Gum Disease

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Gum disease – also known as periodontal disease – is a condition in which the teeth, gums, and even the bones of the jaw become infected. Its typical cause is bacteria (which naturally occur in the mouth) and the acid these bacteria produce. This acid attacks the enamel of the teeth, which brings about a process called “demineralization”. Demineralization is countered by various ions found in saliva, which causes “remineralization” of dental enamel, but if the bacteria is overly abundant, and the acid it produces in great enough quantity, it can wear pits and eventually even holes in the enamel itself. Additionally, the ordinarily smooth surface of teeth can be roughened by the acid, allowing the bacteria to stick to the teeth and form a film called plaque. Plaque then secretes the acid directly onto the tooth, further weakening the enamel and enlarging the pits and holes. In time, plaque can harden to form tartar (or calculus).

The acid that damages the teeth is also harmful to the gums, causing them to be inflamed and to pull away from the teeth. This inflammation is known gingivitis (from the Latin gingiva, “gums” + –itis, Greek for “inflammation”). Worse still, plaque can grow below the gum line, allowing its acid to attack the roots of the teeth and even the bone of the jaw. This stage is what is known as periodontal disease.

Signs and symptoms

Only a dentist can properly diagnose gum disease, but a few warning signs may suggest that a trip to the dentist is in order.

Periodontal disease may be indicated by:

  • Teeth that feel loose or hurt while chewing
  • Persistent bad breath or bad taste that will not go away, even with brushing
  • Bleeding when brushing or flossing
  • Red, swollen gums that are tender and/or seem to have receded from the teeth

Since dentists are trained to treat gum disease, it is wise to be skeptical of chemicals or devices that claim gum disease can be treated at home.


When dentists check for periodontal disease, they will usually take a preliminary medical history since certain medical conditions can make people more prone to gum disease even if they maintain a robust dental hygiene regimen.

These conditions include:

Pregnancy and menopause

Hormonal changes contribute significantly to periodontal disease. Pregnancy is especially linked to gum disease, as gingivitis occurs in about 70% of pregnancies.

Additionally, women are particularly susceptible to gum disease as a result of hormonal changes brought on by menopause or the use of birth control.

Medical conditions, medicines, and substance use

Maladies like Crohn’s disease, leukemia, rheumatoid arthritis, and diabetes increase the risk of gum disease, as do medications such as some blood pressure medicines that cause dry mouth or cancer medicines that weaken immune systems.

Finally, tobacco and cannabis use (and especially if smoked) can render a person more likely to develop gum disease, as can excessive use of alcohol.


Numerous studies have shown that a predisposition to periodontal disease is hereditary.

In addition to a medical history, the dentist will want to examine the gums for signs of gum disease directly. This is done with a probe, which will measure the pockets to see if they have receded beyond the normal range (about 1 to 3 millimeters). The dentist will probably also want to take x-rays to see if any bone loss is present.


If gum disease is found, the dentist will recommend treatment options. These tend to depend on how severe the condition may be; if it is still in its early stages – if, in other words, the plaque has not gotten past the gumline – it can be treated with a rigorous but standard cleaning. From that point, the best procedure is to monitor the patient and dedicate increased attention to preventative oral hygiene.

In more advanced cases, the plaque and tartar may have extended below the gums; it may even have reached the root of the tooth itself. This will require more extensive procedures. Since plaque at this depth cannot be removed by a standard cleaning, its removal will require a “deep cleaning”, sometimes referred to as scaling and root planing. For this procedure, a thorough scraping of the teeth under the gums will get rid of all the bacteria and plaque. The roots of the teeth will then be resmoothed to make the gums reattach, and the procedure may also include the application of an antibiotic gel. This can take up to four hours but is usually not painful; a local anesthetic may be given to minimize discomfort.

Another treatment like PerioLase surgery may be needed. This uses lasers to remove residual bacteria and plaque and any tissue that is too damaged to survive. Laser surgery is usually nearly entirely pain-free.

If periodontal disease has damaged the gums and caused them to recede past their ability to return to their previous location, a graft may be used. This will take tissue from the top of the mouth and sew it into the gum area, which will cover the roots of the teeth and return the gum line to its original, healthy extent.

Finally, if gum disease has progressed to the point where teeth have been lost, missing teeth will need to be replaced. This may involve implants, and if the jaw has deteriorated, a bone graft may be performed to stimulate bone repair.

Triangle Periodontics offers a wide range of dental services to the Raleigh area, including a wide array of treatments for gum disease. For more information or to schedule an appointment, call (919) 782-9536 or e-mail