Gum disease treatment

What it is

Gum disease starts with plaque, the sticky film of germs that forms on teeth every day. Plaque that isn’t brushed and flossed away hardens into tartar (also called calculus), which only a dental cleaning can remove.

There are two main stages:

• Gingivitis is the early stage. Gums turn red and puffy and bleed easily, but the bone isn’t affected yet. Gingivitis can often be reversed.
• Periodontitis is the later stage. The infection moves below the gumline, and the gums pull away from the teeth, leaving gaps called pockets. Over time, the bone that holds your teeth can break down, and teeth can loosen. The damage can’t be undone, but treatment can often stop it from getting worse.

The main treatment for periodontitis is scaling and root planing, often called a deep cleaning. Scaling removes tartar from above and below the gumline. Root planing smooths the roots, so your gums can heal and fit snugly around them again.

Who it helps

Gum disease often doesn’t hurt, especially early on, so many people have it without knowing. Watch for:

• Gums that bleed when you brush or floss
• Red, swollen, or tender gums
• Bad breath or a bad taste that won’t go away
• Gums that have pulled back, so your teeth look longer
• Teeth that feel loose, or a bite that feels different

Smoking, diabetes, and a family history of gum disease raise your risk.

What happens

1. Exam and measuring. Dr. Minici gently measures the pocket around each tooth with a probe (a thin measuring tool). Healthy pockets are usually one to three millimeters deep. X-rays show the bone around the roots. The probe feels like light poking.
2. Your plan. He explains what he found. Gingivitis may need only a regular cleaning and better habits at home. Periodontitis usually calls for scaling and root planing.
3. Numbing. We numb the area first. You’ll feel a small pinch, then pressure and scraping, but most people don’t feel pain. Treatment is often done one part of the mouth at a time.
4. Deep cleaning. Small instruments clean tartar off the teeth and the roots below the gumline, and then the roots are smoothed. Ask for a break whenever you need one.
5. A recheck. A few weeks later, we measure the pockets again to see how your gums have healed.

Recovery and aftercare

Once the numbing wears off, your gums will likely be sore for a few days, and your teeth may be sensitive to cold. A pain reliever you can safely take and warm salt-water rinses can help. Keep brushing and flossing gently.

As your gums heal, they may shrink back a little, so teeth can look longer. This is common after a deep cleaning.

Treated gums need more frequent cleanings, because the germs come back. This follow-up care is called periodontal maintenance. For advanced gum disease, Dr. Minici may refer you to a periodontist, a dentist who focuses on the gums and bone.

Cost and insurance

The cost depends on how many areas need treatment and how many visits it takes. X-rays, the recheck, and any medicine placed in the pockets can add to it.

Many dental plans cover deep cleanings, but often at a different level than routine cleanings. Ask your plan before treatment. To learn about payment options, see insurance and financing.

Alternatives

• For gingivitis, a professional cleaning and better brushing and flossing are often enough.
• For periodontitis, there’s no home-care substitute, because tartar below the gumline can’t be brushed away.
• Medicine, such as antibiotics, can support treatment but doesn’t replace the cleaning.
• Gum surgery may be needed in advanced cases, usually from a periodontist.

Left untreated, periodontitis keeps damaging the bone, which can lead to losing teeth.