Periodontics is a dentistry discipline that focuses solely on the inflammatory illness that causes damage to the gums and other supportive tissues surrounding the teeth. A periodontist specializes in gum disease prevention, evaluation, and treatment, as well as dental implant placement. Periodontists treat a wide range of conditions, from moderate gingivitis to advanced periodontitis.

At Washington Dental, we provide periodontal dental services for both children and adults in our facilities in the Los Angeles, Carson, Torrance, and Lomita areas. Our dentists provide preventive and restorative oral health services and also promotes preventive awareness on periodontal diseases.

What is Periodontitis?

Gum disease, often known as periodontitis, is a severe inflammation of the gums. It is usually caused by insufficient brushing and flossing practices, which enable plaque, a sticky film of bacteria, to build slowly and harden on the teeth.

Periodontal disease, in its severe stages, can cause painful bleeding gums and chewing issues, and sometimes tooth loss. If periodontitis is treated early and the appropriate dental care is upheld, this damage can be prevented.

Stages of Periodontitis

Gingivitis, mild periodontal disease, moderate periodontal disease, and advanced periodontal disease are the four phases of periodontal disease.


Gingivitis is the single stage of periodontal disease that may be reversed since the infection has still not reached the bones. It is caused by plaque accumulation on the teeth. At this point, there are just a few indications of the disease, and most of them are not painful. That is why periodontal disease is so widespread.

Periodontal disease usually does not make an appearance till the last stage. Bad breath, inflammation, soreness and bleeding of your gums when brushing  your teeth or flossing are all early warning symptoms to look out for. Gingivitis can be treated and reversed with good general dental hygiene and frequent dental examinations.

Mild Periodontal Disease

The second phase of periodontal disease is mild periodontal disease. It is irreversible, but can be managed. When the disease comes to this stage, the infection has migrated to the bone where it starts to damage it.

The bacterium develops and becomes more aggressive, resulting in increased loss of bone mass. Normal dental care is not going to cut it anymore at this point.

Excessive gum inflammation or redness, foul breath, bleeding when brushing, and probing depths of four to five millimeters are some indicators of mild periodontal disease.

Moderate Periodontal Disease

The third stage of periodontal disease, like the second stage, is also irreversible. Similar signs and symptoms present at the second phase appear in stage three, however probing depths are larger, allowing for bacteria to damage your bones and your entire immune system.

Scaling and root planing procedures are used to treat periodontal disease in stages two and three. Scaling and root planing are thorough cleaning procedures that remove bacteria residues that have been embedded in your gums. These phases can lead to bone and tooth loss,excessive bleeding, sensitivity, and tooth movement if left untreated.

Advanced Periodontal Disease

When periodontal disease progresses to its ultimate stage, the infection progresses even more and the bacterium develops into pathogenic bacteria yet again. You now have a 50% to 90% chance of losing bone mass.

Advanced gum disease produces red, inflamed, pus-filled gums, temperature sensitive, additional tooth loosening, painful biting, severe foul breath and bone loss. To remove the deep pockets filled with bacteria that have developed, periodontal surgery or periodontal laser treatment is required.

If it is not treated, stage four periodontal disease results in tooth spacing and gaps, gum recession, the necessity for dentures, and other serious health issues.

Periodontal disease can be avoided or slowed down by scheduling frequent examination and cleanings as well as following good, everyday dental care routines.It is, however, critical to treat periodontal disease as soon as possible before it worsens.

Types of Periodontal Disease

Types of periodontal disease include:


You may have gingivitis, the least severe form of periodontal disease, if your gums are red, swollen, bleed easily, or are painful. Gingivitis is a reversible gum disease that is usually caused by poor dental hygiene. Your gums can be restored to health by getting special treatment and practicing proper dental hygiene at home.


This is the most advanced form of gum disease. Not only does it damage your gum tissue, but it also affects your teeth and degrades your jawbone, resulting in tooth loss and jawbone damage. Chronic foul breath, receding gums, and gingival pockets that may contain pus as a result of infection are some symptoms of periodontitis.

