Before getting into the ins and outs of treating periodontitis, or advanced gum disease, let's repeat the really, really good news about gingivitis again: It is treatable and reversible. If you have the telltale symptoms mentioned earlier in this article, it's best to get to a dentist as soon as possible and start taking care of the problem. Once plaque has hardened, whether below or above the gum line, it has to be removed by professional cleaning.
A dentist and hygienist can use ultrasonic devices and good old fashioned dental picks to chip off the calculus or tartar and return teeth to their smooth-sided selves. Gums can then cling and cozy up next to the tooth surfaces as inflammation subsides, and with follow-up care, gingivitis has less of a chance of rearing its swollen head until plaque builds again.
If gingivitis has been left untreated and periodontitis is advancing, a dentist may start by checking the depth of the problem, literally. Periodontal probes, the kind many dread to see coming at their open mouths, do a lot to assess the gum damage and course of treatment needed. These probes are marked with grooves that measure the depth of pockets between the gums and teeth. Sliding the probe gently into the gum line and noting where the tip stops helps determine how much the gum disease has progressed. Healthy gums have about 1 and 3 millimeters of space, while larger and deeper pockets show diseased tissues and areas where teeth need to be deep cleaned [source: NIH].
Treatment for gum disease involves the whole mouth and not just the gums. Because gingivitis starts first with plaque and tartar buildup on the teeth, which irritates gum tissues and keeps them from clinging tightly to tooth surfaces, cleaning the teeth is an important part of treatment. Battling the toxins and infections within the pockets is essential. When deep pockets have developed, the dentist or periodontist will likely perform one or several procedures:
- Scaling -- Removing tartar buildup from teeth both above and below the gum line
- Root planing -- Forcing off remaining buildup and smoothing rough spots deep along the sides of teeth and at roots
- Killing bacteria -- Using medications either on the teeth topically, such as rinses and gels, or through oral antibiotics to kill and repress bacteria in the mouth and/or body
- Surgery and grafts -- Pulling back the gums to get inside for thorough cleaning and grafting new tissues or bones to rebuild recessed areas of tissue and bone. Some interventions attempt to restart bone growth.
Probes and visual exams are two tools a dental professional will use to assess damage and make a care plan. X-rays will be used to check for bone loss between the roots, gums and jaw bones. Sometimes too much damage and bone loss have occurred and teeth have to be extracted or will fall out, but dentists are trained first and foremost to save teeth, so gum disease interventions will likely be aggressive treatments to kill bacteria, repair tissues, and establish root and bone health to save teeth. Although it isn't reversible, gum disease is very treatable [sources: NIH; Mayo Clinic; AAP].
Toxins, root cleaning, antibiotics and surgery! Can all of this be prevented? In most cases, yes, it can. Take a look at some ways to tighten up you oral care and gums, next.