Gum Disease – Periodontal Disease

San Antonio Dental Office

Gum Disease: A Silent Killer

Gum disease is a dangerous infection in your gums. Dentists get fancy and call this infection periodontal disease or periodontitis. Gum disease or periodontal disease is the #1 reason adults lose their teeth. Want to keep your teeth? Find out what gum disease is, how it hurts teeth and how to treat it. Keep reading to learn about gum disease symptoms and to answer key questions about gum disease including: What does gum disease look like? What is the difference between early stage gum disease and advanced periodontal disease? How can I know what the most effective periodontitis treatment is for me?  Is there really a difference between a periodontal cleaning and a regular cleaning? Why in the world should I care about periodontal pockets? And, finally what will happen if I just pretend it’s not there?

Getting the answers to these questions could make the difference between saving your teeth and losing them.

gum disease periodontal pocket periodontitis treatment periodontal cleaning

Gum Disease Symptoms

What Does Gum Disease Feel Like?

Surprisingly, it usually doesn’t hurt. Many people had gingivitis before the pandemic but during lockdowns that gingivitis grew into gum disease. When they hear they have periodontal disease, nearly EVERYONE responds the same way: “But it doesn’t hurt!”

The most SHOCKING thing about periodontal disease is that it doesn’t hurt.

You may not feel pain, but all the symptoms of gingivitis are still there to feel: bleeding, puffiness and a slight pressure between the teeth. As gum disease advances, people usually start feeling tooth sensitivity from recession and movement in their teeth. Until a gum abscess forms, this terrible disease is painless.

Periodontal Surgery Services

What Does Gum Disease Look Like?

Early stage gum disease looks a lot like gingivitis. Because the infection is under the gums, there isn’t much to see in the mouth at first. Gums bleed when brushing and flossing and sometimes when eating. Infected gums will be an irritated red color instead of a nice rosy pink. As periodontal disease advances, the gums will recede up the tooth and you’ll start to see swelling. Eventually, the teeth will stick out way above the gums . When you notice bleeding, that’s the earliest visible sign that something is wrong.

Severe Gum Disease

Gum Disease

Moderate Gum Disease

Periodontal dentistry

What Does Gum Disease Smell Like?

Gum disease stinks! Think about it – periodontal disease is a bunch of bacteria under the gums eating away your flesh and bone. Periodontal pockets store bits and pieces of everything you eat as well as bacteria. Combine the smell of rotting food, bacteria and dying tissue and you have a recipe for VERY bad breath. If you have periodontal disease, you may get used to the smell, but the people around you won’t. It cannot be cured or masked with any mouthwash, gum, mints. The smell can only be fixed with periodontal treatment. Keep reading to learn more about the stages of gum disease and to see pictures of both early and advanced infection.

broken teeth chipped

Gum Disease Stages

Early Stage Gum Disease

Early stage gum disease looks a lot like gingivitis. The difference between gingivitis and early stage gum disease is that in gingivitis, the gums still have an intact seal on the tooth. (Read more about gingivitis here.) When the infection gets serious enough that it compromises the gum’s seal around the tooth, the bacteria move in to the spaces around the tooth root and into the bone.

Interesting Fact: The fact that the infection is now “around the tooth” is what gives the disease its fancy dental name: periodontal disease. Perio means around. Dontal refers to tooth – so “disease around the tooth.” It sounds like a Harry Potter spell, but it makes sense.

In early stage gum disease, the bacteria start creating pockets in the tissue and bone around the gums. Normal pocket depths for healthy gums are 3mm or less, ideally 1-2mm. When we start seeing 4mm and 5mm pockets, we know that the gums are being compromised. If talk about pockets is confusing to you, read our section below on periodontal pockets and it should make a lot more sense.

