Welcome to the FIRST informative blog of Terrace Hill Dental Center. We hope to provide some education to everyone about our practice philosophies and the procedures we can provide in our clinic. The first topic we are going to tackle is gum
disease. What is it? Why is it important? How do we treat all the different conditions that may exist?

What causes gum disease?

Have you ever wondered, “What is that substance I can scratch off my teeth if I haven’t brushed in a while?” Well, our mouths are full of bacteria, mucus, and other particles which are constantly forming a sticky, colorless “plaque” on our teeth. Brushing and flossing help get rid of plaque, but plaque that is not removed can harden and form “tartar” that brushing cannot clean. Only a professional cleaning by one of our awesome dental hygienists can remove tartar!


The longer plaque and tartar are on teeth, the more harmful they become, harboring bacteria that causes inflammation of the gums called “gingivitis.” With gingivitis, the gums become red, swollen, and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing and regular cleanings by a dentist/dental hygienist, and it does not include any loss of bone and/or
tissue that hold teeth in place.


When gingivitis is not treated, it can advance to “periodontitis,” meaning inflammation around the tooth. In periodontitis, gums pull away from the teeth and form spaces or “pockets” that become infected, and the damage is irreversible. The body’s immune system begins to fight the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Risk Factors

  • Smoking: Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the periodontal disease and also can lower the chances for successful treatment.
  • Hormonal changes in girls/women: These changes can make gums more sensitive and make it easier for gingivitis to develop.
  • Diabetes: People with diabetes are at higher risk for developing infections, including gum disease.
  • Other illnesses and their treatments: Diseases such as AIDS, cancer, and other immunological diseases and their treament modalities can also negatively affect the health of gums, as can treatments for cancer.
  • Medications: There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections, such as gum disease. Some medicines can even cause abnormal overgrowth of the gum tissue, which can make it difficult to keep teeth and gums clean.
  • Genetic susceptibility: Some people are more prone to severe gum disease than others.
  • Age/Gender: Although, teenagers rarely develop periodontitis, they can develop gingivitis. People usually don’t show signs of true gum disease until they are in their 30s or 40s, and men are more likely to have gum disease than women.

How do I know if I have gum disease?

Symptoms of gum disease include:

  • Bad breath that won’t go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Receding gums or longer appearing teeth

Any of these symptoms may be a sign of a serious problem, which should be checked by a dentist. At your next dental visit, the dentist or hygienist should:

  • Ask about your medical history to identify underlying conditions or risk factors that may contribute to gum disease.
  • Examine your gums and note any signs of inflammation.
  • Use a tiny ruler called a “probe” to check for and measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters. This test for pocket depth is usually painless.

The dentist or hygienist may also:

  • Take an x-ray to see whether there is any bone loss.
  • Refer you to a periodontist. Periodontists are experts in the diagnosis and treatment of gum disease and may provide you with treatment options that are not offered by your dentist.

How is gum disease treated?

The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up their home care. The doctor may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome.

Deep Cleaning (Scaling and Root Planing)

The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called “scaling and root planing.” Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease. In some cases, a laser may be used to remove plaque and tartar. This procedure can result in less bleeding, swelling, and discomfort compared to traditional deep cleaning methods.


Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment. Long-term studies are needed to find out if using medications reduces the need for surgery and whether they are effective over a long period of time.

How can I keep my teeth and gums healthy?

  • Brush your teeth twice a day (with a fluoride toothpaste).
  • Floss regularly to remove plaque from between teeth. Or use a device such as a special brush or wooden or plastic pick recommended by a dental professional.
  • Visit the dentist routinely for a check-up, x-rays, and a professional cleaning.
  • Don’t smoke!!

Can gum disease cause health problems beyond the mouth?

In some studies, researchers have observed that people with gum disease were more likely to develop heart disease or have difficulty controlling blood sugar. Other studies showed that women with gum disease were more likely than those with healthy gums to
deliver preterm, low birth weight babies. More research is definitely needed to clarify the link between oral health and overal body health, but in the meantime, it’s a fact that controlling gum disease can save your teeth – a very good reason to take care of your teeth and gums!!

Dr. Jay Henderson

Dr. Janice Touchstone