Healthy gums are the foundation of a beautiful smile. Dr. Hardin provides comprehensive periodontal disease treatment in Indianapolis, IN, at Harding Cosmetic and Family Dentistry. He can help you treat gum disease and restore your oral health. Our team provides gentle and effective restorative dental treatments so you maintain a healthy smile for life.
How Does Gum Disease Develop?
The word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums. Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease. Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.Common Causes and Risk Factors of Gum Disease
Gum disease is a serious dental problem that can lead to tooth loss if not treated. It often starts with red, swollen gums and can get worse over time. Some of the most common reasons why people develop gum disease include the following.Poor Dental Hygiene
Gum disease often starts when people don’t brush and floss their teeth regularly. Good dental care at home, along with regular visits to the dentist for cleanings, exams, and x-rays, helps keep your gums and teeth healthy. If plaque and tartar aren’t removed, they can cause the gums to become inflamed. Early signs like gum inflammation can develop into gum diease. Over time, gum disease can damage the bone around your teeth and lead to tooth loss.Tobacco Use
Smoking and using tobacco are major causes of gum disease. Tobacco makes it harder for your gums to heal and makes you more likely to get infections. Smokers tend to have more tartar buildup, deeper gum pockets, and more bone loss compared to non-smokers.Genetics
Some people are more likely to get gum disease because of their genes, even if they take good care of their teeth. Studies show that about 30% of people may be more at risk due to family history. A genetic test can help determine your risk, and early treatment can help prevent problems.Pregnancy and Menopause
Hormonal changes during pregnancy and menopause can make gums more sensitive and prone to infection. That’s why it’s especially important to brush, floss, and visit the dentist during these times.Chronic Stress and Poor Diet
Stress weakens your immune system, which makes it harder for your body to fight off the bacteria that cause gum disease. A poor diet can also affect your body’s ability to heal and keep your gums healthy. Getting enough vitamins and eating balanced meals helps support gum health.Diabetes and Other Health Problems
Certain medical conditions, like diabetes, heart disease, arthritis, and osteoporosis, can increase your risk of gum disease. For example, people with diabetes have a harder time fighting infections, which makes gum disease more likely and more difficult to treat.Teeth Grinding
Grinding or clenching your teeth, especially at night, can wear down the tissue that supports your teeth. If you already have gum disease, grinding can make it worse by putting extra pressure on the gums and bone.Medications
Some medicines can make gum disease more likely. These include birth control pills, heart medications, antidepressants, and steroids. Some drugs can cause gum swelling, which gives bacteria more space to grow and increases the risk of infection.Signs and Symptoms of Gum Disease
Gum disease can progress without any signs or symptoms. This is why regular dental checkups are important. Contact our office if you notice these signs:- Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
- Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
- New spacing between teeth – Caused by bone loss.
- Persistent bad breath – Caused by bacteria in the mouth.
- Pus around the teeth and gums – Sign that there is an infection present.
- Receding gums – Loss of gum around a tooth.
- Red and puffy gums – Gums should never be red or swollen.
- Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.
