Why Gum Disease Requires a Deep Clean

deep cleanRaleigh, NC

Gum disease – also referred to as periodontal disease – is the general name for when the teeth, gums, and even the bone around teeth become infected. Gum disease is ultimately caused by bacteria in the mouth and the acid the bacteria produce. This acid attacks the enamel of the teeth, which brings about a process called “demineralization” and, if sufficiently advanced, will lead to pits and eventually holes in the enamel itself.

Worse, the ordinarily smooth surface of teeth can be roughened by the acid, which allows for the bacteria to stick to the teeth. When it does, it forms a film called plaque, which can then secrete the acid directly onto the tooth. This plaque, in turn, can harden to form tartar (or calculus).

Gums are also sensitive to this acid, causing them to be inflamed and to pull away from the teeth. This stage is called gingivitis (from the Latin gingiva, “gums” + –itis, Greek for “inflammation”). Worst of all, the plaque can go below the gum line, and its acids can attack the roots of teeth and the jaw itself.

Periodontal disease in some form or another is quite common: a 2012 report from the Centers of Disease Control suggests it is present in almost half of all adults aged 30 or older. Incidence tends to increase with age, such that 70 percent of adults aged 65 or older has it. In fact, this is the origin of the expression “long in the tooth” to mean age: the teeth of elderly people are not longer but appear that way because the gums have receded.

Symptoms and of gum disease

Although only a dentist can properly diagnose gum disease, there are a few warning signs that may arouse suspicion.

Gum disease may be present if a patient has:

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

If these symptoms are present, a visit to the dentist may be in order.

Diagnosing gum disease

A dentist will note your medical history during an examination. This is important because while the main cause of gum disease is insufficient oral hygiene, certain medical conditions can make people more prone to gum disease no matter how attentive they are to their oral health.

These include:


Numerous studies have shown a direct connection between family members and severe periodontal disease. So, a dentist will want to know of a family history of gum disease.

Medical conditions, medications, and substance use

Certain medical conditions increase disposition to gum disease, including Crohn’s disease, leukemia, rheumatoid arthritis, and diabetes.

Likewise, medications that cause dry mouth (like some blood pressure medicines) or weaken immune resistance (such as cancer medicines) will make a person more prone to gum disease.

Finally, excessive use of alcohol, tobacco, and cannabis (especially if the latter two are smoked) can make a person more likely to develop gum disease.

Hormonal changes

Women are more prone to gum disease as a result of hormonal changes, including those brought on by menopause, pregnancy, or the use of birth control.

In addition, the dentist will want to examine the gums for signs of gum disease, using a probe to measure the pockets to see if the gums have receded beyond the normal range (about 1 to 3 millimeters). He or she will also want to take x-rays to see if any bone loss is present.

Treatment – deep cleaning

If the dentist concludes that gum disease is present, treatment will be recommended. In mild cases – as in, early-stage gingivitis – a cleaning will be sufficient to clear it up, and the focus will then be on preventing its return.

For more advanced cases, the plaque and tartar may have reached below the gumline and may have even reached the root of the tooth itself. This depth cannot be reached by a simple cleaning and will require a deep clean.

A deep clean is sometimes called “scaling and root planing”. The former consists of a thorough scraping of the teeth to get rid of all bacteria, plaque, and tartar. The latter consists of resmoothing the roots of the teeth to make the gums reattach. Once this is completed, additional treatments (such as PerioLase laser surgery) may be necessary.

A deep clean is needed to repair damage caused by gum disease. This procedure is time consuming and in some cases may take multiple visits. Nevertheless, only a deep clean can stop plaque and tartar. While it sounds daunting, it can be done fairly comfortably, with a numbing agent administered to reduce potential discomfort.

Triangle Periodontics offers a wide range of dental services, including treatment of gum disease, to the Raleigh area. For more information or to schedule an appointment