Periodontal Disease

Periodontal Disease Burbank - Dr. Diana Sedler - Cutting Edge Periodontist
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If you were bleeding from a cut, you would immediately assess the damage and treat the injury. Bleeding isn’t normal – it’s a cry for help. Nonetheless, many people still think it’s normal for their gums to bleed when they are brushing or flossing. Bleeding gums are an indication that your gums have been infected with bacteria, which can spread below the gum line and affect surrounding bone and tissue, leading to periodontal disease. This is usually caused by poor oral hygiene.

If periodontal disease is detected early, it is possible to prevent and reverse any damage. However, if left untreated and unaddressed, periodontal disease can eventually lead to gum recession, bone loss, and total edentulism (toothlessness). Use this guide to learn about periodontal disease and identify the stages of the disease to determine the proper treatment.


What is Periodontal Disease?

What Is Periodontal Disease? Glendale Periodontist

Periodontal disease is a common type of gum infection that can eventually destroy the jawbone and cause tooth loss. The word “periodontal” consists of the words perio, meaning around, and dontal, which refers to teeth. “Periodontal” refers to the structure around the teeth, such as the tissue, bone, and ligaments. Periodontal disease is caused by plaque buildup on your teeth, which can then spread below the gum line. When the disease spreads, it damages the gums and tissue holding teeth in place.

Below we will explore the different stages of periodontal disease. Treating the disease in the early stage and quickly is critical.

Periodontal Disease Pathology

Stages of Periodontal Disease

Gum disease is largely thought to be caused by the actions of tiny bacteria. This is true across the board, from mild gingivitis to severe periodontitis.

Typically, periodontal disease begins as a harmless biofilm, or bacterial buildup, along the gumline of a person’s teeth. Over time, this biofilm buildup leads to hardened calculus and tartar, which, in turn, accelerates the buildup of other harmful types of bacteria. Eventually, the toxins released by these bacteria damage gum tissues, resulting in gum recessions and full-blown periodontal disease.


Factors that Contribute to Periodontal Disease

What Is Periodontal Disease? Glendale Periodontist

Plaque is the number one cause of periodontal disease. Plaque is a sticky film of bacteria. This bacteria forms on the surface of teeth throughout the day and night. One specific type of bacteria that resides within dental plaque is streptococcus mutans. Streptococcus mutans feed off the sugars that enter the mouth from a person’s diet. These bacteria then release acids that start to dissolve the tooth’s outer layers. When tooth enamel is attacked, it can eventually result in cavities.

Brushing, flossing, and being committed to routine dental exams and cleanings help control plaque build-up and damage. However, when plaque is not removed with daily brushing and flossing, it can harden and form tartar or calculus. The more tartar forms, the more difficult it is to remove, and teeth cleaning becomes more difficult.

Tartar that collects under the tissue can become highly problematic. Tartar under the gum line can cause inflammation. As a result, the gums can become red, swollen, and bleed. This is the beginning stage of periodontal disease called gingivitis.

Several factors can contribute to periodontal disease:


1. Poor dental hygiene

Poor dental hygiene, including poor brushing habits and not flossing daily, sets the basis for gingivitis to begin.


2. Heredity

Heredity has been shown to play a factor in contributing to a person’s development of gingivitis.


3. Hormonal changes

Hormonal changes, including changes during menopause, puberty, and pregnancy, affect the blood supply to the gum tissue. This affects the body’s response to the toxins that plaque releases.


4. Health factors

Health factors can directly affect the condition of the gum tissue. These health issues include:

  • Cancer
  • HIV
  • Diabetes
  • Immune system deficit


5. Medications

Medications can affect the flow of saliva.

Saliva protects the teeth and gums, and when medication alters the salivas’ ability to function, the gum tissues can be adversely affected.


6. Smoking

Smoking adversely affects the gum tissue, making it hard for gum tissue to repair itself.


7. Stress

Stress, especially prolonged stress, has been found to strongly correlate with gum disease. Stress causes the body to release inflammatory hormones, which have been shown to cause or worsen gum disease.



8. Misaligned or crowded teeth

Misaligned or crowded teeth may be a factor in periodontal risk. Whenever the ability to remove plaque from teeth is impeded, the risk of developing gum disease increases.


9. Improperly fitted dental crowns, bridges, or dental implants

Improperly fitted dental crowns, bridges, or dental implants may also play a role in causing periodontal disease.

Poor dental work can cause food to be trapped, encouraging bacterial growth.


10. Poor diet

A poor diet or outright malnutrition is a risk factor for periodontal disease. Healthy diets rich in vitamin C are crucial to staving off gum disease.


The key to good oral health is to work daily to eliminate plaque accumulation from the surface of the teeth. Plaque buildup leads to tartar buildup. If left unchecked, this can cause painful, swollen, red, and bleeding gums. Ultimately bone loss can occur, and teeth can become loose and fall out.

In addition, improper oral hygiene causes periodontal disease to arise.



Stages of Periodontal Disease

Periodontal Disease

Periodontal disease is a progressive affliction that gets worse over time. As a result, the signs and symptoms of early-stage periodontal disease may look different than the effects of late-stage periodontal disease. To better understand how gum disease works and advances, it is important to understand how periodontal disease staging is defined according to the American Academy of Periodontology (AAP). It is also important to understand what forms periodontal disease may take.

