Periodontal Disease

Do your gums bleed when you brush? Do you dread going to the dentist for a checkup because the instruments always make your gums bleed? Periodontal disease is often characterized by bleeding gums and this preventable condition can be treated through a number of options offered in our clinic. If left untreated, periodontal disease often leads to tooth loss, and we are able to help with that as well.

What is Periodontitis?

Periodontits is a broad term that encompasses a variety of gum disease and conditions that are characterized by inflammation, bleeding, and development that gets worse over time. Microorganisms and bacteria stick to the teeth and grow. When brushing and flossing habits are insufficient or inconsistent, these microorganisms and bacteria all able to grow substantially; building colonies in the mouth that start creating problems.

Some of the early signs of a periodontal problem include redness seen in the gum tissue, especially around the teeth. The gums may appear puffy or swollen, and will often bleed when flossing, brushing, or when chewing on tough or harder foods such as biting into an apple or chewing on a large piece of steak. The swelling and bleeding may subside at times, and then return. Over time, the gums start receding and the teeth may become sensitive, especially to hot and cold temperatures, or contact. Bad breath can also be a sign of periodontal disease, often associated with a metallic taste.

Diagnosing Periodontitis

At dental checkups, the dentist inspects the gingiva (soft gum tissue) as well as teeth and other parts of the mouth, jaw, and face. The dental probes are used to check the thickness of the gums around the teeth, checking for swelling and inflammation. You may recall hearing the dentist call out numbers and millimeter values while poking at gums with a dental probe. The values in millimeters are a standard for determining the severity of gum disease, generally ranging from 1-2mm for mild cases, to over 5mm for very severe cases.

The gums are less visible on dental X-rays but the X-rays are used to determine if the conditions have worsened to the point of bone loss. Over time, alveolar bone loss is a major problem associated with periodontics. The alveolar bone is the portion of the skull bones that contain the teeth. In humans, the alveolar bones containing teeth are the upper jaw bones (i.e. maxillae) and the lower jaw bone (i.e. mandible). When periodontitis is allowed to continue, gum tissue suffers, but so do the jaw bones.

The dentist will classify the type of periodontitis based on the symptoms and visible or detectable signs, estimated progression so far, and potential for successful recovery. The current classification for periodontitis includes a list of seven diagnosable conditions ranging in severity from gingivitis to combined periodontic-endodontic lesions. Of the list, only gingivitis is considered reversible, while the others may be treatable but damage is often permanent, which is why we stress the importance of regular checkups and diligent at-home oral hygiene habits.

Periodontitis and Dental Implants

Having dental implants doesn’t remove the risk of periodontitis since the periodontitis affects the gum tissue directly. Patients with dental implants are also at risk of bone and tissue loss from periodontal disease and must also maintain diligent at-home oral hygiene habits and attend regular checkups at the clinic for continued health and monitoring.

Deep Pockets Have Nothing to Do With Money!

As periodontal disease progresses, the gum tissue recedes leaving empty spaces between teeth, and leaving a pouch-like space between the roots of the tooth and the remaining gum tissue. This space is known as a Periodontal Pocket or, more commonly, Deep Pocket and Deep Pockets set the stage for tooth loss. Gum tissue should hug teeth and remain rather close to support the teeth and they’re overall health and functioning. The gum tissue also typically shows the level of alveolar bone underneath, due to their close nature and development.


Deep Pockets signify periodontal disease that has progressed for quite some time, and the pockets will continue to grow deeper. Bacteria, microorganisms, food, and other harmful substances can slip into the pockets and make a home there. Plaque and tartar build up, affecting the roots of the teeth by allowing dental caries (cavities) to attack teeth deep in the gums and jaw. The continued loss of bone and tissue leave teeth weakened and they eventually become loose. Some teeth will fall out on their own, while others will require extractions to prevent further damage.

Periodontitis Affects More Than Just Your Mouth

While anyone can get periodontitis or periodontal disease, those with glucose-related conditions such as Diabetes Mellitus, are shown to be somewhat more susceptible to the development of gum disease. The presence of periodontitis has been linked to increased inflammation throughout the body, as well as increased risk of stroke, heart attack, and certain types of arteriosclerosis. Periodontal disease is also uncomfortable for many patients, affecting eating and drinking habits, which also have a profound effect on the entire body.

What Can I Do to Prevent Periodontitis?

Preventive measures are always the best approach to disease, including periodontitis. Visiting the dentist for a professional cleaning and oral health examination twice a year is highly recommended, but at least once a year. The dentist checks for gum disease, dental caries (cavities), and signs of inflammation, abnormalities, and many other possible concerns.

At-home oral hygiene habits play a HUGE ROLE in preventing gum disease! American Dental Association statistics suggest only about half of American adults brush their teeth twice daily, and approximately half of American adults report flossing daily but other sources suggest this is far less than 50%. Flossing at least once a day can do numbers for gum tissue health and overall oral health. If you are only going to floss once a day, do it at night before brushing your teeth so you go to bed with far fewer bacteria that can work through the night wreaking havoc. Using an interdental brush, available in a variety of sizes to fit between all teeth, will stimulate blood flow in the gums for health and healing, as well as remove a significant amount of plaque and food particles from between teeth. Ask the dentist today about TePe Interdental Brushes and related product options and techniques!

Proper brushing techniques can be taught to patients in the clinic. Children require assistance brushing, though professionals have conflicting opinions as to how long. The range of ages suggest somewhere between age 7 and age 12 children reach the capacity to effectively brush on their own, though with continued supervision.  When brushing habits are insufficient, the dentist sees the results almost instantly at dental checkups. Children and adults that do not brush properly cannot hide this fact from a dentist during an examination. There are no shortcuts and one extensive brushing session just before a dental exam will not cut it.

A Chlorhexadine gluconate mouthwash can help remove bacteria from the mouth. The dentist prescribes this type of mouthwash, it is not available for purchase like other mouth rinse products, and it is less effective on advanced types of periodontal disease but can help mild cases of gingivitis.

Using a fluoride mouth rinse will help strengthen teeth and enamel, preventing many cavities for patients of all ages. We often recommend patients use a weekly fluoride gel treatment when teeth are sensitive, weakened, or more susceptible to damage. The same fluoride gel treatment can be used with children for weekly strengthening of teeth and the promotion of good oral hygiene at-home care. Last but not least, attending regular checkups and exams at the dental clinic, and consulting the dentist at the first signs of a problem, can greatly improve chances of success when treating gum disease and maintaining overall oral health.

Treating Periodontitis

At Praxis & Klinik we use a variety of specialized tools and treatments for periodontitis, depending on the patient, circumstances, and individual treatment needs. The Helbo Treatment System makes cleaning Deep Pockets easier and more efficient, and the use of specialized Helbo tools remove microbial and other harmful things from the oral environment for better treatment success.

Contact Praxis & Klinik today for more information or to make an appointment!

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