Gum (periodontal) treatment

What is gum disease?

Gum disease describes swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.

What is gingivitis?

Gingivitis means inflammation of the gums. This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning.

What is periodontal disease?

Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost making the teeth loose. If this is not treated, the teeth may eventually fall out.

What is the cause of gum disease?

Nearly all gum disease is caused by plaque. Plaque is a film of bacteria which forms on the surface of the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to cause gum disease. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day. This is done by brushing and flossing.

What happens if gum disease is not treated?

Unfortunately, gum disease progresses painlessly, on the whole so that you do not notice the damage it is doing. However, the bacteria is sometimes more active, and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can become more difficult and in some cases hopeless.

What treatments are needed?

Your dentist will usually give your teeth a thorough clean. You’ll also be shown how to remove plaque successfully yourself, cleaning all the surfaces of your teeth thoroughly and effectively. This may take a number of sessions with the dentist or hygienist.

Symptoms to watch out for are:

  • Gums that have receded
  • Persistent bleeding
  • Pus between the teeth and gums
  • Persistent bad breath or bad taste
  • Permanent teeth that are loose or are changing position

Is it linked with other diseases?

Researchers around the world have found strong links with a number of systemic conditions, including cardiovascular disease, diabetes, hypertension, Alzheimer’s, and pre-term births. Each day, new evidence is emerging. This is logical; the mouth is very vascular and provides an excellent means for bacteria to gain access to the blood supply.

Am I likely to suffer from gum disease?

Probably. Most people, 90% suffer from some form of gum disease, and it is the major cause of tooth loss in adults. However, the disease develops very slowly in most cases, and it can be slowed down to a rate that should allow you to keep most of your teeth for life provided it is seen early.

What do I do if I think I have gum disease?

The first thing to do is visit your dentist for a thorough check-up of your teeth and gums. The dentist can measure the ‘cuff’ of gum around each tooth to see if there is any sign that periodontal disease has started. X-rays may also be needed to see the amount of bone that has been lost. This assessment is very important so the correct treatment can be prescribed for you.

Scaling and Root debridement

Scaling and root debridement, as it is technically known, is a conservative and many times, a very effective form of treatment for gum disease. Especially in the early stages of gum disease, like gingivitis, scaling and root planning, along with an evaluation of contributing health factors that you may be causing, may be all that is needed to get the disease under control. With more advanced gum disease, this would be the preparatory phase or initial therapy Depending on the response to this treatment, further corrective surgical treatment may be indicated.

Why Scaling and Root debridement can help you save your teeth.

Scaling is the removal of calculus (tartar) and plaque from the tooth. Gum disease is particularly a problem when the calculus (tartar) gets below the gum on the root surface where you can no longer clean it. It becomes a haven for pathogens which are harmful. Special ultrasonic scalers can be used to initially break down the hard calculus. Then, special hand-held instruments like scalers and curettes are used to do fine scaling. Bacteria is more likely to stick to the rough surfaces (the root). The root surface is cleaned in a process called root debridement. This helps removes any remaining calculus or “contaminated” cementum on the root and leaves the surface less susceptible to the bacteria. If you have gingivitis or periodontitis that is localized to one part of your mouth, scaling and root debridement can be done in just that area. However, if you have a more generalized form of periodontitis spreading throughout your mouth, your dentist typically will do a quarter (a quadrant) or half of the mouth at one time. This means that two to four visits may be necessary to complete the scaling and root debridement.


The outcomes of having treatment for gum disease varies from one person to the next.  For many people gum disease can be cured, while for others, treatment may only slow down the disease process. In spite of all the treatments, effort and expense to keep the tooth or teeth, they may still be lost. However treatment gives you a better chance of keeping your teeth and can alleviate some of the symptoms, such as the inflammation and bad breath.  Cosmetic dentistry and or surgery can help rebuild the look of the teeth and gum back to a more normal appearance, if required.

Gum disease