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Do you suffer from bleeding gums and chronic bad breath?

If you said YES then you may have a serious infectious, contagious, inflammatory disease that requires immediate treatment. Periodontal disease is the result of bacteria collecting on the surfaces of the teeth as well as above and below the gum line. The disease destroys gums and bone and is the main cause of adult tooth loss. The harm from this disease also extends beyond the mouth, as the bacteria can travel to the bloodstream, which allows it to infect any major organ. Watch the video below on the research that has linked cardiovascular disease to periodontal disease.

You are not alone. At Zak Dental we can combat this problem with a personalized treatment plan to eliminate the infection in your gums and teeth at Zak Dental offices in Agoura Hills, Covina/San DimasDowney, Long Beach, North ParkSan Diego, Santa Barbara, Simi Valley, Temecula, Valencia, Ventura, and Whittier/La Mirada.

Periodontal Treatment FAQ


What is periodontal disease?

Periodontal disease, also known as gum disease, is an inflammatory condition that affects the tissues surrounding and supporting the teeth. It is caused by bacteria in plaque, a sticky film that forms on the teeth. If left untreated, periodontal disease can lead to gum recession, tooth loss, and systemic health problems.

What are the signs and symptoms of periodontal disease?

Common signs and symptoms of periodontal disease include:

    • Persistent bad breath
    • Swollen, red, or tender gums
    • Bleeding gums, especially during brushing or flossing
    • Receding gums or changes in the position of teeth
    • Loose or shifting teeth
    • Pus between the teeth and gums
    • Changes in the fit of dentures or partial dentures

How is periodontal disease treated?

Periodontal treatment aims to control the progression of the disease and restore gum health. Treatment options may include:

    • Scaling and root planing (deep cleaning) to remove plaque and tartar from below the gumline.
    • Antibiotic therapy to reduce bacterial infection and inflammation.
    • Surgical procedures, such as gum flap surgery or bone grafting, for advanced cases of periodontal disease.
    • Maintenance therapy, including regular dental cleanings and periodontal maintenance appointments, to prevent recurrence.

Is periodontal treatment painful?

The level of discomfort during periodontal treatment can vary depending on the severity of the disease and the type of procedure performed. Local anesthesia is often used to numb the area and minimize discomfort during treatment. Additionally, dental professionals may provide pain management strategies to help patients feel more comfortable.

Can periodontal disease be reversed?

In the early stages, known as gingivitis, periodontal disease can often be reversed with proper oral hygiene and professional dental care. However, in advanced stages, such as periodontitis, the damage to the gums and bone may be irreversible. Treatment aims to manage the disease and prevent further progression.

How long does periodontal treatment take?

The duration of periodontal treatment varies depending on the severity of the disease and the specific treatment plan recommended by the dental professional. In some cases, treatment may be completed in a single appointment, while others may require multiple visits over several weeks or months.

Can periodontal disease affect overall health?

Yes, research has shown that periodontal disease is associated with an increased risk of systemic health problems, including cardiovascular disease, diabetes, respiratory infections, and adverse pregnancy outcomes. Managing periodontal disease through proper treatment and maintenance may help reduce the risk of these complications.

How can I prevent periodontal disease?

To prevent periodontal disease, it’s essential to practice good oral hygiene habits, including brushing twice a day, flossing daily, and using antimicrobial mouthwash. Additionally, regular dental check-ups and cleanings are crucial for early detection and treatment of gum disease. Avoiding tobacco use and maintaining a healthy diet can also contribute to gum health.

If you have concerns about periodontal disease or are experiencing symptoms, it’s important to schedule an appointment with your dentist or periodontist for an evaluation and appropriate treatment recommendations. Early intervention can help prevent further damage and preserve oral health.

Scaling and Root Planing

Why is Scaling and Root Planing necessary for maintaining good gum and teeth health?


One of the most common and confusing procedures in dentistry is scaling and root planing.

Root planing is indicated for patients who have experienced a breakdown of the periodontal attachment fibers that hold the gingiva to the tooth roots and the teeth to the jaw bone. Root planing is an active treatment for an existing disease process. To put it simply, if there has been no loss of attachment, then there is no need for root planing.

Scaling, on the other hand, is used to remove tartar wherever it accumulates on a tooth, as a preventive measure – to prevent the onset of periodontal disease.

Loss of attachment at an early stage is the source of most of the confusion about root planing. With the help of a periodontal probe, the gingival attachment is evaluated at six different positions around each tooth. These numbers are recorded and become part of the patient’s permanent record. Healthy gingival pockets, where teeth emerge from the gums, are three millimeters deep or less.

Daily brushing and flossing can generally keep the area clean. If left on the teeth for more than 24 hours, bacterial plaque begins to solidify into tartar, which adheres strongly to the sides of the teeth – especially the cheek side of the upper molars; and the tongue side of the lower front teeth, because that’s where the major salivary glands are located.

The gums begin to swell with fluid in response to the constant presence of bacteria. If attachment loss occurs, the probe measures more than four millimeters and a diagnosis of periodontitis is made.

Periodontitis can be localized to a single tooth, generalized to all teeth, or anywhere in between.