Stage 1: Initial Periodontitis

Gingivitis - Periodontal Disease

The first stage is commonly referred to as gingivitis.

Signs of gingivitis include redness and swelling of the gums.

Gums that bleed while brushing or flossing can also be an important early indication of gingivitis.

Catching periodontal disease in its early form is crucial. Early treatment consisting of improved oral hygiene habits and professional care can help prevent further deterioration and even reverse the damage.

At this stage, untreated periodontitis can still affect the jawbone and surrounding tissue and lead to the separation of the gums and teeth.

Stage 2: Moderate Periodontitis

Moderate Periodontitis - Burbank Periodontist

This Moderate Periodontitis stage includes the following symptoms:

  • Damage to supporting gums
  • Teeth in the form of gum recession
  • Separated gums
  • Loose teeth
  • Bad breath
  • Possibly signs of pus

Pockets formed from loose gingival tissues can form and deepen over time, making them very difficult to clean. Bacteria that gather in these pockets further accelerate damage to gum tissues and bone. This can cause the disease to progress rapidly and without warning.

At this stage, professional therapies performed by a periodontist are necessary to remove bacteria and monitor symptoms to stop the disease from progressing.

Stage 3: Severe Periodontitis – with potential for additional tooth loss

Severe Periodontitis with additional tooth loss

Much of the damage to the gums and teeth is permanent and cannot be reversed at this stage.

Teeth increase their sensitivity to heat or cold, which leads to pain when eating hot or cold foods.

Extensive damage to soft tissues and the bone tissues that support the teeth may eventually lead to tooth loss.

To prevent the disease from spreading, a periodontist may need to remove rotted teeth and infected tissues.

Stage 4: Severe Periodontitis – with potential for loss of the dentition

Stage 4 - Severe Periodontitis

Once a patient reaches Stage 4, the chances of retaining or salvaging their natural teeth are quite slim. As a result of severe receding gums, the remaining teeth are unsupported. Fibers, bone, and ligaments that support the teeth and anchor them are destroyed, resulting in widespread tooth loss.


Forms of Periodontitis

Types of Gum Disease

Gum disease can refer to multiple types of infections of the gums, tissue, and underlying periodontal bone tissues.

Each person’s case of periodontitis can vary in the severity of the disease.

Besides staging, another essential way to categorize the different types of periodontitis is what form it takes. Recognized forms include:

  1. Standard Periodontitis (which is described by staging)
  2. Necrotizing Periodontitis
  3. Periodontitis – as a result of systemic diseases

1. Standard Periodontitis

Stages of PeriodontitisAs described above, standard periodontitis is typically represented by its stages. In general, each stage is based on the severity and complexity of the management required to treat the disease.

2. Necrotizing Periodontitis

Necrotizing periodontitis is a unique form of gingivitis that spreads quickly and leads to rapid tissue death, or necrotization, in the mouth.

Below are three generally recognized types of necrotizing periodontitis.

  • Necrotizing gingivitis
    This form of the disease affects only the gums, with patients suffering from bleeding gums, pain, and bad breath.
  • Necrotizing periodontitis
    This is indicated by receding gums firmly attached to the teeth. Other symptoms include severe pain, spontaneous bleeding, loss of bone, or exposed bone.
  • Necrotizing stomatitis
    Stomatitis refers to sores in the mouth. This is an aggressive form of gum disease resulting in mucosal and bone loss to the gums and tissue that surround the teeth. Other symptoms include frequent bleeding, severe pain, multiple affected teeth, and gaps between teeth.

3. Aggressive Periodontitis

Periodontal disease does not operate in a vacuum. While it is often initiated by bacteria infection and exacerbated by an overabundance of bacteria, many cases of periodontal disease can be tied to other underlying systemic health issues. According to Nature, periodontal disease is associated with several other systemic diseases, including respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome, and cancer.

This new understanding of how oral diseases, such as periodontitis, may be linked to other chronic diseases has changed the way periodontists and doctors view periodontal disease.

As a result, doctors now categorize cases of periodontitis that arise from an existing condition in a separate group.

Understanding the underlying health causes driving or exacerbating periodontal disease can help periodontists develop a holistic therapy that addresses not only the symptoms of periodontitis but also the root causes.


What Do Healthy Gums Look Like?

Healthy Gums - Toluca Lake Periodontist

Healthy gums are firm and pink.

Furthermore, gums that are in good shape do not bleed at all with routine brushing and flossing.

To keep or obtain healthy gums, it is essential to implement good oral hygiene in your daily life.

Regularly brush your teeth gently, and ensure all parts and surfaces are clean. Also, make sure to brush along your gum line. The American Dental Association recommends brushing for a full two minutes twice a day.

The first sign of gum disease is the inflammation of the gums.

So what are healthy gums supposed to look like?

Here’s a healthy gums checklist for comparison.

  • Healthy gums should be firm and light to a medium pink (or a darker pink depending on your skin pigmentation).
  • Healthy gums do not bleed easily. Sometimes it is easy to miss bleeding if it doesn’t make it to the sink. If there’s a metallic taste after brushing, it could be a sign of bleeding gums.
  • Healthy gums fit snugly and naturally around your teeth. Healthy gums should not include receding gums or pockets between the tooth and the gum line. Longer than usual-looking teeth can be an indication of receding gums.
  • Pay attention to your breath in addition to the appearance of gums. Even though bad breath is normal, regularly rancid breath could be another telltale sign of gum disease. The buildup of bacteria produces foul-smelling gases that can signal gum disease.


