Periodontal (Gum) Care
Healthy gums, kept that way — and treatment when they need it.
Healthy Gums Are the Foundation Everything Else Sits On
Most people think of dental care as taking care of teeth. But your teeth sit in something — bone, ligament, and gum tissue — and if that something starts to fail, the teeth go with it. Gum disease (periodontal disease) is the leading cause of tooth loss in adults. It's also one of the most preventable. The two halves of that sentence don't cancel each other out by accident.
At every cleaning, we screen your gums for the earliest signs of trouble. If we catch something, we've got a full set of treatments — from improved home care, to a deep cleaning, to surgical care when needed — to get you back to healthy. Most patients never need anything beyond what we do at a regular visit.
The Three Stages, Plainly
It helps to know how gum disease progresses, because what we recommend depends on where we catch it.
1 · Healthy gums. Pink, firm, fit snugly around each tooth. Don't bleed when brushed or flossed. This is the goal.
2 · Gingivitis. The earliest stage. Gums look red, may swell, and bleed easily. Bone is still intact. Fully reversible with a regular cleaning, better home care, and time. If we catch you here, we win.
3 · Periodontitis. The bacteria has worked its way below the gum line and started to break down the bone holding your teeth in place. Pockets form between the gum and the tooth. The damage to the bone is permanent — we can stop it but we can't reverse it. Treatment focuses on stopping the progression, restoring healthy gum tissue, and keeping your teeth.
How We Screen for It
Every adult cleaning visit includes a periodontal screening. The hygienist uses a small instrument with a gentle, rounded tip to measure the depth of the space between your gum and tooth in six locations around each tooth. Healthy depths are 1 to 3 millimeters. Anything deeper means there's a pocket where bacteria can hide. Bleeding while we measure is another important sign. The whole screening takes a couple of minutes and tells us a lot.
Treatment, Matched to the Stage
Gingivitis. A thorough cleaning, a refresh on home care technique (sometimes a small change makes a big difference), and a follow-up at your next regular visit. That's usually all it takes. We may also recommend a fluoride rinse or a specific brush head depending on what we're seeing.
Early-to-moderate periodontitis. Scaling and root planing — a deep cleaning under local anesthesia, usually split over two visits, that clears bacteria and tartar from below the gum line and smooths the root surfaces so gums can reattach. Highly effective for the majority of patients we see at this stage.
Advanced periodontitis. Flap surgery lets us fold back the gum tissue, clean deeply, treat the bone, and restore the gums to a healthier position. Dr. Carroll performs flap surgery in-house, which means continuity of care — same dentist who diagnosed you, planned your treatment, and knows your history.
Soft-tissue laser care. For some procedures we use the Biolase dental laser instead of (or alongside) traditional instruments — less bleeding, fewer stitches, faster healing.
After Treatment: Periodontal Maintenance
Once your gums are healthy, the goal is to keep them that way. Most periodontal patients move from a six-month cleaning schedule to every three or four months — at least for the first year. The shorter interval keeps the bacteria population from rebuilding to the levels that caused the original problem.
Periodontal maintenance visits look a lot like a regular cleaning, but they go a little deeper around the gumline and we re-measure your pockets to make sure the gains are holding. If everything stays stable, we may eventually move you back to a longer interval. Some patients stay on the shorter schedule for life — and that's a fine outcome.
Risk Factors Worth Knowing About
Some things make gum disease more likely or harder to control. Knowing where you stand helps us tailor your care:
- Smoking and tobacco use — the single biggest modifiable risk factor
- Diabetes — the relationship runs both ways: gum disease makes blood sugar harder to control, and uncontrolled diabetes makes gum disease worse
- Family history — some genetic predisposition is real
- Hormonal changes — pregnancy and menopause can both affect the gums
- Certain medications — especially those that reduce saliva
- Stress — directly affects immune response and indirectly affects home care
- Crooked or crowded teeth — harder to keep clean
More Than Your Teeth
The bacteria from untreated gum disease doesn't stay in your mouth. It enters your bloodstream and can contribute to inflammation elsewhere in the body — most clearly in cardiovascular disease and diabetes. Taking care of your gums is part of taking care of you.
See our patient-education articles on your mouth and your heart and dental care with diabetes for more.
Frequently Asked Questions
How do I know if I have gum disease?
The earliest signs are easy to miss: gums that bleed when you brush or floss, redness or swelling along the gumline, and bad breath that doesn't go away. As it progresses you may notice gums pulling away from your teeth, teeth feeling loose, or pus along the gumline. The trouble with gum disease is that it's often painless until it's already done damage. The reliable way to know is a periodontal screening at your regular cleaning.
Can gum disease be cured?
Gingivitis — the earliest stage — is fully reversible with a thorough cleaning and consistent home care. Once it has progressed to periodontitis and bone has been lost, the damage is permanent. We can stop it from getting worse, get the gums healthy again, and save the teeth — but we can't grow back the lost bone. That's why early treatment matters so much.
What does periodontal maintenance involve?
After active treatment, we'll typically see you every three or four months instead of the usual six. The visits are similar to a regular cleaning but more thorough below the gum line. The shorter interval keeps bacteria from rebuilding to the levels that caused the original problem. Most patients stay on this schedule indefinitely.
Why are my gums bleeding when I floss?
Bleeding gums almost always mean inflammation, and inflammation almost always means bacteria. If you've recently started flossing, you may see bleeding for the first week or two — that's expected, and it should stop as your gums get healthier. If it doesn't, or if your gums also bleed when you brush, schedule a visit. Don't stop flossing — that makes it worse.
Is gum disease really linked to other health problems?
Yes. The bacteria from periodontal infection can enter your bloodstream and contribute to or worsen problems in other parts of the body — most strongly cardiovascular disease and diabetes complications. Treating gum disease isn't just about saving your teeth. It's part of taking care of the rest of you.
Will I need surgery?
Most cases don't require it. Scaling and root planing — a deep, non-surgical cleaning below the gum line — handles most early-to-moderate periodontal disease. Surgery (flap surgery) is reserved for advanced cases where the pockets are too deep to clean closed. Dr. Carroll performs flap surgery in-house, so if it ever does come to that, we don't have to send you to a specialist.
If your gums have been bleeding, if you've been told before that you have gum disease, or if you just haven't had a cleaning in a while, give us a call. Earlier treatment is always easier — and almost always saves teeth.
Schedule a Periodontal Visit
A standard exam includes a periodontal screening. We'll know within minutes whether you need any further treatment — and walk you through what it would look like.
Book AppointmentBleeding Isn't Normal
Healthy gums don't bleed when you brush or floss. If yours do, it's usually the earliest sign of gum disease — and the easiest stage to treat.
Ready for a Healthier Smile?
Whether you're due for a cleaning or considering a smile makeover, we're here to help. Schedule your appointment today.
Call us for emergency care