Gum disease treatment

Gum disease rarely hurts until it's advanced, so the early signs are easy to brush off. Watch for:

• Gums that bleed when you brush or floss
• Red, puffy or tender gums
• Bad breath or a bad taste that doesn't go away
• Gums pulling back, so your teeth look longer
• Teeth that feel loose or have started to shift
• A partial denture that suddenly fits differently
• Pus between a tooth and the gum

Gum disease comes in stages. Gingivitis is the early stage: the gums are inflamed from plaque, but the bone underneath is still intact. It's reversible with a professional cleaning and steady brushing and flossing at home.

Periodontitis is what gingivitis becomes when it's left alone. Bacteria and hardened tartar work below the gumline, the gum pulls away from the tooth, and the bone that holds the tooth starts to break down. Bone lost to gum disease doesn't grow back on its own, which is why early treatment matters. It can be controlled, though, and many people keep their teeth for life by staying on top of it.

At your exam we gently measure the small pocket between each tooth and the gum with a thin probe. Healthy pockets are shallow, usually 1 to 3 millimeters. Deeper readings, bleeding when we measure, and bone loss on your digital x-rays together tell us whether it's gingivitis or periodontitis, and how far along it is.

You'll see the numbers and the images with us. If we recommend a deep cleaning, it's because the readings show a regular cleaning can't reach the problem, and you'll see exactly which areas need it.

Scaling removes plaque and tartar from below the gumline, down along the root where a toothbrush and a regular cleaning can't reach. Root planing smooths the root surfaces so bacteria have a harder time sticking and the gum can tighten back against the tooth.

We numb each area before we start, so most people feel scraping and pressure rather than pain. It's usually done one section of the mouth at a time, over one or two visits.

Afterward, your gums may be tender and your teeth a little sensitive to cold for a few days. Rinse with warm salt water and keep brushing gently but thoroughly. Most people notice less bleeding within a couple of weeks, and we'll measure again later to see how your gums responded.

Gum disease is managed over time, not fixed once. After a deep cleaning, many people do best with cleanings every three or four months for a while instead of every six, because the bacteria tend to settle back into deep pockets on about that schedule. We'll suggest a schedule based on your numbers and stretch it out as your gums improve.

At home: brush twice a day with a soft brush angled toward the gumline, and clean between your teeth every day with floss, small brushes or a water flosser. Don't skip the spots that bleed. Bleeding is a sign to clean gently and consistently, not to stop.

If you smoke, quitting is one of the best things you can do for your gums. Smoking also hides bleeding, so gum disease in smokers is often further along than it looks.

Gum disease becomes more common with age, and a few things that come with age make it worse. Many medications cause dry mouth, and saliva is one of your mouth's natural defenses. Arthritis can make brushing and flossing harder; an electric toothbrush and a water flosser can make a real difference.

Diabetes and gum disease feed each other. High blood sugar makes gum infections harder to control, and ongoing gum inflammation can make blood sugar harder to manage. Research has also linked gum disease with heart disease, though that connection is still being studied. If you have diabetes, tell us, and keep your gum visits on the same calendar as your other checkups.

Healthy gums matter for whatever comes next, too. Crowns, bridges, partial dentures and implants all depend on healthy gum and bone. If you're planning any of those, treating gum disease comes first.

Gums can pull back for reasons besides gum disease: brushing too hard, grinding or clenching, naturally thin gums, or teeth that were moved during braces years ago. Whatever the cause, the exposed root is softer than enamel, sensitive to cold, and more likely to decay.

We'll tell you which is happening. If it's gum disease, treating the infection comes first. If it's brushing or grinding, the fix may be a softer brush and a lighter hand, a custom night guard, a toothpaste for sensitive teeth, or a tooth-colored filling over a worn notch at the gumline. Gums that have receded don't grow back on their own, so the goal is to stop it where it is.

Most plans cover scaling and root planing as basic care, often around 70 to 80 percent after the deductible, rather than the full coverage many plans give regular cleanings. The follow-up maintenance cleanings are often covered as well, though some plans count them differently from routine cleanings. We check your plan and give you the numbers in writing before treatment.

No insurance? The Sunshine Membership is a $110 one-time fee for 2 checkups with x-rays, unlimited limited exams for pain, and 30 to 40% off dental treatment. Cleanings, deep or regular, aren't included. Sunbit and Cherry offer monthly payments on larger treatment plans. And if it's been years since your last visit, the $80 new patient exam with x-rays is the place to start. Nobody here will lecture you about the gap.