How To Keep Your Gums Healthy


Flossing - Dr. Diana Sedler Glendale Periodontist

Flossing helps to keep gums healthy by reaching the in-between places that brushing misses. It leaves bacteria with no place to hide.

Each tooth has five surfaces, and it’s important to remember that flossing reaches two of those areas. It strengthens your gums and prevents plaque buildup.

Use Mouthwash

Use Mouthwash

Use a mouthwash to reduce the risk of gum disease and improve your overall oral health. Mouthwash removes food particles, kills harmful bacteria, strengthens tooth enamel, and helps control plaque and gingivitis. This is an additional protection that can be added to your oral hygiene routine.

Eat Healthy

Healthy Diet

You’ll also want to eat a well-balanced diet that incorporates fruits, vegetables, and lean proteins into your meals. Avoid sugar and starches, which cause tooth decay and bacterial growth.

Drink water instead of sugary drinks.

Get regular dental exams

Dental Exam

Finally, try to schedule regular dental exams every six months to a year.

Professional cleanings remove bacteria and plaque from your teeth and gums, which can prevent gingivitis and slow periodontitis.

Plaque and bacterial buildup along your gums can lead to gum infection, leading to periodontal disease.

Dental checkups are critical in spotting early signs of gum disease and preventing any existing damage from getting worse.


Gingivitis: Symptoms and Causes

The beginning stage, and mildest form of gum disease, is known as gingivitis. In this early stage, periodontal disease can still sneak up on you since many people with gingivitis experience only mild discomfort. It may be tempting to ignore gingivitis at this early stage, but it will cost you money, time, and pain over time.

Detecting and treating gum disease early is vital since gingivitis can be reversed with treatment.

However, when gingivitis is left untreated, it can progress into periodontitis. Advanced periodontal disease in periodontitis is characterized by permanent damage such as tooth loss and bone loss. By the time you are diagnosed with periodontitis, it’s too late to turn back the clock.

Our mouths are teeming with bacterial organisms. This is totally normal as long as the various inhabitants of your mouth are kept in check through proper oral hygiene. An increase in pathogenic (harmful) bacteria can disrupt that balance and cause periodontal disease. How can you tell if your oral microflora is getting out of control? The telltale sign is the presence of plaque.

Pathogenic microbes combine with dead cells, mucus, saliva, and other particles to form plaque on our teeth. If the plaque is not removed, it calcifies or hardens and forms tartar. Tartar is so tough that it cannot be removed by simply brushing or flossing at home. The tartar acts as a shield allowing bacteria to colonize, irritate, and damage your gums. Because of the unhealthy population of harmful bacteria in your mouth, your body reacts by sending the immune system into overdrive. This immune response to persistent irritation causes inflammation, damaging gum tissues over time, leading to gum disease.

How can you tell if you have gingivitis?

The following symptoms signal inflammation in your gums as your body naturally responds to the harmful bacteria:

  • Swollen or/and puffy gums
  • Red gums
  • Gums that bleed easily
  • Bad breath
  • Receding gums
  • Tender gums

It is not often you get a second chance to avoid an oral health disaster. Dealing with your gingivitis is a crucial preventative step that will help you avoid a lot more pain down the line. Treating gingivitis can be as simple as getting a professional cleaning and following a rigorous daily oral hygiene routine.

Patients with chronic gingivitis should regularly check in with their periodontist to ensure their condition is monitored by a professional.

Causes of Gingivitis

Inadequate oral hygiene is the most common cause of gingivitis.

The buildup of bacterial plaque along and below the gumline can trigger the inflammatory response that leads to gingivitis.

If left untreated, gingivitis can progress into a more serious form of gum disease known as periodontitis.


Periodontitis: Symptoms and Causes

By the time a patient is diagnosed with periodontitis, bacteria has already spread below the gum line. Bacterial toxins may have also caused a separation between the gums and teeth, forming pockets or spaces that trap debris. Over time, these pockets deepen as a combination of bacterial toxins and inflammation weaken then destroy surrounding tissues such as ligaments, bone, and gingival tissues. With the loss of these crucial oral structures, your teeth will loosen and start to fall out.

At this advanced stage, the damage caused by periodontitis is irreversible. Even worse, unchecked periodontitis threatens more than just your oral health. New research links periodontitis and other chronic conditions and diseases, including Alzheimer’s, cancer, heart disease, and more.

Periodontitis does not appear overnight. For most people, it is a gradual progression that takes place over many years. The following are some changes you may experience as gingivitis advances to periodontitis:

  • Chronic bleeding from the gums
  • Pus between your teeth and gums
  • Loose teeth or tooth loss
  • Painful chewing
  • Receding gums or longer appearing teeth
  • Chronic bad breath
  • Chronic sensitive teeth
  • Changes to your natural bite

Early detection and treatment of periodontitis is important. Unfortunately, many individuals do not realize they have advanced gum disease until serious damage has already occurred. One of the best ways to detect periodontitis is to pay regular visits to your dentist or periodontist.

