Periodontal Therapy

Periodontal disease, commonly known as gum disease, affects about 30% of the adult population.  It is the number one cause of tooth loss in adults.  While periodontal disease is not curable, it is controllable with regular visits and a well-rounded home care routine.

Gum disease can advance with few signs or symptoms in its early stages.  Many patients diagnosed with this condition experience no pain and are surprised by the quiet yet swift damage that periodontal disease leaves in its wake.  In simple terms, consider the gums and bone around your teeth as the foundation of a house.  Just like a house, the foundation must be sound regardless of the beauty of the home.  When the foundation crumbles, the rest of it does too.  

Regular dental exams, professional cleanings, and good oral hygiene practices are essential to detecting and managing periodontitis.

What Causes Gum Disease?

Our mouths provide a home to millions of bacteria, both beneficial and harmful.  Bacterial waste forms a sticky substance called plaque which adheres to the teeth.  Brushing and flossing aim to remove plaque before it mineralizes into tartar.  Tartar becomes a colony for more bacteria which then release toxins into the gums.  

Gums react to this bacterial invasion with an inflammatory response due to your immune system.  Around the base of each tooth, there is a small collar of gum tissue that forms a small crevice or pocket.  This warm, dark environment provides a perfect habitat for deeper tartar and bacteria to infiltrate. 

Early inflammation results in bleeding gums, known as gingivitis.  Bacteria left untreated and undisturbed successfully create a chronic infection in the periodontal pocket.  In many cases, the bone begins to deteriorate around the teeth.  While gums may be slightly tender at this stage, there's generally minimal discomfort as the bone begins to erode. 

More than 50% of the bone around your teeth can disappear before any signs of loose teeth or pain appears.  The bone around your teeth never regenerates, so this loss becomes permanent and harder to control as the bacteria hide deeper into the gums.  Untreated gum disease leads to abscesses and generalized tooth loss in many advanced cases.


There are several factors we take into account before we make a gum disease diagnosis.  The small collar of gum or pocket around each tooth usually sits 2 - 3 millimeters deep, a space easily cleaned by floss.  Dr. Raman or our hygiene team measure and chart multiple areas using a small measuring device called a periodontal probe.  If these measurements are more than 3 millimeters and bleed upon probing then periodontal disease is present.  Deeper readings indicate more advanced disease than shallower readings.  

Dr. Raman will also evaluate the texture and shape of your gums, and any movement detectable in each tooth.  It is also vital to examine the levels, shapes, and density of the bone around your teeth on digital x-rays.  By collecting all of this data, a clear picture forms about your gum condition.


After establishing a diagnosis defining the severity of gum disease, we can develop a personalized treatment plan.  In milder forms with little or no bone loss, one or two visits with our hygiene team may bring the condition under control.  When you leave our office with a strategy for daily home care and an established schedule for maintenance, little additional treatment may be needed.

If the inflammation has advanced and measurable bone loss is evident, a proactive approach to stop further deterioration should be strongly considered.  Often, we will suggest gentle numbing of your gums, and a more in-depth cleaning process sometimes called root planing or scaling.  Over a few visits, half or a quadrant of your mouth will be deep cleaned. The infected pocket around each tooth, including the mineralized tartar, must be carefully cleaned out with hand and ultrasonic instruments.  Polishing the teeth to establish glassy surfaces that help repel stain and plaque accumulation usually finish this initial therapy.

Dr. Raman may suggest a medicated rinse and electric toothbrush, and other specific strategies to help you with your home care routine.  Remember, gum disease can be controlled but not cured.  Dedicated daily efforts must be consistent to control the disease.

Maintenance Matters

Regular home care is critical to arrest the progression of gum disease.  Within a few hours of cleaning, the bacteria begin to repopulate and adhere to the teeth.  Plaque left undisturbed will start to harden and mineralize within 24 hours.  Remember, deeper gum pockets require even more diligence to prevent the bacteria from undermining the foundation of your teeth.  

Since gum pockets previously damaged by bacteria can be difficult to reach at home, a faithful maintenance schedule with us is essential.  We can customize your plan to include 2, 3, or 4 visits a year depending on the severity of disease, its response to treatment, and the consistency of home care.  

If our combined efforts don't slow or stop the progression of your gum disease, we will suggest you go to see a specialist known as a periodontist.  Whit specialized training in gum conditions, further treatment may be recommended.

Mouth-Body Connection

Research continues to establish clear links between bacterial disease in your mouth and ailments in other parts of the body.   Studies show a link between oral bacteria and conditions such as heart disease, stroke, arthritis, Alzheimer's Disease, and certain types of cancer. The relationship between a person's oral health and their whole-body health has never been more understood than it is today. 

Bleeding gums provide a direct pathway into the bloodstream, a journey that oral bacteria can quickly take.  If an open wound existed on your skin, infection would become a concern.  Gum tissue that bleeds should be looked at no differently.  This helps explain why researches continue to identify oral bacteria deposits in various areas of our bodies. 

Diabetes and other auto-immune disorders lower the body's ability to fight infection, allowing uncontrolled gum disease to advance faster and with more destruction.  Research also confirms that inflammation in the mouth can aggravate diabetes, making it harder to control.  This two-way relationship between two chronic conditions emphasizes the importance of optimal oral health.

OralDNA® Labs

Using a simple chairside oral rinse, OralDNA® Labs can safely and non-invasively collect saliva for testing in our lab to determine your risk of developing dental caries (cavities) and periodontal disease. Within the last decade alone, scientists have found an even stronger connection between oral health and conditions throughout the whole body. 

Tests available through OralDNA® Labs include:

Alert 2™ Helps to create a personalized treatment plan by providing a specific bacterial profile in combination with inherited genetic risk. Alert 2™ combines the most widely used test for oral pathogens that cause gum disease with inherited genetic risk to create a personalized treatment plan. All from the same simple oral rinse collection.

MyPerioPath® This test identifies and measures 11 specific bacteria in your mouth that cause gingivitis (early stage gum disease) and periodontal disease (late stage gum disease).

OraRisk® Caries a simple screening test that allows you to identify your bacterial risk for dental caries! This test can help determine your risk of developing caries before they develop and cause permanent damage to your teeth. 

MyPerioID® determines whether you are more likely to develop more severe gum tissue infections, such as periodontal disease. With this information, your dentist can identify which patients are at increased risk for more severe periodontal infections due to an exaggerated immune response and can personalize therapy and treatment before the disease takes hold.

As scientists continue to learn more about the connection between tooth decay, periodontal disease, and overall body wellness, access to tests like these can give you valuable information about your risk of developing certain diseases.

See all OralDNA® Tests >