The word periodontal means “around the tooth.” Periodontal disease attacks the gums and the bone that support the teeth.
It all starts with plaque. Plaque is a sticky film of food debris, bacteria, and saliva. Over time plaque turns into calculus (tartar). Plaque and calculus can destroy the gums and bone if they are not removed. That is why it is so important to maintain good dental hygiene with regular cleaning and scaling.

Four out of five people who have periodontal disease are not aware of it. This is because the disease is usually painless in the early stages.
Not only is it the number one reason for tooth loss, research suggests a link between periodontal disease and other diseases such as stroke, diabetes, cardiovascular disease, and increased risks during pregnancy. Smoking also increases the risk of periodontal disease.

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 fibres (fibres that attach 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 – A sign that an infection is 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

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.

A periodontal probe (a small dental instrument) is gently used to measure the sulcus or space between the tooth and the gums. A healthy sulcus is no more than three millimetres deep and does not bleed. The pockets usually deepen as periodontal disease progresses.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc. to make a diagnosis that will fall into a category below:

Gingivitis: the first stage of periodontal disease. Plaque and its toxic by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis: plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.

Advanced Periodontitis: the teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.

Good oral hygiene, a balanced diet, and regular dental cleanings and checkups will help reduce your risk of developing periodontal disease.

A number of factors can cause gum recession. Some of the common causes are:

poor oral hygiene
aggressive brushing over a long period of time
improper brushing technique
brushing with a medium or hard bristled toothbrush
smoking
thin gingiva
malpositioned teeth

Recession exposes the root surface of a tooth, possibly making the teeth sensitive, more prone to decay, and uncomfortable when eating or brushing . The appearance of “longer” teeth can make you look older and your smile less attractive. Teeth can fall out if recession is not treated.

Soft tissue grafting is a simple surgical procedure which can correct gum recession. The procedure involves taking a healthy piece of gum tissue from an area near the area of recession or from the roof of the mouth and attaching it to the area with gum loss.
Soft tissue grafting creates a new protective barrier, covering the exposed root and resisting further bone loss, sensitivity, and decay. It can be done for one or several teeth to straighten the gum line and improve the appearance of your smile.

Pocket reduction surgery, also known as periodontal or flap surgery, is done to gain better access to the roots of the teeth. It gives the dentist a clearer view of the entire tooth, permitting thorough debridement (cleaning), and allowing the gum tissue to attach more securely to healthy bone.

Reducing pocket depth and removing dangerous bacteria help you maintain a healthy smile by preventing the damage caused by periodontal disease. Deep pockets are more difficult for you and your dental care professional to clean. Shallow pockets, combined with good daily oral hygiene and professional dental care, increase your chances of keeping your natural teeth – and decrease the chance of developing the serious illnesses associated with periodontal disease.

Pocket reduction surgery is similar to other periodontal procedures. Access to the roots is gained by elevating a “flap” of the gums. The roots are thoroughly cleaned, removing disease-causing bacteria, and irregular surfaces on the bone are smoothed to remove areas where bacteria can hide. The tissue is then returned to its normal place. Most patients are back to work the next day.

Missing teeth can lead to further complications, such as bone loss, changes in facial structure, difficulty chewing, and changes in speech. We can discuss ways to replace missing teeth once we have managed your periodontitis. This may involve dental implant surgery, dental crowns, or bridges. These are durable, natural-looking tooth restoration options that can improve your oral health.