Causes of Periodontitis

Inadequate oral hygiene, typically over a long period of time, is the most common cause of periodontal disease.

Like gingivitis, the ultimate causes of periodontitis revolve around bacteria and inflammation.

As discussed in the previous section, Gingivitis: Symptoms and Causes, bacteria on the gums and beneath the gum line trigger a destructive immune response in the form of chronic inflammation. In the beginning, this chronic inflammation is typically only mildly irritating. This phase of the development of gum disease is known as gingivitis.

Over time, gingivitis progresses into periodontitis. At this stage, the bacteria and subsequent inflammatory response have caused significant and irreversible damage to your gums and underlying bone tissues.

Anyone can be susceptible to gum disease, but several factors increase the risk of developing periodontitis. Understanding these risk factors is just as crucial as establishing good oral hygiene habits.

Some factors include the following:

  • Older age
  • Smoking or chewing tobacco
  • Hormonal fluctuations, especially during pregnancy
  • People with underlying medical conditions such as diabetes or cancer
  • Genetics
  • Using medications that cause dry mouth
  • Stress

How is Periodontal Disease Treated?

Because of the prevalence of periodontal disease and its possible links to other chronic diseases, patients diagnosed with periodontal disease should see a periodontist.

Periodontists are dentists specializing in the prevention, diagnosis, and treatment of gum disease and the placement of dental implants.

Periodontists go through extensive training, including at least three additional years of education beyond dental school, and are experts in treating periodontal disease. Seeing a periodontist instead of a general dentist drastically increases your chances of receiving the best-qualified treatment for periodontal disease.

Depending on the severity and the patient’s preferences, patients will likely have to undergo periodontal therapy. This can include surgical and non-surgical treatments and techniques. However, overall treatment doesn’t end with a visit to a periodontist. Successful treatments should be accompanied by careful daily oral care at home.

Once you are diagnosed with periodontal disease, it is imperative that you speak with your dentist and periodontists about how to treat it moving forward. There are surgical and non-surgical treatments to follow, depending on your level of severity.


Surgical Treatments

If your periodontitis is severe, you may require dental surgery.

Surgical therapies include:

1. Pocket reduction surgery (flap surgery)

Pocket reduction surgery is a more invasive version of scaling and root planing. Your periodontist will make a minimal incision in your gum and pull back the section to completely expose the roots. This way, your periodontist can work with a more effective scaling and root planing process.

If there is bone loss, the underlying bone can also be accessed for contouring or smoothing before suturing the gum tissue back in place.


2. Bone grafting

Periodontitis is a severe form of gum disease that can cause major issues with your oral health. Sometimes, periodontitis destroys the bone that surrounds the root of your tooth. When this happens, bone grafting may be necessary.

The graft used is made out of fragments of your old bone or donated bone. This bone graft will decrease the chances of further bone loss and promote possible regrowth of natural bone.

3. Gum grafting

Periodontitis can destroy your gum tissues causing gum recession. Receding gums exposes your dental roots and negatively affects your appearance as well as your teeth. To repair receded gums, a small amount of tissue from the roof of your mouth or a donor can be grafted to the affected site.


4. Guided tissue regeneration

Like bone grafting, guided tissue regeneration promotes bone growth and maximizes healing. When the bacteria destroy your bone, your periodontist will place a piece of biocompatible fabric between your tooth and the existing bone. This will help ensure the area heals and your bone grows back.


5. Soft tissue grafts

Periodontitis causes your gum line to recede due to gum tissue loss. Soft tissue grafts will be necessary to ensure the tissue can be reinforced.

Soft tissue grafting uses a piece of tissue collected at the roof of your mouth, also known as the palate, or donor tissue can be used and placed at the site of infection. This will help your overall appearance by covering the exposed roots and reducing the chances of the gums receding further.

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Non-Surgical Treatment

Tooth Scaling - Glendale, Burbank Periodontist

Non-surgical treatments include antibiotics and deep-cleaning procedures called tooth scaling and root planing. Deep-cleaning removes tartar and plaque from below the gum line. Root planing involves smoothing away roughness on the roots to prevent bacteria from adhering in the future.

1. Antibiotics

Periodontitis is a severe gum disease where tartar build-up and plaque have taken over the gums, causing infection, which causes bleeding, swelling, and overall pain in the gums.

Antibiotics help control the bacterial infection that is causing your periodontitis. Topical or oral antibiotics are available to you, but oral antibiotics are the most necessary for eliminating the infection.

These antibiotics come in the form of gels or mouth rinses. Your periodontist will know which one will work best for your specific case.


2. Root planing

Root planing is a treatment option where we smooth out the gum line to remove plaque and tartar build-up that has grown, preventing any further build-up in the area. If this is not done, the infectious bacteria will spread and cause inflammation in the gums.

In addition, you will delay the healing process regardless of the other steps taken if this is missed.


3. Scaling

Scaling removes any tartar or plaque attached to your gums and the surface of your teeth. Scaling goes hand in hand with root planing and must be done with a dental instrument like a laser or ultrasonic device.


