pack the bone material tightly. 

A membrane and tissue-stimulating proteins are also placed at the site before the doctor closes up the surgical area. It could take anywhere from a few months to a full year before the grafted bone fuses with the bone from the jawline and an implant is ready to be placed.

Gum Disease Treatment in Central Texas

It’s possible for the early signs of periodontal disease to go unnoticed. That’s why it is so important to schedule regular dental visits where a professional can detect whether gingivitis or an advanced stage of gum disease has already set in. If periodontal disease has progressed to a more serious stage, the specialists at Central Texas Periodontists are expertly trained to diagnose, evaluate, and treat periodontal disease.  Choose from four convenient locations to schedule your appointment today!