• Remove the cause - clean your teeth well. Use a toothbrush and floss
• For acute infections sometimes dentists will recommend chlorhexidine mouthwash or an antibiotic.

Treating periodontal disease

• As per treating gingivitis - effective removal of plaque
  
• Any defective restorations or those that trap plaque may need to be changed so you CAN clean.
• Removal of calculus (hardened plaque)
• Scale and cleaning
• Root planning

How do I know if I have gum disease?

• Bleeding or swollen gums
• Changes in the color of the gums
• Bad breath
• You might not be able to tell! It can be very slow or may cause you no obvious complaints.
• Dentists can tell from "Probing" your gums
• 'X-rays' will show loss of bone which indicates periodontal disease. Calculus that causes periodontal disease may also be seen in x-rays

Bleeding gums
MYTH: Bleed gums are caused by brushing. Bleeding gums are not normal and the cause should be investigated by a dentist.
Bleeding is an early sign of periodontitis but may not result in any further problems. However, it is usually also present where the disease has started to cause loss of bone around the teeth, with development of "pockets" where the gum becomes detached from the tooth and areas of plaque and food accumulation occur, which in turn cause further problems.
Other conditions can cause bleeding gums.

What is plaque?
Plaque is a build up of bacteria and other microorganisms, dead cells, and a bit of left over food. Scrape your fingernail over your tooth and the whitish film that you collect is plaque.
The inside of the mouth is a cosmopolitan village of bacteria and other microorganisms that we can't permanently remove. Experiments have shown that one hour after cleaning up to one million bacteria can be recovered from a tooth surface! A diet of refined foods tends to result in a greater build up of less desirable bacteria on the teeth.

What is tartar/calculus?
Calculus is something studied in higher mathematics and tartar is something said by babies when they wave good-bye! No. Try again.
Calculus (or tartar) is plaque which has been hardened by minerals. The amount of calculus that forms around the teeth is determined by the cleanliness of the teeth and the amount and types of minerals in the saliva and being released around the teeth.

Periodontal pockets
A periodontal pocket isthe gap measured between the tooth-gum edge and the underlying bone. A pocket can be difficult to clean and is a home to bacteria and other microorganisms.This can cause bad breath. Dentists use a periodontal probe to tell if a periodontal pocket is present.

Periodontal probing
A periodontal probe is used to measure the bone loss around teeth and to determine whether gums bleed easily. When the probing measurements are recorded this is called periodontal charting. Up to 6 measurements may be recorded for each tooth. This can help a dentist work out if treatment for periodontal disease is effective.These photos show the periodontal probe inserted into a "pocket" to a depth of 7 mm. In an ideal healthy situation this measurement would be less than 3 mm

Scaling and cleaning
This involves cleaning the root surface of the tooth to remove plaque and calculus.
Cleaning calculus is done with sharp instruments called "scalers" or sometimes with an ultrasonic cleaner which vibrates off the hardened material.

Root planing
When the calculus and plaque is located on the tooth roots and in deep pockets its removal and the subsequent cleaning of the root surfaces is sometimes referred to as "Root planing". The treatment is similar to scaling and cleaning but usually more difficult and time consuming because it is difficult to get to deep areas.

Periodontal surgery and other forms of treatment
When gums are not healing well after scaling or Root planing other forms of treatment may be required. Your dental health professional will discuss these with you.

Smoking and gums
Smoking -Smokers are at between 2.5 and 6 times greater risk of periodontal disease compared with nonsmokers. This may be because smoking affects the immune system by lowering the body's ability to inhibit bacteria that are associated with periodontal disease. To find out more about quitting smoking try the QUIT site

Heart attacks and gums
A lot of recent research has looked at the link between periodontal disease and heart attacks. Heart attacks have been shown to be related to bacterial and viral infections and the mouth is now being examined closely as the source of these microorganisms.
A study* by the school of dentistry in Turkey looked at 120 patients with heart problems and concluded that periodontal disease may be associated with acute heart attacks. To search the internet for research articles on this topic....
*J Periodontal 2000 Dec;71(12):1882-6.

Strokes and gums
Periodontal disease has also been shown to be an important risk factor for strokes (cerebrovascular accidents) according to a study# published in October 2000 which looked at 9962 adults aged between 25 and 74 years. The lowest risk people where those with gingivitis, followed by those with no teeth and those with periodontal disease where at greatest risk. To search the internet for research articles on this topic....
#Arch Intern Med 2000 Oct 9;160(18):2749-55.
The implications of this research are that keeping your teeth and gums healthy is important to your overall health.