General — 6 min read
Gum Care
Periodontal disease removes bone silently and painlessly for years. By the time a tooth feels loose, most of what held it is already gone.
Screened and introduced free, usually within a few hours. Sunny Isles Beach, Florida and the surrounding corridor.
Indications
Get this assessed if you notice
Gingivitis is inflammation of the gum and is fully reversible. Periodontitis is the stage after, where the inflammation has reached the bone — and bone that has been lost does not return on its own. The distinction is the single most consequential one in routine dentistry.
- Blood in the sink when you brush or floss
- Gums that have pulled back, making teeth look longer
- Persistent bad breath or a bad taste that does not clear
- A tooth that feels slightly loose, or has moved position
- Food packing into a space that never used to trap anything
- Gums that are tender, swollen or discharge when pressed
Good candidate if
- Bleeding has been present for more than two weeks
- You have been told you have pockets but not shown the chart
- You are diabetic, pregnant, or a smoker
- You are planning implants or veneers and need a stable foundation
No cost, no obligation, no lead list.
The detail
What is actually happening below the gum line
Periodontal disease removes bone silently and painlessly for years. By the time a tooth feels loose, most of what held it is already gone.
Plaque bacteria at the gum margin provoke an immune response. In gingivitis, that response is confined to soft tissue — remove the plaque and it resolves entirely within weeks. If it persists, the inflammation extends to the ligament and bone that anchor the tooth. The gum detaches from the root, forming a pocket that no toothbrush can reach, which fills with bacteria, which deepens the pocket. It is self-reinforcing, and it is why the disease accelerates once it starts.
There is a two-way relationship with general health that is now well documented. Periodontal disease is associated with poorer glycaemic control in diabetes, and diabetes worsens periodontal disease in turn. Associations with cardiovascular disease and with adverse pregnancy outcomes are established in the literature. This is a reasonable argument for treating gum inflammation as a health matter rather than a cosmetic one — and for telling your physician about it.
The sequence
What actually happens, in order.
Timings vary between practices and cases. The order does not — and a plan that skips a step is worth asking about.
Full charting
Six measurements per tooth, bleeding index, recession, mobility and furcation involvement, with radiographs for bone levels.
Cause control
Scaling and root planing under local anaesthetic, by quadrant, plus specific coaching on the sites you are missing.
Reassess at 6-8 weeks
The chart is repeated. This comparison, not an opinion, determines what happens next.
Residual pockets
Sites still 5mm or deeper are referred for surgical access, regeneration or localised antimicrobials.
Maintenance
Every three to four months indefinitely. Recurrence after successful treatment is almost always a maintenance failure.
Getting the right hands
Who should be doing your gum care.
This is the variable that decides your result, and it is the one you have least ability to assess from the outside.
Not years in dentistry. How many of these they do in a month, and what the difficult ones looked like.
Anyone can photograph a result on delivery day. We want to see it after it has been used.
CBCT, microscope, scanner, printer — whichever this case genuinely requires, on site rather than referred out.
For anything ceramic, the technician is half the result. A dentist who cannot name theirs is outsourcing blind.
Gum Care FAQ
What people ask us about gum care.
Including the cost question, answered with a real range rather than a request to call.
Gingivitis, yes — completely, usually within two to three weeks of thorough plaque removal. Periodontitis can be arrested and pockets reduced, but bone already lost does not regenerate without specific surgical grafting, and even then only in favourably shaped defects. This is why the early stage is worth taking seriously.
Scaling and root planing typically runs $200 to $400 per quadrant in South Florida. Maintenance visits are $130 to $250 each. Surgical treatment for residual pockets is $600 to $1,500 per quadrant. Most dental insurance covers a meaningful share, because it is classified as necessary rather than elective.
Not if it is caught and then maintained. Even advanced cases are frequently stabilised for decades with treatment and three-monthly maintenance. Teeth are lost when the disease goes untreated, or when treatment succeeds and maintenance is then abandoned.
Almost always because specific sites are being missed — commonly between the teeth and behind the last molars. Bleeding is site-specific and highly reliable as a signal. Disclosing tablets at home will show you exactly where in about thirty seconds.
A water flosser is very effective at disrupting biofilm and is markedly better than doing nothing, particularly around implants, bridges and braces. For tight contacts between healthy teeth, floss or interdental brushes still remove more. Used together they outperform either alone.