Periodontal (Gum) Disease & Soft Tissues
Understanding and treating gum disease early is essential to protect your smile and overall oral health
Periodontal disease is a chronic bacterial infection that affects the gums and supporting bone around your teeth. When left untreated, inflammation gradually destroys these tissues, leading to gum recession, mobility, and even tooth loss. Receding gums occur when gum tissue pulls away or wears down along the root surface of the tooth. This can make teeth appear longer and often leads to sensitivity.
Common Symptoms:
- Red or swollen gums
- Persistent bad breath
- Bleeding while brushing or flossing
- Tender gums or loose teeth
- Gum recession and visible root surfaces
Common Risk Factors:
- Diabetes
- Smoking or vaping
- Family history of gum disease
- Teeth grinding or clenching
- Poor oral hygiene habits
Receding Gums: What Now?
While gum disease is a common cause, recession can also be triggered by habits like aggressive brushing or grinding. Your dentist will help determine the cause and recommend solutions, which may include:
- Adjusting your toothbrush, toothpaste, or brushing technique
- Wearing a night guard to protect against grinding
- Orthodontic treatment to correct bite pressure
- Gingival grafting or a frenectomy to reinforce the gumline
- Desensitizing treatments or bonded fillings on exposed roots
Periodontal Treatment: Step-by-Step
Step 1 — Initial Therapy
- Remove bacterial infection and halt disease progression.
- Clean plaque and tartar (calculus) from above and below the gumline.
- Hygienists use hand instruments and ultrasonic tools for complete disinfection.
Step 2 — Follow-Up Procedures (If Needed)
- Minor surgical procedures may be recommended, such as:
• Frenectomy
• Gingival grafting
• Pocket reduction - Dr. Nagel uses a minimally invasive approach and advanced Waterlase iPlus laser technology for optimal results.
Step 3 — Ongoing Maintenance
- Maintain gum health with regular visits, typically 3–4 times per year.
- Follow-up appointments with your dentist ensure long-term success and early detection of any recurring issues.
Soft Tissue Surgeries
What is a frenectomy?
- Most commonly done for children, the lip muscle or tongue muscle attachment can sometimes be “tied” or too tight. These can cause problems with breast-feeding, speech, and eruption of permanent teeth.
- Instead of using invasive techniques that require cutting of the muscle, Dr. Nagel uses the dental laser to reduce the attachment and move it away from the problem area.
- This procedure is sometimes necessary in adults to help prevent or stop the progression of receding gums, or to make room for a prosthesis like a denture.
What is gingival grafting?
- Gingival grafting often involves removing soft tissue from a different area of the mouth, often the hard palate, and transplanting it to a site where the gingiva needs reinforcement, such as in areas of advanced gum recession.
What is pocket reduction therapy?
- Pocket reduction therapy is done when the bone loss around a tooth is significant enough to cause chronic inflammation, and sometimes infection, around a tooth. The deep pocket makes cleaning the area at home impossible, and if it cannot be maintained then the bone loss may progress overtime leading to loss of the tooth.
- Pocket reduction is a surgical technique done mainly with the Waterlase iplus laser, to disinfect the area and gently re-shape the bone to allow the gum tissues to heal and ideally close the pocket to outside bacteria.
What is a gum lift or crown lengthening?
- Using the dental laser, this minimally invasive approach helps to raise the gums away from the teeth to give then teeth a lengthened appearance and reducing a “gummy smile”.
- In some cases, the gums or supporting bone must be reshaped around a tooth, especially if it has been broken or worn down significantly, when placing a crown or filling.