If there is active inflammation, the gums will bleed on light stimulation and may be tender to probing. If tartar is detected on the root surfaces, it must be removed. Again, this is done by means of scaling.

Ultrasonic instruments may be helpful in removing larger deposits. A chlorhexidine rinse or other disinfectant solution may help reduce the bacterial population.

Even after the removal of tartar, the surfaces of the roots can still harbor the bacteria that lead to further periodontal deterioration. Therefore, when the calculus is removed, the root surfaces must be smoothed…by root planing.

In most patients, if the scaling and root planing procedures are completed satisfactorily and the patient maintains excellent oral hygiene, healing will occur. The swollen gums will begin to shrink and the inflammation will begin to subside. There may be some reattachment and re-attachment of the periodontal tissues; and there will be no bleeding on probing. However, periodontal pockets larger than four millimeters are likely to remain.

Additional forms of treatment, including the use of subgingival antibiotics and debridement of periodontal pockets with soft tissue lasers, may be used to help control the disease. Antibiotics may need to be applied several times to different areas of the affected teeth to achieve the best results.

After scaling and root planing, it is not uncommon for teeth to be sensitive, especially to sweets and cold temperatures. This is because the removal of tartar and bacterial plaque exposes healthy, porous dentin, which acts as an unhealthy insulating layer on the roots. Treatment with topical fluoride or other agents may reduce or eliminate sensitivity.

Currently, there is no cure for periodontal disease, and once the disease is diagnosed, there must be regular monitoring for signs of progression. To keep periodontal disease in remission, excellent oral hygiene and regular periodontal maintenance visits are essential.

Treatment of Periodontal Disease

How is periodontal disease treated to make gums healthy again?


Periodontal disease can destroy teeth and the bone that supports them. It begins with bacterial infiltration and inflammation in the gum pockets where the teeth emerge from the gums and ends with tooth loss, bite collapse, and possible systemic disease.

Early gum disease, or “gingivitis,” is reversible and is treated by scaling the teeth to remove plaque and tartar. The roots are not affected and the gingival attachment fibers are intact. Depending on the severity and adhesion of the deposits, ultrasonic cleaning equipment may also be used.

Patients with attachment loss (periodontal disease) may have a build-up of tartar and plaque on the roots. Again, ultrasonic instruments may be used, followed by manual root planing. The goal is to remove bacteria and toxins and to create a smooth root surface that is not susceptible to plaque build-up. Some periodontal tissue regeneration may be stimulated by soft tissue lasers.

In certain cases, your dentist may deem it appropriate to place antibiotics in the gum pockets at various locations around your teeth to reduce the bacterial population and its harmful byproducts, and to promote healing of the soft tissues. The antibiotics are usually released over a period of several days. It is possible to treat up to six different areas on a given tooth. Certain antibiotics may be given in low doses in pill form to suppress harmful enzymes without reducing the number of bacteria themselves, which could upset the delicate balance of bacteria in the mouth.

In advanced periodontal disease, the dentist or periodontist may need to surgically remove deep gum pockets where food is trapped and cannot be removed by the patient.

Stabilization of mobile teeth may also be recommended and typically involves bonding a rigid wire or mesh to the affected teeth to prevent them from drifting and tilting.

In order to prevent the development of caries on the exposed root surfaces and to minimize the sensitivity of the teeth, fluoride gel carriers are often used. The patient simply squirts prescription-strength fluoride gel into the plastic trays and wears them over the teeth for the recommended amount of time each day.

Controlling periodontal disease is almost entirely up to the patient, and requires eliminating smoking, maintaining a healthy diet, excellent oral hygiene, and controlling systemic health problems such as diabetes.

Naturopathic treatments such as essential oils can be effective, but should be used under the supervision of a qualified dental professional to monitor their safety and effectiveness.

Periodontal Maintenance

What exactly is Periodontal Maintenance cleaning and why is it important?


If you’ve been diagnosed and treated for periodontal disease, you probably know that it’s not curable. It’s a lifelong condition that requires ongoing management.

Although improvements in the treatment of the disease have shown promise in reducing its severity, long-term remission from the disease continues to depend on excellent oral hygiene, proper nutrition, control of risk factors such as smoking cessation and control of diabetes, and regular periodontal maintenance visits with your dentist.

Pockets that are more than four millimeters deep typically remain even after bacterial plaque and calculus are removed from gum pockets and tooth roots. The significance of this number is that toothbrush bristles, toothpicks, dental floss, and other home oral hygiene products cannot reach the bottom of these pockets to clean them. Periodontally destructive bacteria will re-colonize these areas unless they are regularly removed by a dental professional with instruments that are not available to the patient.

The length of time between periodontal maintenance visits varies depending on the severity of the disease, the amount of periodontal destruction that has already occurred, and other factors. On average, a patient with periodontal disease will need to be seen at intervals of three to four months.

Periodontal maintenance visits typically include re-measuring the gum pockets and carefully noting any increase in areas that bleed on probing, a sign of ongoing periodontal inflammation or re-inflammation. These areas often require additional treatment, such as local root planing, treatment with subgingival antibiotics, and possible surgical pocket reduction.

