Healthy gums fit snugly around teeth and are light pink in color. Gums that bleed easily, feel puffy or look red are warning signs of gingivitis, an early stage of Periodontitis.

Left untreated, gingivitis advances to periodontitis, which destroys the bone and tissue that support your teeth. Dr Jeremy Vo can use membranes, bone grafts and other procedures to reverse some of the damage.

Symptoms

Bacteria naturally grow in the mouth, but if they aren’t removed regularly with brushing and flossing, they can build up and harden on the teeth, forming plaque. Plaque can also lead to gum inflammation, which results in gingivitis. This early stage of gum disease is reversible with proper dental care. If left untreated, however, the bacteria can destroy the bone and tissue that support the teeth. This can result in severe pain while chewing, bad breath and loose teeth.

During a dental exam, your dentist will check for signs of periodontitis. They will measure the depth of the pockets in your gums with a probe, take X-rays and consider your health history before making a diagnosis. They may refer you to a specialist called a periodontist.

Diagnosis

Your periodontist will diagnose periodontitis by inspecting your teeth and gums, including the depth of the pockets around each tooth (measured with a probe to within a millimeter). A bacterial etiology combined with a host response leads to the breakdown of the tissue and bone that supports the teeth.

At this stage, the inflammation is localized to the gums and can be reversed with proper oral hygiene and a routine professional dental cleaning. Symptoms may include red and puffy gums that bleed easily, especially when brushing or flossing; persistent bad breath; a foul taste in the mouth; shifting teeth; or new gaps between teeth.

Smoking, certain health conditions and hormonal changes can increase your risk for periodontitis. It’s important to see your dentist and hygienist regularly on the schedule they recommend so they can spot any potential problems early and help you keep them in check. Medications such as an antimicrobial mouth rinse or an antibiotic gel that releases medication over time can control the infection and decrease pocket depth.

Treatment

During this mild stage, the gums are red and swollen and might bleed when brushing. The gums may also appear spongy or have a bad taste in the mouth. It is possible to reverse gingivitis with professional treatment and excellent oral-hygiene practices.

During the early stages of periodontitis, the bacteria in the plaque have gotten underneath the gum line and begin to damage bone and tissue. Symptoms in this phase include deep pockets between the teeth and gums that fill with pus and harbor harmful bacteria. This ongoing inflammation can lead to tooth loss and affect systemic health, including a person’s heart attack risk.

The first step in treating periodontitis is thorough scaling and root planing (professional cleaning of the teeth and roots with hand or ultrasonic instruments) to remove the bacteria that cause disease. In addition, antibiotic treatments such as Arestin or a prescription-strength chlorhexidine swab or rinse can reduce bacteria growth and help control inflammation.

Prevention

When bacteria cling to the teeth, they form a sticky film called plaque. This irritates the gums, making them red and swollen and causing them to bleed when they are brushed. Eventually, the bacteria release acids that damage the tooth enamel, and the immune system responds by attacking the bacterial colonies. This inflammatory response results in the loss of gum tissue and bone around the teeth.

At this stage, the gums begin to pull away from the teeth and form pockets. These pockets collect food debris, and harmful anaerobic bacteria thrive. As the bacteria attack the gums and bones, they cause further tissue and bone loss, resulting in loose or missing teeth.

To prevent periodontitis, daily brushing and flossing, professional dental cleanings on a regular basis, and avoiding smoking are essential. A balanced diet that is low in sugar and starch can also help by fueling the body’s natural defenses against infection. In addition, avoid clenching and grinding your teeth as this puts excess stress on the supporting tissues of the mouth.