Gum disease, from early signs to advanced periodontitis.

Gum disease is caused by plaque and bacteria that spread and grow underneath the gum line. The body's immune response to that infection breaks down the attachment between the tooth and the surrounding bone — creating what we call a periodontal pocket.

Untreated, the pocket deepens, more bone is lost, and the tooth gradually loosens. The process is usually painless until late, which is why so many people don't realise they have it until a dentist or hygienist tells them.

• Gums that bleed during or after brushing
• Red, swollen, or tender gums
• Persistent bad breath or an altered taste
• Gums that have receded — teeth look longer than they used to
• Loose or shifting teeth
• A change in how your bite feels

Most of these can be subtle. Many patients arrive at our practice with advanced disease and only one symptom — a single tooth that has started to feel different.

Gingivitis is the earliest, reversible stage. The gums are inflamed — red, swollen, bleeding — but no bone has been lost. Treated promptly, gingivitis resolves completely.

Periodontitis is the more serious form. Bone has begun to recede from around the teeth, creating periodontal pockets that harbour further infection. Bone loss is not reversible — but the disease is treatable, and further loss can be prevented.

Treatment begins with a thorough specialist examination — pocket measurements, X-rays where indicated, and a discussion of your medical history and any contributing factors (smoking, diabetes, medication, family history).

Non-surgical treatment is the foundation, and it is staged in two steps rather than one long appointment. It begins with a routine cleaning above the gum line; at a second appointment we clean below the gum line, where the disease actually sits. That sequence follows the EFP treatment guideline for periodontitis, and for most cases it is enough.

Surgical treatment is reserved for cases where non-surgical methods are inadequate, or where bone reconstruction (regenerative periodontal surgery) can recover some of what's been lost. We discuss this option carefully — it isn't the right choice for every case.

After flap surgery, the full post-operative instructions cover rinsing, medication, diet and brushing through the healing period.

After active treatment, success depends on consistent home care, management of any systemic conditions, and structured maintenance visits on a 3 to 6-month recall.

The same inflammatory process that damages gums and bone has measurable links to diabetes control, cardiovascular health, pregnancy outcomes, and risk of certain respiratory infections. The relationship is not always one of cause and effect, but the associations are well-documented.

Treating periodontal disease is, in part, treating a chronic source of inflammation in the body. We're conservative about claims here — but for patients with diabetes or HIV especially, the benefit of stable periodontal health is clinically significant.