Periodontal Disease

About Periodontal Disease

Bacterial plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:

  • A family history of dental disease
  • Behavioral factors such as smoking, which impedes health and repair of gum tissue, and poor oral hygiene
  • Poor nutrition
  • Hormonal changes from pregnancy, puberty, menopause, and monthly menstruation. These changes can make gums more sensitive, thereby making it easier for gingivitis to develop
  • Illnesses such as cancer or HIV that interfere with the immune system. Diabetes also affects the body’s ability to use blood sugar, and thus, diabetics are at higher risk of developing periodontal disease
  • Some drugs (such as diphenylhydantoin, also called Dilantin, the anti-angina drug nifedipine, also called Procardia or Adalat), can cause abnormal growth of gum tissue, as well as calcium channel blockers, which are used to control high blood pressure or for people with heart problems; cyclosporine, a medication that suppresses the immune system and is used to keep the body from rejecting transplanted organs, and oral contraceptives
  • Some medications, which lessen the flow of saliva, which has a protective effect on teeth and gums
  • Stress
  • Clenching or grinding your teeth


Scaling and Root Planing

Cases of periodontal (gum) disease that do not respond to more conventional treatment and self-care such as brushing and flossing may require a special kind of cleaning called scaling and root planing.

The procedure begins with administration of a local anesthetic to reduce any discomfort. Then, a small instrument called a “scaler,” or an ultrasonic cleaner, is used to clean beneath your gum line to remove plaque and tartar.

The root surfaces on the tooth are then planed and smoothed. This allows the gum tissue heal and reattach itself to the tooth in less advanced cases of disease.

Pocket reduction/ Osseous Surgery

Your bone and gum tissue should fit snugly around your teeth like a turtleneck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to thrive.

As bacteria accumulate and advance under the gum tissue in these deep pockets, additional bone and tissue loss follow. Eventually, if too much bone is lost, the teeth will need to be extracted.

Flap surgery is can be performed to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for you or your dental professional to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again.

A pocket reduction procedure is recommended if daily at-home oral hygiene and Scaling and Root Planing cannot effectively reach these deep pockets.

In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide (“Osseous (meaning ‘bone’) surgery”). This also allows the gum tissue to better reattach to healthy bone.


Periodontal disease causes the supporting tissue and bone around and below your teeth to become lost.  Regenerative procedures can reverse some of the damage by regenerating lost bone and tissue.

The procedure involves folding back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts and/ or tissue- stimulating proteins can be used to encourage your body’s natural ability to regenerate bone and tissue.