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“My dentist says I have gum disease, and wants to do a deep cleaning. Is that the best treatment? And are all deep cleanings basically the same?”

Following a thorough examination, which includes probing of the gum tissue and x-rays, your dentist may say you have gum disease, or periodontal disease. There are several stages of gum disease, and your dentist will explain to you whether you have gingivitis, mild to moderate periodontitis, or severe/ advanced periodontitis.

If your gums are inflamed, tender, and bleed easily, but the bone and connective tissues are unaffected, you likely have gingivitis. This condition usually responds well to a routine dental cleaning and improved home care habits, such as brushing thoroughly at the gumline, flossing regularly, and the use of a Water Pik. No deep cleaning is necessary.

Mild to moderate periodontitis is a chronic infection in the gums, bone, and supporting tissues to an extent that irreversible damage has occurred. Tartar or calculus typically has formed under the gum line, forming pockets where bacteria can collect, causing your gums to become red, swollen, tender, and bleed easily. The bone of the jaw around the teeth can be affected, leaving permanent defects in the bone around the teeth. At this stage, gum disease can usually be treated with a thorough deep cleaning.

However, not all deep cleanings are created equal.

In our office, we make every effort to make certain your experience is as comfortable as possible, with the best outcome as our goal. If you are anxious about the procedure, you will be offered a sedative. If your gum disease is extensive, there will be more than one appointment to complete your treatment. Your gum tissue will be numbed to ensure your comfort and our hygienist’s thoroughness. We use the Perioscope, a dental endoscope that we have been using since its invention about 25 years ago. It is a “pocket camera” that allows vision under the gumline to make sure all of the tartar has been removed- so critical to healing. Very few offices have one.

Left untreated, the infection will progress – slowly at times, but sometimes rapidly, depending on your immune system, whether or not you smoke, or have diabetes. In advanced or severe periodontitis, not only are the gums infected, but the underlying bone and connective tissues have been seriously destroyed, causing teeth to shift and become loose, causing changes in your bite and difficulty chewing. Bad breath and a bad taste in your mouth are also signs of progressing gum disease. If you have these symptoms, a deep cleaning alone will not likely be effective in stopping the disease process. If your dentist is recommending a deep cleaning for your severe periodontitis, it would be in your best interest to see a periodontist (gum specialist) for a second opinion.