Our mouths are overflowing with bacteria that creates plaque on our teeth. Proper brushing and flossing aids in removing plaque before it has a chance to harden. When plaque is not removed, it hardens and is then referred to as “tartar” which cannot be removed by brushing and must be removed by a dentist or dental hygienist. If tartar is not removed it becomes extremely harmful to ones oral health.

The three stages of gum disease, from least to most severe, are gingivitis, periodontitis and advanced periodontitis.

Gingivitis. Tartar left untreated will begin to cause inflammation to the gums, called gingivitis. A patient with gingivitis experiences red, swollen gums that can bleed easily. Gingivitis does not cause loss of bone or tissue and can quickly be treated and reversed after routine cleaning appointments and proper at-home care.

Periodontitis. If gingivitis is not treated it advances to periodontitis. When this happens gums pull away from the teeth and form pockets that are infected. Plaque will continue to spread and grow BELOW the gum line. This causes the breakdown of bone and tissue that hold your teeth in place. If not treated, the bone, gums, and tissue are destroyed and teeth may eventually become loose and need to be removed.

Gum disease can be painless, so it is important to be aware of any of the following symptoms:

  • Swollen, red, tender or bleeding gums
  • Gums that recede or move away from the tooth
  • Persistent bad breath or bad taste in mouth
  • Loose teeth
  • Visible pus surrounding the teeth and gums

At your dental visit, periodontal disease can be identified after x-rays and an examination. A full series of x-rays will show any bone loss, tartar buildup and inflammation can be seen with a visual exam, and the dentist or hygienist will also use a tool to probe (measure) the pockets between your teeth. Healthy pocket depth is between 1-3mm. Pocket depths of 5mm or greater is a sign of advanced periodontal disease.


Controlling the infection is the first step of treating periodontal disease. Excellent home-care in combination with in-office treatment is required for treatment to be a success. You may also be advised to stop any bad habits that may be accelerating your gum disease, such as chewing tobacco.

Infection can be removed with a full mouth deep cleaning (scaling and root planning). A deep cleaning involves scaling off the tartar both above and below the gum line, and root planing removes rough spots on or between the teeth where herms gather. After this procedure, an antimicrobial mouthwash is usually prescribed to control the bacteria while healing. After scaling a root planing, routine periodontal maintenance cleaning appointments, as well as excellent home-care habits, are necessary to ensure that the infection does not resurface.

Surgical treatments

Some patients may have such advanced periodontal disease that corrective surgical procedures are required after scaling and root planning; or, if inflammation and deep pockets remain after the deep cleaning. Surgical treatment is referred to our in-house board-certified periodontist, Dr. Fernando Verdugo. These treatments may include:

Flap Surgery– This common surgery involves lifting back the gums and removing the tartar. Gums are then sutured back into place so the tissue fits around the tooth again. This is performed to remove the tartar in deep pockets and aid in reducing the deep pockets all together. After flap surgery is completed it is much easier to keep the area clean.

Bone and Tissue Grafts– Grafting can replace or support new growth of bone or gum tissue that periodontal disease has destroyed. One technique used with bone grafting is guided tissue regeneration, in which a piece of mesh-like fabric is inserted between the bone and gum tissue. This stops the gum tissue from growing where the bone should be, allowing the bone and tissue to re-grow.

To learn more about specific bone graft procedures, please see our blog posts.

Dr. Verdugo is highly trained and skilled to perform all treatment involved in periodontal surgery. The above-mentioned surgery is the most commonly required course of treatment. However, there are a variety of periodontal surgeries that you may be a candidate for. Each patient and case is unique. Dr. Verdugo travels to our office twice a month to see our patients and patients referred from other Bakersfield offices, for all aspects of periodontal concern.

Treatment results depend on many things, including severity of the disease, ability to maintain oral hygiene at home, and certain risk factors, such as smoking, which may lower the chances of success. Dr. Verdugo will advise you what level of success you will have with your specific case.

If you have questions about periodontal disease please give us a call!