Disease stages: Mild to Advanced

periodontitis treatment periodontal cleaning periodontal pocket early stage gum disease gum disease symptoms

Early Stage

periodontal pocket periodontal cleaning

Advanced Stage

gum disease symptoms, advanced periodontal disease

Severe Advanced Stage

periodontitis treatment, periodontal cleaning, periodontal pocket

Severe End Stage Disease

Advanced Periodontal Disease

In advanced periodontal disease, the bacteria really start to take over. As the gum tissue is attacked, it recedes up the tooth, leaving tooth root exposed. The bone pulls back as well. Pocket depths increase to 5mm, 6mm and 7mm or more. The deeper the pocket, the more bacteria and food are collecting under the gums and the less support the tooth has. Teeth start to wiggle and get loose.

For anyone with advanced gum disease, it’s important to understand that your teeth may or may not be savable. The decision to keep teeth needs to be made on a tooth by tooth basis at this point. You don’t “fix” a tooth only to lose the whole thing after a few months. The next section describes what periodontitis treatment options are available at each phase of the disease.

too little gum tissue periodontal pocket periodontitis treatment

Periodontitis Treatment

Choosing a periodontitis treatment depends on how deep the infection has gotten under the gums. Periodontal cleanings treat mild to moderate periodontal disease. Moderate to severe cases typically require periodontal surgery. Either kind of periodontitis treatment requires a strict periodontal maintenance plan to insure that the disease doesn’t relapse. Finally, infections that have eroded all of the surrounding bone are left with the option of extractions and dentures.

Periodontal Cleaning

Remember what “periodontal” means? It means “around the tooth” and specifically it’s referring to around the tooth root. A periodontal cleaning goes beneath the gums and cleans around the tooth roots. These cleanings are done under anesthetic and require special instruments and techniques to completely clean out periodontal pockets. We use laser therapy, ultrasonic scaling, and place antibiotics in pockets to insure the best results possible.

Periodontal cleanings can treat mild to moderate disease because we are able to very effectively clean pockets up to 6mm deep. Cleaning deeper pockets typically requires surgery.

Curious what the difference is between a periodontal cleaning and a regular one? Read our section lower on the page to find out.

Periodontal Surgery

Periodontal surgery sounds scary, but it is really just a more advanced kind of a periodontal cleaning. In periodontal surgery, the gums are opened to allow us to clean deep along the tooth roots. Sometimes a surgery will also include bone or gum grafting to replace lost tissue.


End Stage Periodontitis Treatment: Extractions

Sadly, when periodontal disease gets deep enough into the bone, the only option is to pull the teeth. Often the teeth are fine. The bone loss and the infection are the problem. Without bone surrounding them, the teeth have no support. They are being held in the mouth by luck and calculus. Second, deep infection puts you at risk of a blood infection.

Dental Extraction

Periodontal Maintenance

Maintenance is where the rubber meets the road. Many people get periodontitis treatment. Many of those people still lose their teeth after several years because they didn’t realize that all successful periodontitis treatment requires maintenance. Periodontal disease is an infection that never goes away and is always trying to grow back. Keeping your teeth means controlling the infection to prevent more damage. That requires maintenance. It takes approximately 3 months for the bacteria that cause periodontal disease to grow back to harmful levels. Because of this, periodontal maintenance means seeing your dentist every 3 months for a periodontal maintenance cleaning. Don’t bother with periodontal treatment if you’re not ready to commit to maintenance. Periodontitis treatment without maintenance simply prolongs the inevitable and wastes your money.

How is a Periodontal Cleaning Different from a Regular One?

If you know what periodontal means, then you can probably guess the difference. Periodontal cleanings clean around the tooth root and deep into pockets. They are focused on treating the infection UNDER the gums. A regular cleaning, on the other hand, cleans everything ABOVE the gum seal around the tooth and nothing lower.

Different types of dental cleaning San Antonio Tx

What Is a Periodontal Pocket and Why Do Gum Pockets Matter?

What Is a Periodontal Pocket?