Oral Care At Home

Brush and Floss - Burbank Periodontist

None of the treatments can completely eradicate gum disease without proper oral care at home. Periodontal disease can quickly make a comeback if oral care at home is neglected. Here are six ways you can personally prevent all stages of periodontal disease:

  • Brush at least twice a day or, ideally, after each meal.
  • Floss every day.
  • Rinse with a mouthwash designed to fight tartar and plaque.
  • Give up tobacco.
  • Keep up with regular dental checkups every six to 12 months.
  • Incorporate a healthy diet with whole grains, fruits, and vegetables.

Oral Health Is Self-Care

It may feel like a constant battle against nature and millions of microscopic, harmful microbes. However, now with the right knowledge, you are in control.

Whether you aim to prevent periodontal disease or to treat an existing condition, it’s time we start treating our daily oral routines and regular dentist visits as self-care instead of errands we dread.


6 Myths About Periodontal Disease

Sinus - Radiography

Periodontal disease, also known as gum disease, is a severe oral health issue that may often be overlooked. There are four stages: initial (also known as gingivitis), moderate, and severe. It is important to catch and treat periodontitis in its earlier stages to prevent any permanent damage. This article will debunk the myths associated with periodontal disease.

Myth 1. Periodontal / Gum Disease is Rare

Gum disease is a prevalent oral health issue that affects many people.

According to the CDC, 47% of adults older than 30 suffer from periodontal disease, and 70% of adults 65 or older have periodontitis. Therefore, it is vital to monitor your oral health to try and prevent gum disease and catch it in its earliest stage.


Myth 2. Periodontal Disease Only Affects Your Oral Health

Periodontal disease is not only dangerous for your oral health and dentition, but it can indirectly cause other severe health issues. Apart from tooth loss, receding gums, and deteriorating bone and tooth roots, periodontitis can be a factor in the following health issues:


Myth 3: Not Having Cavities Means You Can’t Have Periodontitis

Cavities and periodontitis do not go hand in hand. Each of these diseases is caused by a different bacteria:

Even if you have never had cavities or do not currently have cavities, your teeth can still loosen and fall out due to the effects of gum disease. So never rule out gum disease if your dentist doesn’t find any cavities.


Myth 4: Practicing Proper Brushing and Flossing Techniques Completely Prevents Periodontitis

Proper dental hygiene: brushing, flossing, and mouthwash help prevent periodontal disease but does not eliminate its chances of occurring.

The pockets that form around your gums become more profound and deeper as untreated periodontitis progresses. Once they become deeper than 4mm, you can’t clean the affected area yourself. This is where regular dental cleanings become vital. Other factors like tobacco use, genetics, and diabetes can cause periodontitis no matter how often you practice proper dental hygiene.


Myth 5: Periodontal Disease is Extremely Painful

So often, people don’t realize they are suffering from periodontal disease. Initial gum disease is not painful so much as it can cause tender, bleeding gums and loose teeth. People usually associate bleeding gums with a lack of flossing and intense brushing and don’t immediately assume it is gum disease. Likewise, don’t assume that you will start to feel pain if you suffer from periodontal disease. Here are a few early signs to look for so you can be vigilant:

  • Bleeding and tender gums
  • Loose teeth
  • Bad breath
  • Pain when chewing
  • Receding gums


Myth 6: Gum Disease Can Be Cured

It doesn’t feel good to say, but severe periodontitis cannot be cured. However, in its beginning form of gingivitis, you can reverse it with proper at-home oral care and regular dental checkups.

However, once it surpasses that, you can only manage it.

Do not get discouraged.

If you have passed the gingivitis stage and are suffering from moderate or severe periodontitis, there are treatments that help maintain it to prevent tooth loss and other health issues.


Is It Time To See A Periodontist?

Dr. Diana Sedler - Periodontist - Burbank - Toluca Lake - Westwood - Los Angeles

You should consult a periodontist if you notice any of the following warning signs.

1. A distinct change has occurred in your bite.

2. It feels like your teeth are loosening.

3. There is bleeding, swelling, or redness on your gums.

4. You are experiencing receding gums.

5. Pain and discomfort are heightened

6. Your teeth feel overly sensitive, not just from cold or hot foods.

7. You feel pain when you chew food.

8. No matter what you do, a persistent bad taste in your mouth will not go away. In addition, a rancid odor may be coming from your mouth.

9. The fit of your partial denture, if applicable, may have changed, making it uncomfortable and not fitting correctly in your mouth.

Periodontal disease is no laughing matter. The state of your oral health is extremely important, especially when it can significantly impact your general health.

Due to the disease’s prevalence and ease of prevention, taking steps to rid yourself of it should be a top priority if you see early signs. Save yourself the pain of gum disease by consulting with your dentist or a periodontist.


Detecting Periodontal Disease

Better Health - Glendale Periodontist

Gum disease is extremely common and can become very serious if left untreated. According to a report done by the CDC, 42.7% of adults in the United States 30 and older suffer from periodontal disease. As the age increases to 65 and older, the number jumps to 70.1%. It is more prevalent in men than in women, with the difference reaching 56.4% versus 38.4%.

42.7% of adults in the United States 30 and older suffer from periodontal disease. As the age increases to 65 and older, the number jumps to 70.1%. It is more prevalent in men than in women, with the difference reaching 56.4% versus 38.4%.

