Periodontal Therapy
Healthy gums are the foundation of every other thing we do.
Periodontal therapy treats gum disease at every stage — from early inflammation to advanced bone loss. The goal is the same throughout: stable, healthy gums that support the rest of your dental care for the long term.
What is at stake
Why gum health matters
Gum disease is the leading cause of tooth loss in adults — not decay, not trauma, not anything else. It is also one of the most under-diagnosed and under-treated conditions in dentistry, because it is painless in its early and middle stages. By the time most people notice something is wrong, significant damage has often already occurred.
The disease process is straightforward: bacteria accumulate at the gumline, the gums become inflamed, the inflammation gradually destroys the bone supporting your teeth, and eventually the teeth loosen or fall out. The early stages are reversible. The late stages are not.
Beyond your mouth: A growing body of research links chronic periodontal inflammation to broader health concerns including heart disease, diabetes, and other systemic conditions. Healthy gums are part of a healthy body.
Diagnosis
What "having gum disease" actually looks like
Gum disease is not usually obvious from looking. We diagnose it through specific measurements and observations:
Periodontal probing.
A thin instrument measures the depth of the small space between your tooth and gum at multiple points around every tooth. Healthy depths are typically 1–3 mm. Deeper measurements indicate the gum has detached from the tooth — a hallmark of gum disease.
Bleeding on probing.
Healthy gums do not bleed when gently probed. Bleeding indicates inflammation.
Bone level on X-rays.
Periodontal disease destroys the bone that supports teeth. We can see bone loss on X-rays, often before any other obvious sign.
Visible signs.
Gums that look red, swollen, or that have receded from the teeth.
We capture and document these measurements at every comprehensive exam. Trends over time tell us whether your periodontal health is stable, improving, or declining.
Treatment stages
How we treat gum disease
- 1
Stage 1
Gingivitis (early inflammation).
The earliest stage of gum disease — gums are inflamed but no bone loss has occurred yet. Treatment is typically a thorough professional cleaning combined with improved home care. Reversible with consistent attention.
- 2
Stage 2
Mild to moderate periodontitis.
Bone loss has begun and pockets between the gum and tooth have deepened. Treatment usually involves scaling and root planing — sometimes called a "deep cleaning." This is a careful, methodical removal of plaque and hardened tartar from the root surfaces below the gumline, often performed in two appointments with local anesthesia for comfort.
- 3
Stage 3
Advanced periodontitis.
Significant bone loss and deep pockets. Treatment may involve periodontal surgery to access and clean root surfaces, reduce pocket depths, and in some cases regenerate lost bone with grafting.
- 4
Stage 4
Maintenance.
After active periodontal treatment, ongoing maintenance — typically every three to four months — is essential. The disease is manageable but rarely "cured." Consistent maintenance keeps it stable for the long term.
Surgery
When surgery becomes the right answer
Most periodontal cases are managed without surgery. When surgery is needed, it is typically for one of these situations:
Pocket reduction surgery.
When pockets between gums and teeth are too deep to clean effectively, we surgically reduce their depth — making the area accessible for daily home care and routine cleanings.
Bone grafting.
When periodontal disease has destroyed significant bone, we can sometimes regenerate it with bone grafting — particularly when the goal is to save a tooth or prepare the area for a future implant.
Soft tissue grafting.
When recession has exposed root surfaces, soft tissue grafts can rebuild the gum line — protecting the tooth, reducing sensitivity, and improving appearance.
We perform periodontal surgery in our Eustis office, with the same surgical precision and 3D planning we apply to implant cases.
The long term
Maintenance
Periodontal disease is chronic, like high blood pressure or diabetes. You can manage it well — but you cannot ignore it.
After active periodontal treatment, most patients move into a periodontal maintenance schedule, typically every three to four months. These visits are similar to routine cleanings but with extra attention to the deeper pockets and areas that have been treated. The interval is shorter because periodontal disease can recur if maintenance is delayed.
For patients with implants, periodontal maintenance is even more important. Implants can develop a condition similar to gum disease — called peri-implantitis — that threatens the implant if not caught early. Regular periodontal maintenance protects your implant investment for the long term.
Frequently asked
Common questions about periodontal therapy
Will scaling and root planing hurt?
The procedure is performed with local anesthesia for comfort. Most patients are surprised by how manageable it is. There may be mild soreness for a day or two afterward.
How many appointments does scaling and root planing take?
Typically two — half the mouth at each visit. Some cases can be completed in a single appointment.
Will my gums grow back after periodontal treatment?
Treatment can stop the disease and stabilize what is there. Lost bone and gum tissue typically do not regenerate on their own, though specific surgical procedures can rebuild some lost tissue. The earlier we treat, the more we can preserve.
Does insurance cover periodontal treatment?
Most dental insurance plans cover scaling and root planing, periodontal maintenance, and periodontal surgery — though specifics vary. We will review your benefits with you.
I have implants. Do I need periodontal care?
Yes — arguably more than someone with all natural teeth. Implants are vulnerable to a gum-disease-like condition called peri-implantitis. Regular periodontal maintenance is essential for protecting your implants long-term.
Concerned about your gum health?
A comprehensive exam tells us exactly where things stand. From there, we will explain what we see and what your options are — without alarmism and without minimizing real concerns.