To evaluate the tooth-supporting bone for disease progression, dental radiographs can be exposed and compared to previous images. The movement of the teeth will be recorded and a careful assessment of the fit of the teeth will be made. It may be necessary to make minor bite adjustments to ensure that periodontally involved teeth are not overburdened, as the teeth may shift a bit when their bony support is lost. The adjustment is as simple as removing a small amount of the non-sensitive enamel to eliminate the tipping forces.

Dentists often prescribe at-home fluoride gel trays and antiseptic rinses to help control the disease and prevent complications such as tooth decay and sensitivity. Be sure to use them as directed, and for the best chance of preventing the progression of periodontal disease, make sure you keep your regular maintenance appointments.

Periodontal Disease and Heart Problems

Is it true periodontal disease and heart problems connected?


Blood vessels form a vast network of channels that carry nutrients from the food we eat to the muscles and other tissues of the body. They also carry oxygen, healing and immune cells, and other substances necessary to sustain life.

When chronic inflammation occurs anywhere in the body, such as in the gums and supporting bone of patients with moderate and severe periodontal disease, certain blood vessels can narrow and form clots that prevent critical blood flow. When this happens, the problem can be particularly dangerous in the small blood vessels of the heart and in the brain.

Impaired blood flow to the heart muscles can lead to heart disease and ultimately a heart attack, in which part of the heart muscle dies from lack of oxygen. Although it’s not entirely clear whether periodontal disease causes heart problems, the two conditions have been linked – which is significant because so many adults have some degree of periodontal disease.

If you’ve been diagnosed with periodontal disease, follow your dentist’s recommendations for treatment and be sure to follow up with your dentist at the recommended intervals.

Periodontal Disease and Stroke

Can untreated Periodontal Disease be connect to having a stroke?


Blood vessels form a vast network of channels that carry nutrients from food to muscles and other body tissues. They are also the transporters of oxygen, healing and immune cells, and other life-sustaining substances.

Certain blood vessels can narrow and clot when there is chronic inflammation anywhere in the body, such as the gums and tooth-supporting bone in patients with moderate and severe periodontal disease. When this happens, the problem can be particularly dangerous in the small vessels of the heart and brain.

A stroke is a condition in which the blood flow to an area of the brain is interrupted, resulting in the death of brain cells in the affected area. Depending on the area of the brain affected, the severity of stroke complications can range from loss of muscle control and sensation, to problems with vision and speech, to death.

Although the exact mechanism by which periodontal disease impairs brain blood flow is not fully understood, the problem is significant because so many adults have some periodontal disease.

If you’ve been diagnosed with periodontal disease, follow your dentist’s recommendations for treatment and be sure to follow up with your dentist at the recommended intervals.

Periodontal Disease and Diabetes

How does diabetes contribute to the development of periodontal disease and what can be done to prevent it?


The pancreas is an organ located in the abdomen. It plays an important role in digesting food and regulating blood sugar levels.

In healthy people, the pancreas produces insulin, a hormone that captures sugar from the bloodstream and transports it to the body’s tissues, where it can be used for energy or stored.

In people with type 1 diabetes, the pancreas does not produce enough insulin, so blood sugar levels are higher.

In people with type 2 diabetes, the pancreas produces enough insulin, but the tissues of the body become resistant to the insulin.

The result in both cases is that the blood is thicker or more viscous and may have difficulty flowing through the small blood vessels – such as those found in the heart, brain, eyes, and other organs. Decreased blood flow may rob downstream tissues of nutrients, oxygen, healing and immune cells. The results can be crippling and even fatal.

Diabetics are more likely to develop periodontal disease because the gums and the bone supporting the teeth, which make up the periodontal tissues of the mouth, are supplied by small blood vessels, and the blood flowing through them is more viscous in a diabetic. Gum tissue is constantly exposed to bacteria, viruses, and other germs in the mouth that can cause inflammation.

The ability of a person with diabetes to fight off these foreign invaders is less than ideal. That’s why it’s important to keep your mouth clean by brushing at least twice a day, flossing daily, and following the specific advice your dentist has given you to manage your unique oral health needs.

If you have diabetes, it’s especially important to maintain excellent oral hygiene and see your dentist for preventive and maintenance appointments on the schedule he or she recommends.

Periodontal disease is now considered an independent cause of type 2 diabetes, which is significant because so many adults have some degree of periodontal disease.

Chronic inflammatory conditions, including periodontal disease, cause blood vessels to narrow, reducing blood flow and increasing the likelihood of clot formation.

If you’ve been diagnosed with periodontal disease, follow your dentist’s recommendations for treatment. And be sure to get your teeth cleaned at the recommended intervals.

Remember that type 2 diabetes sometimes has no symptoms at all. Testing involves one of several simple blood tests: Fasting Blood Glucose, which measures blood glucose levels after you haven’t eaten for at least eight hours; Oral Glucose Tolerance Test, which measures how quickly glucose is absorbed from the blood after a dose of sugar is given; and the emerging standard: Hemoglobin A1C test, which evaluates blood glucose levels over a period of about 120 days.