Diagnosis
Dr. Hardin can find signs of gum disease during a periodontal examination. This exam is an important part of your regular dental check-up and helps catch gum problems early. During the exam, Dr. Hardin uses a small tool called a periodontal probe. He places this thin instrument between your teeth and gums to measure the depth of the space, called a pocket. In healthy gums, these pockets are usually 3 millimeters deep or less and do not bleed. If the pockets are deeper or there is bleeding, it may be a sign of gum disease. Other things your dental team looks for include swelling, redness, bleeding, loose teeth, and how much your gums have pulled away from your teeth. These signs help us find your stage of gum disease and find the right treatment option.The Stages of Gum Disease
Knowing the stages of gum disease can help you understand what’s happening in your mouth and when it’s time to get treatment. Gum disease doesn’t usually hurt at first, so it’s important to know the warning signs and how the condition can progress if it’s not treated. The four main stages of gum disease affect your gums and teeth differently.Gingivitis
Gingivitis is the earliest and mildest stage of gum disease. At this point, your gums may look red, feel swollen, and bleed easily when you brush or floss. Gingivitis is caused by the bacteria in plaque, a sticky film that builds up on your teeth. It’s most common in people with poor oral hygiene, but some are more at risk, including pregnant women, people with diabetes, and those who take medications like steroids, birth control pills, or certain blood pressure medicines. The good news is that you can reverse gingivitis. With a professional cleaning and better brushing and flossing habits at home, your gums can heal.Early Periodontitis
If gingivitis is not treated, it can turn into early periodontitis. In this stage, the infection starts to spread deeper below the gumline. The gums begin to pull away from the teeth, forming small pockets. These pockets trap more bacteria and food, making the infection worse. You may notice bad breath, more bleeding, or slight tenderness in your gums. Dr. Hardin may recommend deep gum cleanings every 3 to 4 months to remove bacteria from your gums.Moderate Periodontitis
As the disease progresses, it becomes harder to control. The infection damages more of the gum tissue and bone that support your teeth. The pockets around your teeth become deeper, and your teeth may start to feel loose. You may also notice that your bite feels different or that chewing is uncomfortable. At this point, treatment becomes more involved. Dr. Hardin may recommend special deep cleaning or other procedures to stop the damage.Advanced Periodontitis
This is the most serious stage of gum disease. There is rapid loss of the gum and bone that hold your teeth in place. Teeth may become very loose or even fall out. Chewing can be painful, and your bite may change a lot. People who smoke or have a family history of gum disease are more likely to develop this advanced form quickly. At this stage, gum disease can no longer be reversed. You may need regular scaling and root planing, gum surgery, or even tooth replacement options.Periodontal Disease Treatment at Hardin Cosmetic and Family Dentistry
We offer several effective treatments at Hardin Cosmetic and Family Dentistry, to help stop the progression of gum disease and protect your gums. Our dental team uses gentle techniques and advanced tools to clean your gums, reduce infection, and promote healing.Professional Dental Cleaning
Regular cleanings help remove plaque and tartar from your teeth before they can cause gum disease. We recommend most patients come in for a professional cleaning every six months. These cleanings also allow our team to check your gums and catch any early signs of infection.Periodontal Scaling & Root Planing
The objective of scaling and root planing is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus). These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.Reasons for scaling and root planing
Scaling and root planing can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer. Here are some reasons why these dental procedures may be necessary:Disease prevention
The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body. Research has shown that lung infections and heart disease have been linked to periodontal bacteria. Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.Tooth protection
When gum pockets exceed 3mm in depth, there is a greater risk of periodontal disease. As pockets deepen, they tend to house more colonies of dangerous bacteria. Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss. Periodontal disease is the number one cause of tooth loss in the developed world.Aesthetic effects
Scaling and root planing help remove tartar and plaque from the teeth and below the gumline. As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planing procedure.Better breath
One of the most common signs of periodontal disease is halitosis (bad breath). Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing. What do scaling and root planing treatments involve? Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures. Depending on the condition of the gums, local anesthetic may be used. This decision depends on three factors. First, the amount of tartar. Second, the depth of the pockets. Third, how far the periodontitis has progressed.Scaling
This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.Root Planing
This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future. Following these deep cleaning procedures, the gum pockets may be treated with antibiotics. This will soothe irritation and help the gum tissues to heal quickly. During the next appointment, the dentist or hygienist will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended.Antibiotic Therapy
Sometimes, we use antibiotics to help fight infection in the gums. Antibiotics may be placed directly into the gum pockets or prescribed as a pill. These medications work alongside deep cleanings to stop bacteria and reduce inflammation. Oral Antibiotics Oral antibiotics affect your whole body and are usually prescribed for more serious gum infections. Different types include:- Tetracycline antibiotics: These include doxycycline and minocycline. They fight bacteria, reduce swelling, and help protect the tissues that support your teeth.
- Macrolide antibiotics: These help stop inflammation and reduce bacterial growth in gum disease.
- Metronidazole: Often combined with other antibiotics like amoxicillin or tetracycline, this medicine helps treat more severe or long-lasting gum infections.