Center for Disease Control and Prevention

Initially, periodontal disease is characterized by inflammation and infection in the gums and jaw bone. If left untreated, gingivitis may cause swollen, red gums, which can rapidly develop into periodontitis, accompanied by the following symptoms:

  • There is bleeding from the gum sockets
  • A visible separation occurs between the gums and the teeth
  • Bone loss in the jaw
  • Loss of teeth is possible

By taking the appropriate steps, this can be prevented.


Preventing Periodontal Disease

Dental implant cost

Proper oral hygiene can prevent periodontal disease, which is a severe result of gum disease. The most effective way to prevent periodontal or gum disease is by doing the following:

  • Maintaining a regular dental check-up schedule. It would be best if you visited your dentist every six months for a check-up and cleaning. A professional teeth cleaning will remove any plaque or tartar accumulated since your last visit.
  • You should brush your teeth and floss twice a day. As a result, you will remove any food that may cause buildup throughout the day.

How Do I Know If I Need To See A Periodontist?

Dr. Diana Sedler - Periodontist - Burbank CA

Dentists are the most widely known providers of dental care. As a result, dentists are often the first person you think of when you need dental care.

The dentist, however, works much like a general doctor in that they refer you to a specialist based on your need. Many types of dental specialists specialize in a specific area of dentistry, such as orthodontists, endodontists, periodontists, oral surgeons, etc. All of these specialties are essential, but we will focus on why you might need a periodontist.

Despite understanding every aspect of the mouth, a dentist does not specialize in every field. Among other things, your dentist will check, clean, and treat your teeth and gums. A periodontist specializes specifically in the gums and the bones that support the teeth. When it comes to high-level and severe cases, general dentists can’t provide as much attention and direct care as a periodontist.

Why Was I Referred To A Periodontist?

1. Detection of periodontitis

Stages of Periodontitis

Periodontal disease, also known as periodontitis or gum disease, is the number one concern of a periodontist. Periodontal disease is an infection in the gums that causes inflammation and weakens the soft tissue, supporting bone, and tooth roots. Extreme tooth and bone loss is often the consequence of severe periodontal disease.

The earliest stages of periodontitis are known as gingivitis, which can still be reversible and treated. It is vital to consult a periodontist once gingivitis turns into periodontitis. It is not possible to reverse periodontitis. Instead, it can only be managed so that it does not progress. A periodontist can adequately handle the treatment of gingivitis and periodontitis.


2. Swollen and puffy gums

The swelling of the gums indicates that they are inflamed and likely infected. This is often the first stage of periodontitis known as gingivitis.

A dentist will most likely refer you to a periodontist to treat gingivitis and avoid it worsening since it is still treatable. Leaving gingivitis untreated will lead to permanent damage and tooth decay.


3. Bad breath, bleeding gums, or difficulty chewing

Although these issues aren’t as dramatic as others, they can develop into much worse ones in the future. Although each of these issues can be considered non-emergent, if they are chronic, then early gum disease or tooth loss may develop. If these issues persist, speak with your dentist to be correctly referred to a periodontist.


4. There is a receding gum line

Additionally, periodontists can help reverse receding gum lines. There is no direct correlation between receding gums and periodontal disease, but it is often caused by improper brushing and brushing too hard. In such cases, a periodontist can perform gum grafts for cosmetic purposes.

In the absence of improper brushing techniques, if your gums are receding, it may be an indication of moderate to severe periodontitis. A periodontist can determine whether a receding gum line is caused by an underlying issue and develop a treatment plan.


Differences Between Gingivitis and Periodontitis

Gingivitis - Periodontal Disease

Inflammation of the gum line is essentially gingivitis, while periodontitis can lead to bone loss in the jaw. Unlike periodontitis, gingivitis does not affect the structures that hold your teeth in place. In cases of gingivitis, you can restore healthy gums by maintaining good oral hygiene at home.

Periodontitis, however, cannot be treated simply with good oral hygiene. It is impossible to rebuild bone once it is lost due to inflammation. In this sense, gingivitis is often referred to as the initial stage of periodontal disease, whereas severe periodontitis is the final stage.

While gingivitis can be reversed if caught early, periodontitis lasts forever and can only be managed because the bone structure will never be able to go back to normal. So what are the key differences between them?



Gingivitis is an inflammation of the gum line caused by bacterial infection. Poor oral hygiene is the most common cause of this infection. In order to avoid gingivitis, you need to brush, floss, use mouthwash, and have regular dental checkups. To determine whether you have gingivitis, you should examine all your symptoms. Ideally, healthy gums should be pale pink, firm, and closely fitted to the teeth.

There are a number of symptoms associated with gingivitis, including:

  • Swollen or puffy gums
  • Dark red gum
  • Your gums can bleed easily when you brush and floss your teeth
  • The smell of bad breath
  • Receding gums
  • Tender gingival tissue

Having gingivitis is a serious condition, which requires immediate treatment from a dentist or periodontist. In this stage, the disease is reversible as long as you follow proper checkups and at-home dental cleanings.


Periodontitis, periodontal disease, or severe gum disease is an infection and inflammation of the gums and bone surrounding and supporting the teeth. It starts at its first stage, gingivitis and if not treated, progressively gets worse and more severe. Once it worsens, the gums will go from puffy and swollen to completely pulling away from the teeth. As this happens, the bone begins to decay, and the teeth loosen and eventually fall out.