Aggressive Periodontitis

This is the swift progression of periodontitis. At this stage, the loss of the gingival ligaments and bone occurs at a rapid rate.

Chronic Periodontitis

This is characterized by the swelling of the gingival tissues and the wasting away of the bone. This is the most prevalent type of periodontitis, which is defined by gingival pockets and gum atrophy. Deterioration of the bone and gum typically happens over time.

Systematic Periodontitis

This is the occurrence of periodontitis as a result of systemic illness. Systemic illnesses may include:

  • Heart disease
  • Diabetes
  • Respiratory disease

Necrotizing Periodontal Disease

This form of gum disease is more common in persons with systemic illnesses such as malnourishment, HIV and immunosuppression. Necrosis is defined as the death of living tissue, which means that illness does not erode the gingival tissue, periodontal ligaments, or alveolar bone, but instead deprives them of the nutrients they require to be healthy.

Symptoms of Periodontitis

Some gum problems may be treated by your regular dentist. However, if you have advanced gum disease, a complicated case, or are at danger of tooth loss, your dentist will send you to a periodontist.

Schedule an appointment with your dentist to see whether you should see a periodontist if you detect any of these gum disease signs and symptoms:

Swollen Gums

Plaque and tartar-forming bacteria cause inflammation, which is typically the first indication of gingivitis. This irritation, if left untreated, can cause pockets to develop around your teeth. This increases your chances of getting an infection, which might then lead to tooth loss.

Gums that are swollen might make your teeth appear shorter. In the early stages, you can manage the inflammation by seeing your dentist for a comprehensive cleaning and maintaining good dental hygiene at home.

Gums That Bleed Easily

When you brush, floss, or eat, your gums may bleed due to the inflammation. If your gums are sore to the touch, your toothbrush pink after brushing, or you spit up blood when you brush or floss, see your dentist immediately.

Foul Breath

Foul breath is common, but it is not usually a reason for alarm. However, if you take proper care of your mouth and the foul breath persists, it might be an indication of infection or the presence of bacteria pocket holes in your teeth.

Pain When Chewing

Gum inflammation can cause pockets to develop around your teeth, causing them to loosen and become more sensitive. You may also have difficulty chewing. If you detect a change in the way your teeth fit together or new gaps appearing between your teeth, schedule an appointment with your dentist for a diagnosis.

Decreasing Gum Line

Receding gums are not always the result of gum disease. This can also be caused by cleaning your teeth vigorously, which causes gum tissue damage. A periodontist can correct this condition for aesthetic reasons, perhaps decreasing your risk of future gum issues.

Gum recession that is not caused by excessive brushing, on the other hand, is typically an indication of advanced gum disease. At this stage, a periodontist may assess the problem and advise on the best course of action.

Causes of Periodontitis

Normally, healthy persons have dozens of different bacteria in their mouth. The majority of them are absolutely harmless. Bacteria develop and build up on your teeth if you don't brush them properly every day.

Poor dental hygiene is the most common cause of periodontitis. If you do not clean your teeth or brush in difficult to reach areas of your mouth, the following might occur:

  • Bacteria in your mouth will grow to form dental plaque.
  • If you do not brush away the plaque, the bacteria will accumulate minerals over time. This mineral deposit is known as tartar, and it encourages bacterial development near the tooth's root. The defensive response of your body to this bacterial proliferation causes gum inflammation.
  • The bond of the gum to the root of a tooth is destroyed over time, resulting in the formation of a periodontal pocket (gap) in between gum and root.
  • Dangerous anaerobic bacteria grow and thrive in the pocket, emitting toxins that can destroy the gums, teeth, and surrounding bone structures.

