Periodontal Disease

​​Periodontitis, often referred to as gum disease, is an inflammatory condition that affects the soft tissues surrounding the teeth. In its early stage, known as gingivitis, the gums become red, swollen, and prone to bleeding.

If not addressed promptly, the condition can progress past gingivitis, causing the gums to gradually recede and expose the tooth roots, leading to potential tooth loss.

As the gums detach from the teeth, small pockets form, trapping debris and becoming susceptible to infection. The accumulation of plaque beneath the gum line causes these pockets to deepen and results in further damage to the gum tissue and bone.

The treatment approach for periodontitis varies depending on the severity of the condition. Possible treatments include non-surgical procedures, such as thorough dental cleanings, or surgical interventions, like bone grafting for dental restoration.

Causes of Periodontal Disease

Periodontal disease, also known as gum disease, is caused by the buildup of plaque and bacteria around the teeth and gums, which can lead to inflammation, infection, and damage to the supporting tissues.

Several factors can contribute to the development of periodontal disease:

  1. Poor oral hygiene: Inadequate brushing and flossing can lead to plaque buildup, which can eventually harden into tartar. This creates an environment in which harmful bacteria thrive and cause gum inflammation and infection.
  2. Smoking: Smoking increases the risk of developing periodontal disease, as it reduces blood flow to the gums and weakens the immune system, making it more difficult for the body to fight off infection.
  3. Genetics: Some people may be more susceptible to periodontal disease due to their genetic makeup.
  4. Age: The risk of developing periodontal disease increases with age, as the gums and supporting structures of the teeth can weaken over time.
  5. Hormonal changes: Fluctuations in hormones, such as during pregnancy or menopause, can make the gums more sensitive and susceptible to infection.
  6. Medications: Certain medications, such as those used for high blood pressure or depression, can cause dry mouth or affect the gums, increasing the risk of periodontal disease.
  7. Chronic illnesses: Conditions like diabetes, heart disease, and rheumatoid arthritis can also increase the risk of developing periodontal disease.
  8. Stress: High-stress levels can weaken the immune system, making it more difficult for the body to fight off infection.

To prevent periodontal disease, it is essential to maintain good oral hygiene habits, including regular brushing, flossing, and dental check-ups.

Additionally, lifestyle changes, such as quitting smoking, managing stress, and maintaining a healthy diet, can help reduce the risk of developing gum disease.

Signs of Periodontal Disease

Signs of periodontal disease include:

  1. Swollen, red, or tender gums: Inflammation is one of the first signs of periodontal disease, and it may cause the gums to appear swollen or red and feel tender.
  2. Bleeding gums: Gums that bleed during or after brushing or flossing could be a sign of periodontal disease.
  3. Receding gums: If your teeth appear to be longer than before or if the gum line is pulling away from the teeth, it could be an indication of gum recession, which is often associated with periodontal disease.
  4. Persistent bad breath: Bad breath that doesn't go away even after brushing, flossing, and using mouthwash can be a sign of periodontal disease.
  5. Loose teeth: Periodontal disease can cause the supporting tissues around the teeth to weaken, leading to loose teeth.
  6. Changes in bite: If you notice a change in the way your teeth fit together when you bite, it could be a sign that the bone and tissue surrounding your teeth are being affected by periodontal disease.
  7. Pus between teeth and gums: The presence of pus is a sign of infection, which can be a symptom of periodontal disease.
  8. Pain when chewing: Discomfort or pain while chewing can be a sign of gum inflammation or damage caused by periodontal disease.

If you experience any of these symptoms, it's important to consult a dental professional for an evaluation and appropriate treatment. Early detection and treatment can help prevent further damage and potential tooth loss.

How Periodontal Disease is Diagnosed

Periodontal disease, also known as gum disease, is diagnosed through dental examinations, assessment of the patient's dental and medical history, and clinical tests. Here are the steps typically involved in diagnosing periodontal disease:

Dental Examination

A dentist or periodontist will visually examine your gums, teeth, and overall oral hygiene. They will look for signs of inflammation, redness, swelling, or bleeding in your gums.

Medical and Dental History

Your dentist will review your medical and dental history to identify possible risk factors for periodontal diseases, such as smoking, diabetes, or a family history of gum disease.

Measuring Pocket Depth

The dentist or periodontist will use a small dental probe to measure the depth of the spaces (pockets) between your teeth and gums. Healthy gums typically have a pocket depth of 1-3 millimeters. Deeper pockets may indicate the presence of periodontal disease.


Dental X-rays may be taken to evaluate the health of the bone supporting your teeth and to detect any bone loss or other issues that may not be visible during the visual examination.

Assessing Tooth Mobility

Your doctor may gently wiggle your teeth to check for any looseness or movement, as this can be a sign of advanced periodontal disease and bone loss.

