According to the CDC…Open a new window to the CDC’s source…, periodontal disease affects more than 47% of adults over the age of 30.

But what exactly is it, and is there a cure? This blog post will explain what periodontal disease is and how it can be treated.

Check out our video for a detailed explanation from Dr. Shawn Keller:

What is periodontal disease?

Also called gum disease and periodontitis, periodontal disease is an infection in the gums that occurs when bacteria seep into the periodontal pocket–the space between the tooth and gum below the gumline.

A healthy periodontal pocket is between 1-3mm in depth. In advanced cases of the disease, the periodontal pocket can be 8mm or deeper. This space can’t be reached by brushing and flossing.

Periodontal disease and your bite

Your bite can cause periodontal disease if your teeth don’t hit evenly on both sides.


It can also change your bite, making the disease worse.

A healthy bite means your top or and bottom teeth bite down in the center of each other.

If your bite is off-center, it may cause a rocking motion in the teeth, similar to a fence post in loose dirt.

This rocking motion causes abfractions, areas at the gumline where the enamel has sheared away.

This makes the gumline rough and tough to keep clean. Over time, plaque will build up, creating a breeding ground for bacteria.

An uneven bite also causes the tooth to pull away from the gum, allowing bacteria to get under the gumline.

These bacteria form something called a biofilm. Once this happens, brushing and flossing alone won’t be able to keep your mouth clean.

It’s important to note that not all cases of periodontal disease are caused by poor brushing and flossing habits.

What are the four stages of periodontal disease?

There are four stages of periodontal disease:

  • Stage 1: Gingivitis – This initial stage is the only stage of gum disease that’s considered curable and reversible.
  • Stage 2: Slight (Mild) periodontal disease – At this point, periodontitis is no longer curable. But it is still manageable with the help of a dedicated home care routine and more frequent professional cleanings.
  • Stage 3: Moderate periodontal disease – Regular dental cleanings won’t work once your gum disease has progressed to this level. You need a deep cleaning called scaling and root planing.
  • Stage 4: Advanced periodontal disease – At this point, your gums show significant signs of gum disease. You can expect substantial bone loss and tooth loss.

How do you know if you have periodontitis?

When periodontal disease is in its early stages, you may not have any symptoms other than red gums or gums that bleed when you floss.

As the disease progresses, symptoms develop rapidly and become much more severe.

Symptoms of severe periodontitis include:

  • Red or swollen gums
  • Bleeding gums
  • Teeth hurt when biting down
  • Pain while chewing
  • Bad breath or bad taste that won’t go away
  • Loose teeth
  • Gums that have pulled away from your teeth
  • Your bite suddenly feels “off”
  • Your dentures don’t fit correctly

Can periodontitis be cured?

Regular hygiene cleanings and a strict homecare routine can reverse stage one of periodontitis.

Once your disease progresses past this point, you cannot cure it. You can successfully manage the symptoms and return to some level of health, but the disease will never entirely go away.

How do you treat periodontitis?

For decades the method of choice for managing periodontal disease has been a series of deep cleanings called scaling and root planing.

This involves numbing one quarter or one side of the mouth and using traditional dental tools and an ultrasonic scaler to deep clean below the gum to remove plaque and bacteria.

Scaling and root planing helps in the short term but also has its drawbacks.

Some disadvantages of scaling and root planing include:

  • Post-procedure soreness
  • Potential for further gum recession
  • Risk of leaving a root surface rough allowing bacteria to read adhere

Periodontal treatment will never be effective if your bite isn’t corrected first. Bacteria will continue to seep down between the tooth and gum where no toothbrush and floss can reach.

Dr. Keller uses a Tekscan to evaluate your bite. A Tekscan is a computer program that can tell where you are biting the hardest. You’ll bite on a wafer-thin sensor, and an image of your biting force will show up on a computer screen. This lets Dr. Keller see exactly where your bite is uneven.

Once the bite is fixed, modern periodontics allows us to sterilize the periodontal pockets and kill the bacteria while leaving the root surface smooth to help prevent reinfection.

How, you may ask? With lasers!

This means that instead of traditional periodontal surgery, we can now go in with a special laser and sterilize the periodontal pocket.

The gum can reattach to the tooth and bone by sterilizing the pocket, creating a tight seal that bacteria can’t penetrate.

When followed by excellent home care and regular visits with your hygienist, we have seen some patients reverse some of the more severe symptoms of periodontal disease.

Why choose Dr. Shawn Keller?

Kirkland dentist Dr. Shawn Keller delivers exceptional care without compromise.

He’s an artist at heart and combines this passion with his hours of dental training to ensure you always have the best care.

Led by a journey through his own chronic health issues, Dr. Keller learned about the total body approach and how seemingly unrelated health problems can be connected to your dental health.

Dr. Keller now uses these modern dental techniques to look at your whole health, how it relates to your dental health, and vice versa.

If you’re ready to restore your smile’s health and well-being, click below to set up a virtual consultation or schedule an in-office appointment.


Smiles by Design is located in Kirkland, WA…Open a new window to Google Maps for directions…, and serves patients from the Seattle-Bellevue area and out of state.