Understanding Gum Disease
Periodontal (gum) disease is a bacterial infection that goes after your gums and the bone supporting your teeth. The CDC estimates nearly half of adults over 30 in the United States have some form of it. The tricky part is that it’s often silent — no pain, no obvious warning signs — until real damage is already done. Gum disease has also been linked to cardiovascular disease, diabetes complications, preterm birth, and Alzheimer's, so keeping it in check matters for your whole-body health, not just your smile.
The Stages of Gum Disease
Stage 1: Gingivitis
The earliest stage, and the only one that can be fully reversed. Your gums may look red, puffy, or bleed when you brush or floss. Gingivitis comes from plaque building up along the gumline, and it’s cleared up with a professional cleaning and steady home care. Caught here, there’s no lasting damage at all.
Stage 2: Early Periodontitis
The infection has started attacking the bone and ligaments holding your teeth in place. Pockets form between the gum and tooth at 4–5 mm deep (healthy pockets measure 1–3 mm), and some bone loss shows up on your X-rays. Damage at this stage can be stopped, though not reversed.
Stage 3: Moderate Periodontitis
Pockets deepen to 5–6 mm. Bone loss is more noticeable, your gums begin to recede, and teeth may start to feel a bit loose. This stage calls for a deep scaling and root planing, often paired with a targeted antibiotic like ARESTIN, and a steady ongoing maintenance rhythm.
Stage 4: Advanced Periodontitis
Pockets pass 6 mm. Significant bone and tissue loss, teeth that shift or loosen, chronic bad breath, and pain. Treatment at this stage may need surgery from a periodontist and, in some cases, gentle extraction and implant replacement — all planned and explained before any next step.
How Your Gums Are Evaluated
Your hygienist does a full periodontal screening at every comprehensive exam. A small, calibrated probe measures the depth of the sulcus (the little space between your gum and tooth) at six points around every tooth. You’re also checked for bleeding on probing, gum recession, loose teeth, and any bone loss on your X-rays. Everything is charted so changes can be tracked visit by visit — and if anything is slipping, it gets caught early.
Scaling & Root Planing
If you have active gum disease, scaling and root planing (sometimes called a “deep cleaning”) is the reset. Unlike a regular cleaning that focuses on the visible part of the tooth, this one gently clears bacteria and hardened tartar off the root surfaces below the gumline. Local anesthetic keeps you comfortable throughout, and your mouth is usually treated in halves or quadrants across a couple of unhurried visits. Smoothing the root surface gives your gums a chance to reattach and those deep pockets a chance to shrink.
Periodontal Maintenance Visits
Once gum disease has been treated, it doesn’t simply disappear — it gets managed for life. Periodontal maintenance visits every three to four months replace the standard six-month cleanings for anyone with a history of gum disease. At each visit, pocket depths are re-measured, both sides of the gumline are cleaned, any returning tartar is removed, and localized antibiotics are used if they’ll help. Staying on that rhythm is by far the most effective way to keep your natural teeth for a lifetime.