“Periodontal” means around the tooth. If plaque is not removed, it turns into calculus (tartar). Plaque and tartar destroy gums and bone. Red, swollen and bleeding gums characterize periodontal disease.

Most people are not aware of this because the disease is usually painless in early stages. This is number one cause of tooth loss. Researchers suggest that periodontal disease is linked to other disease such as stroke, bacterial pneumonia, diabetes, cardiovascular diseases and risks in pregnancy.

Inflammation of gums is called gingivitis. This is the first stage of periodontal disease. As calculus and plaque continue to build up, gums begin to recede from the teeth which results in deeper pockets around the teeth. These pockets start inhabiting bacteria and cause bone loss. A slight to moderate bone loss occurs and is called periodontitis.

The following are signs and symptoms of periodontal disease:

  • Bleeding, Red and Puffy gums
  • Loose teeth
  • New spaces between teeth
  • Bad breath (Halitosis)
  • Pus around teeth and gums
  • Receding gums

Types of Periodontal Disease


Gingivitis is the mildest and most common form of disease, caused by toxins in plaque.

Chronic Periodontitis

Inflammation within supporting tissue cause deep pockets and gum recession, teeth look longer but actually gum recedes. It is characterized by progressive loss of attachment, interspersed with periods of rapid progression.

Aggressive Periodontal Disease

Rapid loss of gum attachment followed by bone destruction.

Necrotizing Periodontitis

This occurs most commonly in individuals suffering from systemic condition such as HIV, Immunosuppression, malnutrition, chronic stress or smoking. Tissue death (necrosis) affects the periodontal ligaments, gingival tissues and alveolar bone.

Diagnosis and treatment

Dr. Sandhu uses periodontal probe to measure the pocket depths and performs following procedures as needed:

Scaling and root planning

The bacteria and calculus is removed to preserve the health of gum tissue. In this procedure, gum pockets are cleaned and treated with antibiotics (Arestin) if needed to help alleviate the infection. A prescription mouth wash may be incorporated into cleaning routines.

Periodontal Surgery

Dr. Sandhu performs Flap Surgery, surgical procedure to reduce pocket sizes between the teeth and gums.


Arestin powder is placed inside the infected periodontal pockets just after scaling and root planning procedure to reduce pockets.


Once the periodontal treatment is completed, she recommends four cleanings per year. She monitors pocket depths at each cleaning session to make sure that the gums are healthy.