Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Periodontal Disease
When to See a Periodontist
Periodontal treatment may be sought in several ways. Your general dentist or a hygienist may recommend a consultation with a periodontist if they find signs of periodontal disease through the course of a checkup or other dental care appointment. You may also decide to see a periodontist on your own, as a referral is not necessary to be seen at our office.
In fact, if you experience any of these symptoms, we encourage you to schedule an appointment at our office without delay:
- Unexplained bleeding while performing regular cleaning or consuming food is the most common sign of a periodontal infection.
- Ongoing halitosis (bad breath), which continues despite rigorous oral cleaning, can point to periodontitis, gingivitis or the beginnings of a gum infection.
- Longer-looking and loose-feeling teeth can indicate recession of the gums and/or bone loss as a result of periodontal disease.
Patients with heart disease, diabetes, osteopenia or osteoporosis are often diagnosed with correlating periodontal infections. The bacterial infection can spread through the blood stream, affecting other areas of the body.
- Bleeding while brushing or eating normal foods
- Bad breath
- Loose teeth and gum recession
- Related health concerns
What is Periodontal Disease?
Periodontal disease is a chronic infection of the periodontal or gum tissue. This infection is caused by the presence of a bacterial film, which is called dental plaque, that forms on the teeth surfaces. Bacteria that found in dental plaque produce toxins which irritate the gums. They may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. With periodontal disease, bleeding, redness and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum and jawbone of more than 80% of Americans by age 45. Each case is looked at individually, because in addition to plaque there are co-factors such as genetics, smoking, and overall health, which contribute to disease severity. Once periodontal disease is detected, our goal as therapists is to provide information and treatment necessary to control/ or arrest the active infection, and help keep the disease in an inactive or controlled state.
However, don’t be fooled!
With periodontal disease, bleeding, redness and swelling do not have to be present. The periodontal disease symptoms of inflammation may only be evident with sub gingival probing. Further, pain is usually not associated with periodontal disease.
Even if you brush and floss your teeth faithfully, it is important that you have your teeth professionally cleaned on a regular basis. (Of course, if you aren't quite so meticulous about your oral hygiene, it's even more important!) After a thorough cleaning, your teeth will feel smooth and squeaky-clean, and they will probably look a lot brighter too. But professional teeth cleanings aren't done for looks alone.
Why do your teeth need this kind of attention? Essentially, it's because over time they tend to build up a layer of plaque (a sticky, bacteria-rich film) and hard deposits (called tartar, or calculus) that are very difficult to remove without special tools. When these deposits are allowed to remain on the tooth surfaces or below the gum line, they provide ideal conditions for bacteria to grow and multiply. The acids produced by some bacteria cause tooth decay and gum disease; if left uncontrolled, this can lead to inflammation and infection of the gums, and possibly influence systemic (whole body) diseases.
Dentists have a special term for preventive procedures like tooth cleaning: prophylaxis, from the Greek word meaning to protect or guard against. In this case, the focus is on preventing tooth decay and gum disease. Performed in conjunction with a routine dental examination, a professional cleaning can go a long way toward controlling these two common maladies. While your teeth are being cleaned, it's also a good opportunity to take a close look at your oral health in general and check for a few specific problems.
The Professional Cleaning Procedure
Teeth cleaning is often performed by a dental hygienist — a highly trained technician who uses a special set of tools designed just for this purpose. Because everyone's teeth are a little different, your cleaning will be tailored to your particular needs. However, many cleanings follow a similar pattern.
First, the dental hygienist will do an oral examination to evaluate the health of your oral tissues. Then the cleaning will take place using either an ultrasonic scaler or metal instruments referred to as curettes to remove the plaque and calculus from the tooth surfaces. The ultrasonic scaler is a hand-held tool with a tiny tip that vibrates at a very high frequency. Hardened deposits are broken up by the rapid movement of the tip, which does not damage the tooth. A constant stream of liquid (called lavage) serves to cool the tip and aid in plaque removal; at the same time, it also washes away the debris.
Some hygienists prefer curettes, which are hand-held instruments that are curved and tapered to fit around and in between the teeth. If your teeth are sensitive, using hand-held instruments may be more comfortable for a professional cleaning. In the capable hands of a hygienist or dentist, it takes only moderate pressure to remove any stubborn buildup and scrub the teeth clean, regardless of which instruments are used.
Finally, your teeth are polished with a low-speed rotary brush fitted with a soft rubber tip. A slightly gritty, toothpaste-like gel is applied, and the tip spins around and polishes the teeth, making them smooth and shiny.
A Requirement for Good Oral Health
Most people don't feel any noticeable discomfort during dental cleanings; some even report they enjoy the experience — especially the dramatic results when it's done! If you haven't had a cleaning in a while, however, it may take you a few moments to get used to getting your teeth cleaned. If you experience any discomfort, however, it may be possible to apply a topical numbing gel or another type of anesthetic.
If your gums are irritated due to bacterial buildup, they may become sore or bleed slightly during the cleaning. It may be possible to prevent this from occuring in the future with oral hygiene measures you can perform at home (such as improved flossing techniques or special mouthrinses); it might also indicate that you need more frequent in-office cleanings. This type of regular maintenance will help you avoid more involved dental procedures down the road — and it will give you the best chance of keeping your teeth for life!
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