Periodontal (Gum) Disease

Periodontal disease is an infection of the gums and the bone that surrounds the teeth.

In advanced disease, the teeth themselves will be affected. The primary cause of these infections is the sticky accumulation of bacteria called plaque. Millions of people have some type of periodontal disease but are unaware that they have a problem. Periodontal disease is often painless and may be asymptomatic throughout its early stages.

Periodontal disease can be divided into two main stages:

  • Gingivitis—a superficial infection of the gum.
  • Periodontitis—a more advanced infection that involves the surrounding bone.

Plaque forms continuously, so it must be removed everyday with regular brushing and flossing. If plaque is allowed to build up, tartar or calculus forms, which cannot be removed by brushing and flossing. The bacteria that cause periodontal disease thrive in the calculus deposits. The bacteria’s waste products are toxic. The combined effects of these toxins and the body’s immune response to them will begin to destroy the bone which surrounds the teeth.

Gingivitis can sometimes be recognised by red or puffy gums which may bleed when brushing or flossing. Bad breath or halitosis and a sour taste in the mouth are also common symptoms.

When the infection moves from the gum to the underlying bone, the problem has advanced to periodontitis. In this stage, the bone that supports the teeth is beginning to recede and once this bone is lost it will not grow back.

Periodontitis can be characterised (in addition to the signs associated with gingivitis) by receding gums, spaces opening between teeth, discomfort in the gums and loosening of the teeth. Gum recession is never normal and can expose the root, making it more vulnerable to decay. Loosening of one or more teeth is almost always a sign of severe bone loss. Spaces occur when the gums and underlying bone have receded and is typically a sign of an advanced problem.

Periodontal Examination

Your Dental Hygienist or Dentist first looks at the gums. Depending on skin tone, they should be light pink in colour, have stippled appearance, and tight against the teeth. Then, in addition to a visual examination, your Dental Hygienist or Dentist will use radiographs (x-rays) to display the extent of any bone loss that may have occurred and reveal any decay which may not be visible during the visual examination. The periodontal probe is a particularly valuable innovation as it can reveal the disease long before it becomes visually apparent (even to x-rays).

The periodontal probe measures the depth of the sulcus, the separation that exists between the gum and the tooth. A normal sulcus is 2 to 3 millimetres deep. Anything more than that indicates the development of a pocket which is resultant from the build up of calculus or bone loss. The deeper the sulcus, the more advanced the disease. If too much bone is lost there can be insufficient support for the tooth and it may require extraction.

American Academy of Periodontology, The Mouth-Body Connection, accessed April 2011


Scaling and Root Planning is a common non-surgical treatment for periodontal (gum) disease. Scaling involves a deep cleaning of the tooth above and below the gum line in order to remove any plaque and calculus (tartar) that has accumulated on the tooth. The root is then planed until it is smooth, to eliminate any rough calculus deposits on the root that can facilitate breeding for bacteria.

A smooth and clean root surface provides a much better substrate for the periodontal (gum) ligaments to reattach. This reattachment results in the reduction of the pocked to eliminate the development of bacteria.

After the treatment, our Dental Hygienist will often prescribe chlorhexidine, an antibacterial mouth rinse shown to be effective for the treatment of periodontal disease. We will also schedule a follow-up appointment in the next 4-6 weeks to ensure your healing correctly.

Systemic Effects On The Body

A growing body of research links gum disease or periodontal disease to heart disease, diabetes, pre-term and low birth weight babies, and respiratory disease.

Heart disease

People with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease. Studies indicate that periodontal disease can foster the development of clogged arteries and blood clots when oral bacteria get into the blood stream.


People with diabetes are more likely to have periodontal disease than people without diabetes. Diabetics are more susceptible to contracting infections. Research is also showing that periodontal disease can make it more difficult for diabetics to control their blood sugar because severe periodontal disease increases blood sugar.

Respiratory disease

Research suggests that bacteria found in the throat as well as bacteria in the mouth can be drawn into the lower respiratory tract causing infections or worsening existing lung conditions.