Periodontitis is caused by a number of factors including:

  • This is a huge risk factor
  • type 2 diabetes
  • Obesity
  • In women, hormonal changes (for example during menstruation, pregnancy, or menopause) can make the gums more sensitive.
  • Illnesses that affect your immune system, like HIV
  • Drugs or medications that decrease saliva flow in the mouth
  • Genetics
  • Inadequate nutrition, especially a vitamin C deficiency


A dentist or dental hygienist will do the following during a dental visit:

  • Examine your gums for symptoms of inflammation and take note of them.
  • Look for and measure any gaps around the teeth with a small ruler called a "probe." The length of these holes in a healthy mouth is generally between 1 and 3 millimeters. This pocket hole depth examination is often painless.
  • Inquire about your medical history to discover any illnesses or risk factors for gum disease (such as smoking or diabetes).

In addition, the dentist might:

  • Check for any signs of bone loss using an x-ray.
  • Refer you to a periodontist. Periodontists are specialists in the diagnosis and treatment of gum disease, and they may be able to give you treatment choices that your dentist does not.


Periodontitis can damage the supporting elements of your teeth, including the bones in your jaw, if it is not addressed. Your teeth become loose and may fall out or need to be extracted. Other complications include:

  • Painful abscess
  • Shifting of your teeth, which might make chewing difficult
  • Receding gums that expose the roots of your teeth
  • Complications during pregnancy, such as low birth weight and hypertension, are more likely to occur
  • Gum disease has been linked to an elevated risk of other health problems such as heart disease, lung infections, and diabetes

Preparation for a Periodontal Procedure

Taking certain drugs, such as pain relievers, and blood thinners, may need to be halted a few weeks before your surgery. Most dentists recommend that you do not smoke or drink alcohol for at least 24 hours before your treatment.

To reduce your chances of getting an infection, your doctor may prescribe an antibiotic to take before your surgery.

You should also make arrangements for someone to drive you home following your operation. Your response time may be affected by the anesthetic used by your periodontist, drowsiness, or other drugs you will be given during the operation. That means it is possible you will not be able to drive immediately.

Otherwise, follow your dentist's instructions to the letter.


If you have been diagnosed with periodontal disease, you have a number of treatment choices to choose from, depending on the specifics of your case and the severity of the condition. Treatment always starts with the least intrusive, non-surgical methods. Surgery, on the other hand, may be required in more extreme cases.

Non-Surgical Therapy

A special form of cleaning termed "scaling and root planing" would be the first line of protection against gum disease. Ultrasonic cleaning equipment is used in this process to remove plaque and tartar from areas of your teeth that normal cleaning methods can not reach, like beneath the gum line, on the tooth, and around the root.

The tooth's rough surface and root are then smoothed off. This creates a healthy, clean surface on which the gum tissue may reconnect to the tooth more easily. Scaling and root planing could be the only therapy you need if you manage your gum disease before it becomes serious.

However, like with any dental therapy, proper post-operative care is essential. Brush and floss regularly, eat a nutritious diet, limit tobacco use, and get regular dental exams to maintain your teeth in excellent condition and minimize future instances of gum disease. If you do not properly care for your teeth after a successful scaling and root planing, you are likely to develop gum disease again.

Surgical Treatment Options

Several surgical techniques have been developed to treat serious gum damage and recover a healthy smile. Your dentist will suggest the technique that is most appropriate for your teeth and gums. The following is a list of frequent performed periodontal surgery procedures:

Reduction of Pocket Depth

The teeth are tightly wrapped by gum tissue and securely held by the jaw bones in a healthy mouth. Periodontal disease negatively impacts these tissues and bones, resulting in pockets around the teeth.

The bigger these pockets are, the easier germs will accumulate inside them, causing more harm over time. The supporting tissue eventually deteriorates to the point that the tooth either falls out or needs to be extracted.


Your dentist can use a regeneration treatment to rebuild the bone and tissue that supports the teeth after they have been lost owing to severe gum disease. Folding back the gum tissue and eliminating germs, plaque, and tartar are the first steps in this procedure.