- Atridox®: A gel with doxycycline that fits along the gumline and slowly releases medicine over several days.
- PerioChip®: A small chip placed in the gum pocket that slowly releases a powerful antiseptic (chlorhexidine) to reduce bacteria.
- Actisite®: A thin strip that looks like dental floss and contains tetracycline. It’s placed between the gum and tooth for about 10 days.
- Elyzol®: A gel or strip that contains metronidazole, which helps destroy both bacteria and parasites in the gums.
- Arestin®: We place a tiny capsule filled with minocycline into the gum pocket to fight bacteria after a deep cleaning.
Pocket Irrigation
Periodontal disease is a progressive condition which leads to gum inflammation, the recession of bone and gum tissue, and tooth loss if left untreated. There are a variety of effective treatments and procedures available, including pocket irrigation, which can assist in treating the progression of the disease. Pocket irrigation aims to cleanse plaque from the interdental (between teeth) and subgingival (under the gumline) regions of the mouth in order to prevent the colonization of harmful oral bacteria. This procedure is also used to deliver antibacterials to the subgingival areas. Reasons for pocket irrigation Pocket irrigation, which is also known as oral irrigation, is a versatile dental treatment used for several different preventative purposes. Pocket irrigation may be performed as part of a professional dental cleaning, or at home with a specially modified oral irrigator. Here are the main ways in which pocket irrigation can be beneficial:- Interdental cleaning – Pocket irrigators blast plaque, food particles and other debris from between the teeth. The removal of harmful materials and bacteria keep the gum pockets cleaner and shallower, helping the gum tissue remain healthy.
- Halitosis prevention – Halitosis (or bad breath) is generally a result of old food particles between the teeth, and tooth decay. A toothbrush or dental scraper alone may not be able to reach into the depths of the gum pockets, but water jets can flush out food particles and help clean above and below the gumline.
- Subgingival cleaning – Pocket irrigators have a rounded tip which eliminates the risk of tissue damage while cleaning under the gumline. The side port opening facilitates extensive cleansing by flushing out bacteria, particles and toxins from below the gumline.
- Antimicrobial application – Antimicrobial substances have proven effective for eliminating and preventing some strains of harmful oral bacteria. Antimicrobial substances can be combined with water, or used as a stand-alone treatment for successful pocket irrigation.
Gum Grafting
A gum graft (also known as a gingival graft or periodontal plastic surgery), is a collective name for surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue. Exposed tooth roots are usually the result of gingival recession due to periodontal disease. There are other common causes, including overly aggressive brushing and trauma. Here are some of the most common types of gum grafting:- Free gingival graft – This procedure is often used to thicken gum tissue. A layer of tissue is removed from the palate and relocated to the area affected by gum recession. Both sites will quickly heal without permanent damage.
- Subepithelial connective tissue graft – This procedure is commonly used to cover exposed roots. Tissue is removed fairly painlessly from the outer layer of the palate and relocated to the site of gum recession.
- Acellular dermal matrix allograft – This procedure uses medically processed, donated human tissue as a tissue source for the graft. The advantage of this is procedure is that there is no need for a donor site from the patient’s palate (and thus, less pain).
- Reduced sensitivity – When the tooth root becomes exposed, eating or drinking hot or cold foods can cause extreme sensitivity to the teeth. Gum grafting surgery permanently covers the exposed root, helps reduce discomfort, and restores the good health of the gums.
- Improved appearance – Periodontal disease is characterized by gum recession and inflammation. Gum recession and root exposure can make the teeth look longer than normal and the smile to appear “toothy.” Gum grafting can make the teeth look shorter, more symmetrical and generally more pleasing to look at. In addition, adjacent tissue can be enhanced and augmented during the procedure for aesthetic purposes.
- Improved gum health – Periodontal disease can progress and destroy gum tissue very rapidly. If left untreated, a large amount of gum tissue can be lost in a short period of time. Gum grafting can help halt tissue and bone loss; preventing further problems and protecting exposed roots from further decay.