A periodontal pocket is a pocket, like your coat pocket, that forms around a tooth root. Periodontal pockets form when a periodontal infection breaks through gum seal around the tooth. Pockets can be shallow or extend all the way down the tooth root, depending on the depth of the infection.

Because periodontal pockets are caused by gum disease, dentists use pocket depth to measure the seriousness of the infection. They measure pockets with a tiny pokey tool called a perio-probe. A perio probe is a tiny ruler that slides down a tooth root and shows exactly how deep any pockets are.

How deep is too deep? Anything 4mm or greater signals the presence of infection.

Why Do Pockets Matter?

Periodontal pockets matter because they measure the damage caused by periodontal disease. Pockets can only form when the gum seal around the teeth is injured. They are strongholds of invading bacteria who eat rotting food and flesh. (Yucky, I know. However, it’s true.)

Measuring Periodontal Pockets with a Perio Probe

Is it Possible to Shrink Gum Pockets?

To shrink gum pockets you have to reduce the bacteria and keep it reduced. This requires periodontitis treatment, either periodontal cleaning or surgery, followed by regular periodontal maintenance cleanings every 3 months. It also requires vigilant brushing and flossing at home – especially flossing. Severely deep pockets require gum grafting to shrink, but moderate pockets will see shrinking with good treatment and maintenance.

What Happens If I Don’t Do Anything about Gum Disease?

You will eventually lose your teeth. It’s that simple.

Gum disease tricks people because it doesn’t hurt until it’s too late. People can’t believe that bone can be destroyed without them feeling it. But that’s what really happens. People with untreated gum infections start losing teeth and are shocked. “It never hurt!”

Why Doesn’t Gum Disease Hurt?

We only feel pain when nerves tell our brain that we’re in pain. In the jaw, the nerves run deep under the gums and inside the teeth. Anyone who’s had a toothache knows about the pain receptors inside the teeth. To feel pain from gum disease, the infection has to spread deep inside to set off the nerves inside the jaw and by the time that happens it’s too late for the teeth. If you have gum disease, treat it soon for the best outcome!

warning!! Gum Disease is a Silent Killer…and it kills more than teeth

It sounds crazy until you remember that gum disease is an infection. When this infection builds up in the jaw, it can spill over into the blood. In the blood, the infection spreads through the whole body and can even infect the heart and brain. That’s scary stuff.

And did you know that tooth loss caused by gum disease can shorten your life by up to 10 years? This infection is no joke. Tooth loss shortens people’s lifespan mainly because it impacts what and how they eat. It takes teeth to chew the fresh fruits, veggies and meat that keep us healthy. 

This negative diet change combined with increased inflammation from the infection, explains why gum disease also complicates diabetes control.

As the disease gets worse, the dead and dying gum and bone tissue also begin to smell, causing a form of bad breath that can be smelled across a room and that can’t be fixed with regular tricks like mints or gum. Left untreated, gum disease creates mouth misery and causes potentially life-threatening health complications. Read more on Periodontal Disease (Gum Disease)

Gum Disease

Click below to learn more about how we treat gum disease and help infections heal

Periodontal Dentistry

The Bad News: Periodontal Disease Is Incurable & Cause Tooth Loss

The GOOD NEWS! It’s treatable and you don’t have to lose your teeth! Click to find out how we keep periodontal disease from killing teeth.

Periodontal Surgery

What to do when you’ve got bacteria in your pockets?

Wait, did we just switch from dentistry to laundry advice? Oh no, reducing periodontal pockets is key to keeping your teeth when you have gum disease. Find out more.

Sedation Solutions

Dread the Dentist? Imagine Being Able to Sit Calmly in a Dental Chair with NO Anxiety?

Sound Impossible? Dental Sedation helps…

Schedule Your Consultation

Whether you have teeth or not, you deserve a smile you can be proud of!

A beautiful smile changes how you look. It also changes how you live. Imagine laughing and eating freely with friends again! If you want to smile with confidence, we can help. Take the first step today. Schedule your consultation!

Smiles are our passion so that living can be yours!