Your dentist  may then conduct a bone transplant to encourage new bone development, or he or she may apply a particular sort of protein that stimulates tissue growth to heal the regions that have been damaged by the illness, depending on your condition. This method uses a specific gel to treat the tooth. This gel encourages the formation of healthy bone and tissue by including the same proteins present in the growing tooth enamel.

Soft Tissue Graft

Gum recession is a common sign of gum disease, also called gingival recession. The roots become more visible when the gums recede. This can cause sensitivity to hot or cold beverages or foods, as well as making teeth look longer. It also makes the tooth more susceptible to gum disease, plaque, bacteria, and tartar.

Soft-tissue grafts include sewing tissue from the roof of your mouth or another source to the gum line, covering the roots and returning the gum line to its natural, healthy position. This technique can also be used to improve one's appearance.

Bone Grafting

Bone grafting is a procedure that involves the grafting of bone from one. When periodontitis has damaged the bone that surrounds your tooth root, this treatment is used. The transplant might be made up of tiny fragments of your own bone, donated bone, or synthetic bone.

The bone transplant keeps your tooth in place, preventing tooth loss. It also acts as a platform for natural bone regeneration.

Treatment aims to remove plaque and bacterial deposits from your teeth and gums.

Dental care practices

Your dentist or periodontist will advise you on how to minimize the quantity of bacteria in your mouth, which will include cleaning your teeth and gums. Your dentist will instruct you on how to correctly use toothbrushes and dental floss, as well as other oral hygiene items like mouthwash.

Here are a few pointers to help you maintain healthy teeth and gums:

  • Use fluoride toothpaste to brush your teeth twice a day.
  • Consider replacing your toothbrush with an electric toothbrush, which may be more effective.
  • To eliminate plaque, floss at least once a day.
  • A thorough cleaning by your dentist should be done at least twice a year
  • Avoid smoking or chewing tobacco
  • Book appointments for dental cleanings by your dentist

Your dentist will remove plaque and tartar from your teeth and their roots during a cleaning session, then polish and treat your teeth with fluoride. Deep cleaning may be required to allow periodontal holes to heal.


Antibiotics may be prescribed by your dentist in some situations to aid with chronic gum infections that are not responsive to cleanings. The antibiotic might come in the form of a mouthwash, gel, or capsule that you take orally.

Follow-up Appointments

After a few weeks, your dentist will want to check in with you, and then every three to six months after that to monitor your progress. They may suggest alternative treatment options, like surgery, if periodontal pockets are still present.


As stated before, if irritation worsens in areas that are difficult to reach with brushing and flossing, your dentist may consider flap surgery to remove deposits under your gums. Your gums are raised and the roots of your teeth are cleaned while you are anesthetized. After that, your gums are sewn back in place.

If you have any bone loss, bone grafting may be performed at the same time as flap surgery to replace the missing bone.

Are you a Periodontal Surgery Candidate?

Gum surgery is not necessary for everyone. Dentists, in cases of extreme periodontal disease, recommend gum surgery. It is also recommended to improve smile aesthetics. Patients may require periodontal surgery for a variety of reasons, including the following:

  • Gingival recession
  • Excessive gingival display
  • Inflamed or bleeding gums
  • Pocket holes in between teeth and your gums
  • Loose teeth
  • Pain when chewing
  • Foul breath

Periodontal treatment can help you recover the health of your gums and stop periodontal disease from progressing to the rest of your body. Gum disease, especially in males, can have serious health repercussions if it is not treated.

Find a Los Angeles Periodontist Near Me

Washington Dental has a staff of highly qualified dentists and periodontists that can help with a wide range of dental and periodontal issues. If you experience any of the above problems, we urge that you come in for a full examination so that we can figure out what is amiss and come up with a treatment plan that is right for you. Our dental practice offices are located in Los Angeles, Carson, Torrance, and Lomita. Please make an appointment with a skilled periodontist at the clinic closest to you.