Gum Disease Treatment

Gum disease is an infection of the tissue and bone that hold your teeth in place. It starts as gingivitis, which is reversible. Left alone it becomes periodontitis, which destroys bone and is not reversible. At Pearl32 Dentistry and Wellness in Laguna Hills, we measure it with a probe and x-rays before we treat it. Most cases respond to cleaning below the gum and a three to four month recall. Surgery is reserved for deep pockets.

Gingivitis or periodontitis: what is the difference?

Gingivitis is inflammation of the gum only. The gums are red, puffy and bleed when brushed. No bone has been lost. Clean the plaque off thoroughly and the tissue returns to normal in one to two weeks.

Periodontitis is different. Bacteria have moved under the gum, the attachment has pulled away from the root, and bone has been lost. That bone does not come back on its own. The goal shifts from cure to control: clean the root surfaces, lower the bacterial load, and keep the disease from progressing further.

What are the signs?

Bleeding when you brush or floss is the earliest sign, and it is not normal. Other signs are bad breath that returns quickly, gums that look longer than they used to, dark triangles between teeth, tenderness, and a bad taste. Later signs include loose teeth, teeth that drift, and pus at the gum line.

Many people have no pain at all until it is advanced. That is the difficulty with this disease. Smokers often bleed less, which hides it further. A short exam with a probe finds it years before you would notice.

How is gum disease measured?

We measure six points around every tooth with a small probe marked in millimeters. One to three millimeters with no bleeding is healthy. Four millimeters is a warning. Five millimeters and deeper is a pocket that a toothbrush cannot reach.

Then we compare those numbers with the bone level on your x-rays and note recession, mobility and any bone loss between the roots. The chart is printed for you. At your next visit we measure again, so you can see whether the numbers moved. That is how we judge treatment, not by how the gums look.

What does treatment involve?

Treatment moves in steps. Mild cases need a thorough cleaning and better daily habits. Deeper pockets need scaling and root planing, which cleans the root surface below the gum under local anesthetic.

Antibiotics are used where they help: placed into a specific deep pocket, or taken by mouth when the infection is aggressive. They are not a substitute for cleaning. After treatment you move to periodontal maintenance every three to four months alongside your routine care. Pockets that stay deep are treated surgically by the visiting periodontist here in Suite 450.

How does gum disease affect the rest of your health?

Gum disease and general health travel together. People with diabetes get gum disease more often, and active gum disease makes blood sugar harder to control. Treating the gums often helps those numbers move. Research also links periodontitis with heart disease, though that evidence shows association rather than proven cause.

Tell us about your medical conditions and medications. Blood thinners, immune suppressing drugs and some blood pressure medications change how gums respond. We coordinate with your physician when plans overlap. Smoking is the largest risk you can change, and quitting affects the outcome more than anything we do.

What gum treatment will not do

Treatment will not regrow lost bone. Bone lost to periodontitis stays lost in most cases, which is why early treatment matters so much. Where a defect has the right shape, a graft placed by the visiting periodontist can rebuild part of it, and we will tell you if you are a candidate.

It will not hold without maintenance. Bacteria repopulate a deep pocket in about three months, which is why the recall is three to four months rather than six. It also will not close every pocket. Sites that stay at five millimeters or deeper get surgery or closer monitoring.

What does gum disease treatment cost?

Cost depends on how many quadrants need treatment and how deep the pockets are, and it is quoted in writing, itemized, after an examination and a full set of measurements. We separate the active treatment from the ongoing maintenance so you can plan the year.

We are in network with most major PPO plans and Delta Dental HMO. Most plans cover scaling and root planing when the chart supports it, and they limit how often maintenance is covered. Third party financing is available and the practice is not the creditor, through CareCredit, Cherry, Sunbit and Happen Bank (formerly LendingClub). See financing or our membership plan.

Questions people ask about gum Disease Treatment

Is bleeding when I brush normal?

No. Healthy gums do not bleed when brushed or flossed correctly. Bleeding means inflammation, usually from plaque left along the gum line. In early gingivitis it resolves within one to two weeks of thorough daily cleaning. Bleeding that continues past that deserves measurement with a probe, because it can be the surface sign of deeper pockets.

Can gum disease be cured?

Gingivitis can be reversed completely. Periodontitis can be controlled but not undone, because lost bone does not return on its own. Control means pockets that shallow out, bleeding that settles and bone levels that hold steady on x-rays taken a year or two apart. That outcome is realistic for most people who keep a three to four month recall.

Will I lose my teeth?

Most people who get treated and keep their maintenance visits do not. Teeth are lost when deep pockets go untreated for years, when grinding adds load to weakened support, or when smoking continues. We will tell you which teeth have a poor outlook and why, and we plan for those separately rather than leaving you to guess.

How often do I need cleanings after treatment?

Every three to four months. Bacteria rebuild in a deep pocket within about three months, so a six month interval lets the infection restart between visits. Each maintenance appointment includes new measurements, cleaning above and below the gum, and a check of any site that changed. Insurance frequency limits vary, and we check yours in advance.

Does scaling and root planing hurt?

The area is numbed with local anesthetic, so the appointment itself is comfortable for most people. Afterward the gums are tender for a few days and teeth can feel sensitive to cold for two to four weeks. Warm salt water rinses and a desensitizing toothpaste help. Nitrous oxide and oral sedation are available if the length or the sound bothers you.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination.