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Periodontal Treatment

What is Gum Disease?

Most people will have gum disease at some time in their life. Some of the common signs of gum disease are gums that are red, puffy or bleed.

Causes of gum disease:

Gum disease is usually caused by a build-up of plaque on teeth and along the gum line. Plaque is a sticky coating containing bacteria. The immune system tries to get rid of plaque with an inflammation response. This is seen by the redness and swelling of the gum around the tooth.

Everybody has a range of bacteria in their mouth. Plaque is constantly being formed by some of these bacteria when they feed on the sugars in the foods and drinks you consume. Plaque provides the perfect environment for the bacteria that can cause gum disease to live and multiply.

Stages of gum disease:

The two main stages of gum disease are:

  1. • Gingivitis
  2. • Periodontitis.


Gingivitis is early gum disease. It affects the surface layers of the gum, particularly where the gum meets the tooth. At this stage, there is no damage to the deeper parts of the gums, teeth or bone.

The signs of gingivitis are:

  1. • bleeding gums, especially when brushing or eating
  2. • redness and swelling of the gum.

The good news is that gingivitis can be reversed. You might think it is best to stop brushing if your gums are red or puffy. Try to keep brushing, as this will get rid of the bacteria and plaque that is causing the problem. Soon the gums should look and feel better. If not, see your dentist or dental hygienist.


Periodontitis is an advanced stage of gum disease that may occur if gingivitis is not treated.

The periodontium is the name given to a group of structures that surround and support the teeth, keeping the teeth in place. Periodontitis is the inflammation of the periodontium caused by the bacteria in plaque and the body’s immune response to it.

The structures affected by periodontitis include the covering of the tooth root (cementum), the bone and the fibres that connect the tooth root to the bone (periodontal ligament).

When the gum is weakened by gum disease, spaces can form between the tooth root and the gum. These spaces are called ‘periodontal pockets’. Bacteria get trapped in these pockets and cause even more damage to the periodontium. Over time, bone is damaged and lost, and larger spaces begin to form between the tooth and the gum.

If periodontitis is not treated, the structures that hold the tooth firmly into the gum can become so damaged that teeth become loose and may need to be removed.

Smoking and poorly managed diabetes are risk factors for periodontitis.

Signs of periodontitis include:

  1. • bleeding gums
  2. • swollen gums
  3. • receding gums (the gum line shrinks away from the tooth making teeth look longer)
  4. • bad breath
  5. • a bad taste in the mouth
  6. • tenderness when biting
  7. • loose teeth.

Treatments for Gum Disease

Treatments range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues.

Non-surgical Treatments for Gum Disease

Non-surgical therapy removes plaque and calculus by controlling the growth of harmful bacteria and by treating conditions that encourage gum disease. This type of treatment may be all that's needed, especially when periodontal disease is caught early. During a typical checkup your dentist or dental hygienist will remove the plaque and tartar (plaque that builds up and hardens on the tooth surface and can only be removed with professional cleaning) from above and below the gum line of all teeth. If you have some signs of gum disease, your dentist may recommend professional dental cleaning more than twice-a-year.

Scaling and root planing

This is a deep-cleaning, nonsurgical procedure, done under a local anesthetic, whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing). Smoothing the rough spots removes bacteria and provides a clean surface for the gums to reattach to the teeth. Scaling and root planing is done if your dentist or hygienist determines that you have plaque and calculus (hardened plaque, also called tartar) under the gums that needs to be removed.

Prevention of gum disease

Regular tooth brushing helps to prevent gum disease by removing the plaque that causes it.


  1. • Brush teeth and along the gum line twice a day, in the morning and before going to bed.
  2. • Use a toothbrush with a small head and soft bristles.
  3. • Over 18 months of age, use a fluoride toothpaste, low fluoride for children aged 18 months to six years of age and standard fluoride for people six years and older.
  4. • After brushing, spit out toothpaste, don’t swallow and don’t rinse with water. This leaves a small amount of fluoride in the mouth to protect teeth.
  5. • Floss or use interdental brushes to clean between your teeth at least once a day.

Eating well can also help prevent gum disease. Sugars provide the food for some types of mouth bacteria to multiply and form a plaque layer on the teeth and gums. A high-sugar diet can contribute to a thick layer of plaque. Avoiding sugary foods and drinks, especially between meals, can help to keep plaque levels under control.

Follow the Australian Dietary Guidelines and enjoy a wide variety of nutritious foods from the five food groups every day, including vegetables, fruit, grain foods, lean meats (or alternatives), dairy (or alternatives). Drink plenty of water.
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