Gum Disease

Providing Gum Disease Treatment in Ann Arbor, MI

The number one prevention for gum disease is brushing and flossing daily and visiting your periodontist, Dr. Debby Hwang, and Dental Hygienist for professional cleanings at least twice a year

What is gum disease?

Gum disease, or periodontal disease, is a chronic, incurable bacterial infection of the gums and bone surrounding your teeth. Research shows that 75% of Americans have some form of periodontal disease and is the major cause of tooth loss in adults. Some of the signs of gum disease includes bleeding gums, bad mouth odor, and pain or swelling of the gums. Sometimes gum disease can be painless, and your gums may be absent of the classic signs, therefore you may not know you have it.

How we diagnose periodontal disease

In a healthy mouth, your gums that surround each tooth should be firmly attached to your teeth. The space between your tooth and gums should measure below 3 millimeters in depth. The"V-shaped" space between your teeth and gums is also called a pocket or sulcus. Bacteria grow and multiply in these pockets and the infection process begins.

At each regular dental check up, the Dental Hygienist will assist the dentist to assess your gum health by measuring the pockets with an instrument called a probe. When plaque sits in the pockets, the gums begin to pull away from the teeth. When the gum tissue is damaged, the sulcus develops into a deep pocket, generally causing more severe disease. The greater the depth of the pocket the greater the disease. The Hygienist will also record if there is bleeding upon probing, delayed bleeding, and separation of the tooth and gums. In addition, the hygienist will take x-rays to check for bone loss. The doctor will evaluate this diagnostic evidence to determine the health of your gums.

Causes of Periodontal Disease

Plaque that sits deep in the sulcus or pocket is one of the causes. Plaque is a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums. Yeast, viruses, and fungi can also be in the sulcus along with bacteria. Also systemic illness such as diabetes, or lifestyle choices such as smoking can be contributing factors.


In early stages of gum disease, the gums become red, swollen and bleed easily, this early stage is called gingivitis. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing as well as preventive professional cleanings. Over time, if gingivitis persists and you do not brush or floss regularly to remove plaque; gingivitis can lead to more serious conditions beyond the gums and into deep areas that surround gums, bone, and ligaments.


In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. Whereas healthy gums and bone anchor teeth firmly in place, infected gums can cause teeth to become loose, fall out, or have to be removed by a dentist.

If caught and treated early, a hygienist in our office will provide a professional cleaning. You will not be eligible for a preventive cleaning, as you will need a more advanced cleaning that involves removing calculus, bacteria and infection from under the gum. However, if the disease is allowed to progress, you will be referred to the periodontist in our office. Advanced periodontitis may require surgery as part of the treatment plan.

Periodontitis is an incurable disease that can have serious implications for your overall health.

Increased Benefits

The treatment of periodontal disease is vital for numerous reasons, and most often this entitles you to an additional professional cleaning or two each year. While each insurance policy is individual, most policies cover additional cleanings for patients with periodontal disease, diabetes, heart disease or pregnant patients. Check with your insurance carrier to see if you are covered for additional cleanings each year.

Cardiovascular Disease

Researchers have discovered that if you have periodontal disease, you may have an increased risk of coronary heart disease, or stroke. Bleeding gums are open wounds in the mouth, and this opens a doorway that allows harmful bacteria to enter your bloodstream. Research indicates that bacteria from the mouth that enters your bloodstream can lead to the build-up of fatty deposits and the formation of blood clots that can block your arteries and even trigger a heart attack. If these fat deposits break apart and are carried away in your bloodstream, they can lodge in your brain, block a blood vessel, and cause a stroke.

If you are at risk of cardiovascular disease, or have already suffered a heart attack or stroke, you should visit your Dr. Hwang regularly to either insure the prevention of periodontal disease or to help manage periodontal disease.

If we determine that you have periodontal disease, we will see you for more frequent professional cleanings. We may prescribe antibiotics or medicated mouth rinses. We will work with you and your physician to create a suitable oral hygiene routine.


If you are diabetic, you are at a greater risk of suffering from oral infection and diseases, including periodontal disease. Diabetes contributes to periodontal disease in three ways: It lowers your body's ability to fight infection, results in high blood sugar levels, and causes dry mouth.

Diabetes lowers the body's resistance to infection by causing blood vessels to thicken and become less elastic. This decreases the flow of white blood cell's, oxygen, and nutrients to the body's tissues and slows the removal of harmful wastes. This can weaken your mouth's resistance to infection like periodontal disease.

Poorly controlled diabetes means that there are often excess levels of glucose in the blood and saliva. The bacteria in your mouth that are responsible for periodontal disease thrive on this sugar.

Diabetics who do not control their blood sugar levels can experience dry mouth. A lack of saliva allows plaque to build up easily on teeth.

If you are diabetic, it is important for you to prevent or control periodontal disease, as this can directly affect your blood sugar readings. If you are experiencing high blood sugar levels, you should see your Dr. Hwang immediately for a periodontal evaluation. Helping to manage your periodontal disease can also assist you in managing your blood sugar levels.

To prevent infection in your mouth, you should brush and floss every day to remove plaque and visit us regularly for dental cleanings. We may prescribe antibiotics, medicated mouth rinses, and do more frequent dental exams. With good dental and medical care, your gums and teeth can remain healthy and free of periodontal disease, and you can achieve better control of your diabetes.

Pulmonary Health

Research has discovered a link between periodontal disease and respiratory infections. If you suffer from periodontal disease, you may be breathing harmful bacteria into your lungs every day. As you breathe in, these bacteria enter your lungs, where they can multiply and inflame lung tissues. Evidence indicates that bacteria in your lungs can lead to respiratory infections like pneumonia, bronchitis, emphysema, and chronic obstructive pulmonary disease. If you smoke, chances are that you already have a weakened immune system.

If we determine that you have periodontal disease, we will recommend an appropriate treatment plan and work with you to create a suitable oral hygiene routine. Prompt treatment of periodontal disease and preventive dental cleanings will remove the source of bacteria and allow your gums to heal. Then you will reduce your risk of respiratory infection and increase your overall health.

Mother to be and Baby

It is vital that you take particularly good care of your self when you are pregnant. While you are carrying your baby, your body produces higher levels of hormones, estrogen and progesterone. When these hormones levels are elevated your gums may overact to plaque creating a condition called pregnancy gingivitis. Your gums may become swollen, red and tender and may bleed when you brush or floss your teeth. You may also develop a pregnancy tumor which is a large non-cancerous growth between the teeth. Not all pregnant women developed pregnancy gingivitis, but is most likely to appear in the second trimester or the middle of the third trimester.

Gingivitis can also affect the health of your baby. Research has shown that women with periodontal disease may be seven times more likely to deliver a pre-term, low birth weight baby, than women with healthy gums. During a normal pregnancy, the level of prostaglandins, a hormone-like chemical that signals labor is produced slowly peaking at the time of labor. If you have periodontal disease, excessive plaque bacteria can enter the bloodstream through your gums and trigger the production of prostaglandins. Your body may interpret this as a signal and go into early labor.

Researchers have also discovered that active periodontal disease during pregnancy can raise the risk if preeclampsia, a pregnancy induced high blood pressure that can harm the health of both the mother and baby.

The good news is that you can prevent periodontal disease and reduce your risk of having a pre-term baby by flossing and brushing your teeth daily. Make sure you also come to see us regularly so we can clean your teeth as needed and monitor the health of your mouth.

To learn more about how periodontal disease can affect your health listen to our interviews with Dr. Seel and Patricia Robinson that aired February 14th and 21st on the Smile Files. You can also read more about Dr. Debby Hwang, our resident periodontist.

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