According to the CDC, 47% of adults 30 and older and 70% of adults 65 and older suffer from severe gum disease. It is essential to see the warning signs when gingivitis has turned into periodontitis:

  • Inflammation of the gums or bleeding gums
  • Having discomfort while chewing
  • Teeth are beginning to loosen
  • Extreme teeth sensitivity
  • An unpleasant taste in the mouth or chronic bad breath
  • Gums are incredibly swollen and red
  • A change in your bite
  • Partial dentures no longer fit correctly

The symptoms of gingivitis overlap with many of these, so it’s important to see a dentist or periodontist as soon as possible. Periodontal disease is not reversible. Immediately schedule an appointment with your dentist or periodontist if you notice any of these symptoms.


Surgical Treatment Options for Periodontitis

Periodontitis - Cutting Edge Periodontist - Glendale, Burbank

The purpose of a periodontist is to prevent, diagnose, and treat gum disease. Also, they assist in managing oral inflammation caused by advancing gum disease. In addition to decay, these dental issues can cause various other problems, such as gum recession, tooth loss, and exposure to sensitive root surfaces. It is possible to treat or manage these disorders in several ways, both surgically and non-surgically.

However, advanced cases often require surgical options, so it is imperative to understand them. Following are the surgical treatment options:

1. Gum graft

Gum Graft - Cutting Edge Periodontist - Burbank, CA

A gum graft involves taking tissue from the roof of the mouth where the connective tissue is located or using surface-level tissue or local gum tissue to cover the receding gum line and stimulate regeneration. It consists of taking tissue from the roof of your mouth and covering receded gums with it.

Among the different types of grafts are:

You and your periodontist will decide which procedure is most appropriate based on your unique situation.

2. Laser treatments

Laser Gum Reshaping

In gum surgery, a laser produces concentrated, pinpointed beams of light with thermal energy. In periodontal treatment, they are most commonly used to:

  • Ensure that the treated area is sterilized
  • Coagulate blood vessels to form solid clots
  • Germs and bacteria are eliminated
  • Removing and disposing of diseased tissue

The laser changes the energy in atoms by creating a laser beam. The laser beam excites atoms from their resting states, emitting energy spontaneously. In a resting form, atoms emit photons. This process generates power for specific tasks, like cutting tissue without a blade.


3. Regenerative procedures

Bone Graft - Periodontitis - Cutting Edge Periodontist - Burbank CA

Regenerative procedures are used to help encourage new tissue and bone growth to occur. This occurs most commonly when utilizing bone graft procedures. Due to the surgical procedure involved in bone grafts, new bone and possibly periodontal ligament and cementum can be produced by placing bone or bone substitute material into a bone defect.

New bone will replace most of the graft material over time.


4. Dental crown lengthening

Gummy Smile Correction - Anna Before and After Photos

Before and After Gummy Smile Correction Surgery

In cases where the tooth lacks sufficient structure to support the crown, a crown lengthening may be necessary. A crown may not firmly attach to teeth that are broken or decayed.

As part of crown lengthening, bone is shaved down, and gum tissue is reduced in order to expose more of the tooth. The proper fit of a crown contributes to better oral hygiene and comfort.

Also, crown lengthening may be used to reduce the visibility of gums above the teeth in some people with “gummy smiles.”



5. Dental implants

All On 4 Dental Implants - Burbank Periodontist

Dental implant surgery usually requires a number of appointments and procedures.

The first procedure involves drilling holes into your jawbone, inserting a titanium post, and sewing the gums shut.

In the following step, the foreign but biocompatible substance integrates into the body through osseointegration, allowing the implant to integrate with the jaw bone.

After several months, there will be another appointment to see if the dental implants have been integrated to start work on creating permanent dental crowns to give you your complete smile back. This is also where a digital impression of your mouth will be taken.

Once the dental crowns are made, a final appointment will be created to place the crowns.


6. Pocket reduction

Osseous surgery involves removing or reducing pockets caused by gum disease. When antibiotics or root planing cannot treat severe gum disease, your periodontist will most likely recommend performing pocket reduction surgery.

If this is an option for you, here is what to expect.

Your periodontist will perform the surgery, and be sure to use a local anesthetic to numb the area. It will be necessary to make a small incision along the gum line so the gums can be folded back in order to remove the bacteria.

In the event that the bone is damaged, the periodontist will smooth down the area, but if it is severely damaged, then other treatment techniques, like a bone graft, may be necessary.

Finally, the periodontist will sew the gums back in place and apply gauze to manage any bleeding that may be occurring.




I Have Periodontitis. What Are My Next Steps?

I have periodontitis - Cutting Edge Periodontist - Burbank CA

Dental health problems like tooth decay and gum disease are often discovered when you visit your dentist for a routine checkup. When people see a dentist regularly, gum disease can be detected early and completely treated if it occurs. In contrast, if you have not been participating in routine dental checkups and have had gum disease, you may be told you suffer from severe gum disease or periodontitis.

Periodontal disease is a permanent form of gum disease that cannot be reversed or treated but can be managed so the symptoms do not worsen. In this case, understanding your next steps is essential.

1. See a Periodontist

A periodontist may be referred to you by your dentist, either within your network or by whoever they work with, to help you manage your periodontal disease. Dentists are specialists in teeth, while periodontists are specialists in the teeth’s supporting tissues. A periodontist can tell you how advanced your periodontal disease is and what your options are.

