Periodontal therapy is treatment for gum disease. “Periodontal” means the tissues around your teeth: your gums, ligaments, and the bone that holds teeth in place. When bacteria in plaque and tartar build up along the gumline, the gums get inflamed and infected. This is gum disease, also called periodontal disease.
It starts as gingivitis and can progress to periodontitis. Without care, the infection can damage bone, cause gum recession, and even lead to loose teeth and tooth loss.
Our goal with periodontal therapy is to stop the infection, heal the gums, reduce pocket depth, and protect the bone. Treatment may be non-surgical or surgical, depending on how advanced the disease is.
Healthy gums are the base of a healthy smile. Periodontal therapy also supports your overall health. Studies link advanced gum disease to higher risks of heart disease, diabetes problems, and complications in pregnancy. Dr. John E. Richardson, Dr. Lynnette F. Mesina, Dr. Noelle Ling, and Dr. Pegah Ardestani treat gum disease to reduce harmful bacteria and inflammation, and improve your whole-body health.
Periodontal Treatments
We build comprehensive treatment plans for gum issues at Bryn Mawr Dental Health Group. Your treatment plan depends on your exam, X-rays, and the depth of your gum pockets. Early disease can often be treated with non-surgical care. More advanced cases may need surgery to repair damage and reduce deep pockets that trap bacteria. Common options include:
- Non-surgical periodontal therapy: deep cleaning (scaling and root planing) to remove plaque and tartar above and below the gumline, smooth the roots so gums can reattach, local antibiotics or antimicrobial rinses placed in pockets, laser gum therapy to reduce bacteria and help gums heal, and periodontal maintenance cleanings every 3 to 4 months to keep bacteria under control and prevent new buildup.
- Surgical periodontal therapy: pocket reduction surgery (flap surgery) to lift the gum tissue, clean infected areas, and reshape bone if needed; gum grafts (soft tissue grafting) to cover exposed roots and treat gum recession; bone grafts and guided tissue regeneration to rebuild bone lost to periodontitis; and, when a tooth cannot be saved, extraction with ridge preservation and later dental implant placement to restore your bite and smile.
Most deep cleanings are done with local anesthesia to keep you comfortable. If you feel nervous, ask about gentle sedation options. After treatment, you will get home care instructions. Good brushing, flossing, and using interdental cleaners or a water flosser will help your gums heal and stay healthy.
Regular periodontal maintenance visits are key. They allow your dental team to monitor your gum pockets, remove tartar you can’t reach at home, and adjust your care as needed.
Stages of Gum Disease
Gingivitis
This is the first stage of gum disease. Plaque along the gumline makes the gums red, puffy, and tender. You may notice bleeding when you brush or floss, and bad breath. At this stage, there is no permanent bone loss. Gingivitis is reversible with good home care and a professional cleaning. Early action here prevents bigger problems later.
Early Periodontitis
If gingivitis is not treated, it can progress. Bacteria move under the gumline, and the body’s immune response starts to break down the tissue and bone that support your teeth. Gums may start to pull away, forming pockets around the teeth. You might notice mild gum recession and more frequent bleeding. Deep cleaning (scaling and root planing) is usually recommended at this stage to remove tartar under the gums and smooth the roots so the gums can reattach.
Moderate Periodontitis
Infection and inflammation become more severe. Pocket depths increase, more bone is lost, and teeth may start to feel slightly loose. You may have gum tenderness, bad breath, and more visible recession. Non-surgical therapy can still help, often combined with local antibiotics or laser therapy. Some areas may also need surgical care to reduce deep pockets that harbor bacteria.
Advanced Periodontitis
In this stage, there is significant bone loss, deep pockets, and possible tooth mobility or shifting. You may have pain when chewing, longer-looking teeth from severe recession, and sometimes abscesses. Surgical periodontal therapy is usually needed to clean deep infection, reduce pocket depth, and repair or regenerate lost tissue and bone. In some cases, teeth that cannot be saved are removed, and missing teeth can be replaced with dental implants after the gums are healthy.
Risk Factors for Gum Disease
Anyone can get gum disease, but certain factors raise your risk. Knowing your risks helps you protect your smile.
- Poor oral hygiene and skipped cleanings
- Smoking or vaping nicotine
- Diabetes (especially if blood sugar is not well controlled)
- Family history or genetic tendency to periodontitis
- Hormonal changes (pregnancy, menopause, birth control)
- Dry mouth (from medications or health conditions)
- Stress and clenching or grinding teeth
- A diet high in sugar or acidic drinks
- Certain medications that affect the gums or saliva
- Older age and past gum infections
If you have one or more of these risk factors, regular dental checkups are extra important. Professional cleanings, early screening for bleeding gums or changes in pocket depth, and prompt treatment can prevent gum infection from worsening. If you smoke, talk to your doctor about quitting. If you have diabetes, keeping your blood sugar in range helps your gums heal.
Use a soft toothbrush, brush twice a day with fluoride toothpaste, floss daily, and consider a water flosser or interdental brushes to clean between teeth. An antimicrobial mouth rinse can also help reduce oral bacteria.
What to Expect During and After Therapy
During your visit, your dental team will check your gums, measure pocket depths, and take X-rays to see bone levels. They will explain your diagnosis (gingivitis or the level of periodontitis) and review your options. For deep cleaning, the area is numbed so you feel pressure but not pain. Treatment may be completed in a single visit or split into sections.
Mild soreness or tooth sensitivity is common for a few days. Over-the-counter pain relief and a sensitive toothpaste usually help. After surgery, you will get clear instructions for diet, cleaning, and follow-up. Stitches may be placed and removed at a later visit.
Long-Term Care and Maintenance
Gum disease is a chronic condition for many people. The bacteria that cause it can return if not controlled. That is why periodontal maintenance, usually every 3 to 4 months, is part of your long-term plan. These visits clean deeper areas, check your pocket depths, and catch any new trouble spots early. With steady home care and regular maintenance, most patients keep their gums healthy and their teeth stable for years.
If you are noticing bleeding gums, bad breath, or gum recession, don’t wait. Early periodontal therapy can make a big difference, protect your oral health, and help you keep your natural teeth. Reach out to schedule a gum evaluation and get a personalized plan for healthy gums and a confident, fresh smile. Call (610) 897-0825 or request an appointment online today.