Periodontitis

Diagnosis

To determine whether you have periodontitis and its severity, your dentist may:

• Review your medical history to identify factors linked to your symptoms, such as smoking or certain medications that cause dry mouth.
• Examine your mouth for plaque and tartar buildup and check for areas that bleed easily.
• Measure the depth of pockets between your gums and teeth using a small ruler called a dental probe. Pockets are measured at multiple sites in the upper and lower gums. Healthy pockets are typically 1 to 3 millimeters deep. Pockets deeper than 4 mm may indicate periodontitis, and pockets deeper than 5 mm are difficult to clean with routine care.
• Take dental X-rays to assess bone loss in areas with deeper pockets.

Your dentist may assign a stage and grade to periodontitis based on severity, treatment complexity, risk factors, and overall health. A personalized treatment plan is then created.

Treatment

Treatment can be provided by a dentist or a periodontist, a specialist in gum disease. A dental hygienist may assist as part of your care team. The goal is to clean pockets around teeth thoroughly and prevent further damage to gums and bone. Daily oral care, managing underlying health conditions, and avoiding tobacco use improve treatment success.

Nonsurgical treatments for less advanced periodontitis may include:

• Scaling. Removes tartar and bacteria from tooth surfaces and below the gumline using instruments, lasers, or ultrasonic devices.
• Root planing. Smooths tooth roots to prevent further tartar buildup and helps gums reattach to teeth.
• Antibiotics. Topical or oral antibiotics may control bacterial infections. Topical options include antibiotic mouth rinses or gels applied directly into gum pockets. Oral antibiotics may be needed for more widespread infections.

Surgical treatments for advanced periodontitis may include:

• Flap surgery (pocket reduction surgery). The gums are lifted to allow deep cleaning, and underlying bone may be reshaped before the tissue is stitched back in place.
• Soft tissue grafts. Damaged gum tissue may be reinforced using tissue from the roof of the mouth or a donor source to reduce further gum loss, cover exposed roots, and improve appearance.
• Bone grafting. Rebuilds bone destroyed by periodontitis using natural, artificial, or donated bone to prevent tooth loss and support natural bone regrowth.
• Guided tissue regeneration. A special fabric is placed between existing bone and teeth to prevent unwanted tissue growth and allow bone to regenerate.
• Tissue-stimulating proteins. A gel containing proteins found in developing tooth enamel is applied to diseased tooth roots to stimulate growth of healthy bone and tissue.