Periodontal disease has four stages:

Stages of Periodontitis

  • Initial – Gingivitis
  • Mild periodontitis
  • Moderate periodontitis
  • Severe with possible tooth loss, or
  • Severe with complete tooth loss

Based on the findings, your periodontist will devise a plan for you to maintain your periodontitis and prevent it from getting worse. The goal is to protect as much of the bone, gums, and teeth as possible when diagnosed with periodontal disease to avoid unnecessary tooth loss.


The goal is to protect as much of the bone, gums, and teeth as possible when diagnosed with periodontal disease to avoid unnecessary tooth loss.

Dr. Diana Sedler

2. Get a treatment plan

Periodontal disease can be treated surgically or non-surgically. To determine what’s best for you and your periodontal situation, your periodontist will discuss the pros and cons of both treatment types. Unless periodontal disease is in its most severe stages, most people choose non-surgical options.

Non-surgical Treatment Options

  • Antibiotics
    Inflammation of your gums and decaying bones are all symptoms of periodontal disease, which is a bacterial infection. When possible, an antibiotic helps eliminate the infection. Depending on your case, your periodontist will know whether this is an option for you.
  • Scaling
    Scaling is similar to a deep dental cleaning. Initially, tartar and plaque buildup on the gums and teeth is removed using an ultrasonic or laser device.
  • Root Planing
    Often, scaling is performed alongside root planing. Root planing involves smoothing out all tartar and plaque buildup along the gum line. In this way, you can prevent any future bacterial infection from spreading.

3. Maintain regular dental visits

Periodontal disease should be treated with regular dental checkups. The American Dental Association recommends a dental visit every three months to ensure the infection does not spread or worsen. Regular monitoring of this disease is necessary because of its effects on gums and jawbone.

In addition to scaling and root planing, these visits may involve deep dental cleanings. With the help of your dentist and periodontist, you can devise a timeline.


4. Maintain good at-home dental hygiene

It is very important to maintain good at-home dental hygiene at all times. Once periodontitis is diagnosed, it becomes even more critical. Keeping up with your oral care at home can be achieved in several ways:

  • Brush your teeth twice daily with a soft-bristled toothbrush: in the morning and at night. As a result, any bacteria that have grown throughout the day will be cleaned and removed.
  • Floss your teeth daily; it is often recommended to do this before bed to remove any food or bacteria missed when brushing.
  • For difficult-to-reach areas of the mouth, such as the tongue, cheeks, roof of the mouth, and gums, use mouthwash. Also, this will eliminate all unwanted bacteria. Use a mouthwash that breaks down tartar and plaque.
  • Stop smoking and eat a balanced diet with fewer acidic foods and sugars.

The Perfect Dental Care Routine for Gum Health

Strengthen gums with a gum graft

When it comes to the structure and integrity of the jaw bone, gum health is the next line of defense. However, people don’t always realize that dental health extends beyond teeth.

You should also take care of your gums to prevent gum disease like gingivitis and ensure they remain strong. The belief that brushing your teeth alone will maintain healthy gums is a common misconception. Even though brushing your teeth is the most important step of your dental routine, there are other steps to remember.


The Gum Health Routine

1. Make sure you brush your teeth regularly.

Brush teeth - Cutting Edge Periodontist - Burbank, CA

Brushing your teeth is often overlooked. As a result, many people don’t understand how important it is to brush their teeth regularly.

Regardless of the foods we eat during the day; our mouth collects bacteria. You must remove this bacteria by brushing your teeth. This bacteria can spread infection to the gums and the bones if left unattended.

Brushing your teeth should be part of your daily routine, not just something you do quickly. To maintain good gum health, you should follow these steps:

  • First, make sure you brush at the gum line in a circular motion.
  • After waking up and before going to sleep, brush your teeth twice a day
  • To remove bacteria from your tongue, brush it along with your teeth.

2. After brushing, floss between your teeth.

Brush and Floss - Burbank Periodontist

The hard-to-reach spots between teeth are not easily reached with a toothbrush. Food can easily get stuck between the teeth, especially in the gum pocket. Removing food and particles between the teeth is impossible if floss is not used daily.

The use of mouthwash does not excuse the need to floss. To keep the gums healthy and free of infection, flossing is essential.


3. Use mouthwash and rinse afterward.

Mouthwash - Cutting Edge Periodontist

Using mouthwash, you can remove any leftover bacteria that brushing and flossing did not remove. The purpose of using mouthwash with fluoride is to help strengthen the enamel on your teeth and clean your tongue, cheeks, gums, and the roof of your mouth.

First, rinse your mouth with water after using mouthwash to remove any bacteria left behind.

Then, finalize the process by using mouthwash.


4. Make regular dental visits to check on the health of your teeth and gums.

Dental Exam

Dental checkups are a great way to determine not only the condition of your teeth but also the condition of your gums. When your dentist or periodontist examines your gums, they look for swelling, discoloration, bleeding, inflammation, and other signs of gum disease.

Unfortunately, almost no one realizes they have gum disease until it is too late since it is not a very painful infection. However, a dentist or periodontist can help you resolve the issue if it’s caught early enough.



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