Based on the results of these tests, your dentist or periodontist will determine the stage of periodontal disease (if present) and recommend an appropriate treatment plan to help you manage and improve your oral health.

Treatments for Periodontal Disease

Selecting the most suitable treatment for periodontal disease depends on the extent of gum deterioration and your specific situation. Upon assessing your oral health, your dental professional may suggest one or more of the following treatment methods:

  • Thorough dental cleaning: Also known as Scaling and Root planing (SRP), a deep dental cleaning effectively removes accumulated minerals, such as plaque and tartar, from your teeth and gums, alleviating inflammation in the process.
  • Restorative dentistry: Outdated dental restorations can contribute to plaque buildup and cause irritation to your gums. By employing restorative dentistry, your dentist will remove the old, worn-out treatments and replace them with new restorations, crowns, or bridges, enhancing your overall oral health.
  • Gingival grafting: This procedure is designed to cover exposed tooth roots and increase the volume of receded gum lines. By doing so, gingival grafting provides better protection for your teeth and enhances your smile's appearance.
  • Crown lengthening: If dental decay beneath the gum line has caused teeth to break or crack, a crown lengthening procedure can assist in adding the necessary tooth structure for subsequent restoration. Additionally, this treatment may improve the ease of cleaning the affected area, reducing the risk of future decay.
  • Ongoing maintenance: Regular dental check-ups and professional cleanings play a crucial role in preventing the progression of dental decay and ensuring long-term oral health.

By following your dentist's recommendations and adopting a consistent oral care routine, you can effectively combat periodontal disease and maintain a healthy, confident smile.

Complications of Untreated Periodontal Disease

Addressing periodontal disease as early as possible is essential to prevent complications and maintain optimal oral health. If left untreated, periodontal disease can lead to the following complications:

  1. Tooth loss: Advanced periodontal disease can destroy the supporting structures of the teeth, leading to tooth loss.
  2. Receding gums: As the disease progresses, gums may recede, exposing the tooth's root and making it more susceptible to decay and sensitivity.
  3. Infection: Bacteria from the infected gums can spread to other parts of the body through the bloodstream, leading to other health issues.
  4. Bone loss: Periodontal disease can lead to the loss of bone that supports the teeth, which may result in loose teeth or tooth loss.
  5. Bad breath: Untreated periodontal disease can cause persistent bad breath due to bacteria and plaque buildup.
  6. Impact on overall health: Research has linked periodontal disease with an increased risk of heart disease, stroke, diabetes, and respiratory diseases.

Tips for Preventing Periodontal Disease

Incorporating the following tips into your daily routine can significantly reduce your risk of developing this harmful condition.

  1. Practice good oral hygiene: Brush your teeth at least twice a day using fluoride toothpaste and a soft-bristled toothbrush. Floss daily to remove plaque and food particles between your teeth and the gum line.
  2. Visit your dentist regularly: Schedule routine dental checkups and cleanings every six months to remove plaque and tartar buildup that cannot be eliminated through brushing and flossing alone.
  3. Eat a balanced diet: A healthy diet rich in vitamins and minerals, particularly vitamin C and calcium, can help strengthen your teeth and gums, making them more resistant to infection.
  4. Avoid tobacco products: Smoking or using smokeless tobacco can significantly increase your risk of periodontal disease and other oral health issues. Quitting tobacco use can improve your overall oral health significantly.
  5. Limit sugary and acidic foods: Consuming excessive amounts of sugary or acidic foods can cause tooth enamel to erode, leading to an increased risk of gum disease. Opt for healthier food choices and drink plenty of water.
  6. Manage stress: Chronic stress can weaken your immune system, making it more difficult for your body to fight off infections, including gum disease. Practice stress-reducing techniques, such as meditation, exercise, or deep breathing, to maintain a healthier immune system.
  7. Use a mouth rinse: An antimicrobial mouth rinse can help reduce plaque and bacteria in your mouth, lowering the risk of periodontal disease. Consult your dentist for recommendations on the best mouth rinse for your needs.

By following these tips and maintaining a strong oral care routine, you can effectively reduce your risk of developing periodontal disease and enjoy a healthier, happier smile.

Periodontal Disease Treatment in Honolulu, HI

Black Point Dental offers treatment for patients dealing with gingivitis and periodontitis. We offer comprehensive preventative dentistry to avoid dental issues and periodontal dental care to treat gum disease symptoms.

Dr. Patrick Ferguson is a member of the Hawaii Dental Association, the American Dental Association, and the American Board of Oral Implantology. Black Point Dental offers comprehensive periodontics advanced dental services.

To schedule a consultation or appointment, call us at (808) 955-5922 or request an appointment online. You can also visit our office in Honolulu, HI

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