Periodontal Therapy and Disease Overview

FAQs — Periodontal Therapy & Disease

• What is the difference between gingivitis and periodontitis, and how do I know which stage I have?

  Gingivitis is the earliest, reversible stage of gum disease — characterized by red, swollen, or bleeding gums caused by plaque buildup along the gumline. It has not yet damaged the bone or connective tissue holding your teeth in place. Periodontitis is a more advanced infection where the inflammation has spread below the gumline, forming pockets between the teeth and gums, destroying bone, and — if left untreated — eventually leading to tooth loss. The key difference: gingivitis can often be reversed with a professional cleaning and improved home care, while periodontitis requires active treatment by a periodontist. Patients in the Houston area visiting Periodontal and Implant Surgeons of Houston receive a thorough clinical evaluation to determine which stage is present and what treatment pathway is most appropriate for their individual case. The stage of your gum disease can only be diagnosed through an in-person clinical exam — not through symptoms alone.

• My gums bleed when I brush — is that always a sign of gum disease?

  Bleeding gums during brushing or flossing is one of the most commonly overlooked early warning signs of gum disease, and in many cases it does indicate the presence of gingival inflammation. However, bleeding can also result from brushing too aggressively, certain medications, hormonal changes, or nutritional deficiencies. What’s important is that bleeding gums should never be dismissed as “normal.” At Periodontal and Implant Surgeons of Houston, patients from across the Houston area — including Bellaire, Memorial, and the Galleria corridor — come to our S. Gessner Rd. office for a proper periodontal evaluation to identify the cause and receive a targeted treatment recommendation. Early intervention almost always means simpler, less invasive treatment. If you are experiencing persistent bleeding gums, please schedule a private clinical evaluation rather than relying on a self-assessment.

• What is scaling and root planing, and is it painful?

  Scaling and root planing — commonly called a “deep cleaning” — is the primary non-surgical treatment for periodontal disease. During the procedure, a periodontist carefully removes hardened plaque deposits (calculus/tartar) from above and below the gumline, then smooths the root surfaces of the teeth to eliminate bacterial toxins and make it harder for plaque to reattach. Local anesthesia is used, so the procedure itself is not painful for most patients. Some tenderness or sensitivity in the days following treatment is normal and typically resolves quickly. Patients often experience noticeably improved gum health — healthier pink color, reduced puffiness, and less bleeding — within a few weeks of treatment. For many patients, scaling and root planing effectively halts the progression of gum disease without the need for surgery. Whether this treatment is appropriate for your condition is determined through a private clinical evaluation at our Houston office.

• Can gum disease come back after treatment, and how do I prevent it from returning?

  Yes — periodontal disease can recur after treatment if ongoing maintenance is not maintained. This is because the bacteria responsible for gum disease are persistent, and susceptibility varies between individuals based on genetics, systemic health, and lifestyle factors such as smoking. After completing active periodontal therapy at our Houston clinic, most patients are placed on a periodontal maintenance schedule — typically every 3 to 4 months rather than the standard 6-month cleaning interval. These maintenance visits allow our team to monitor pocket depths, remove bacterial deposits before they re-infect treated areas, and catch any early signs of recurrence. Patients who commit to their maintenance schedule significantly reduce their risk of disease returning. Your recommended maintenance schedule will be determined privately by your treating periodontist based on your individual clinical response to treatment.

• I've been told I need gum surgery — what does that actually involve, and is it avoidable?

  Whether gum surgery is avoidable depends on the severity of your periodontal disease — which is why the recommendation itself matters as much as the procedure. When scaling and root planing alone cannot adequately access and remove bacterial deposits deep in the gum pockets, or when significant bone loss has already occurred, surgical treatment becomes necessary to properly decontaminate the affected areas and regenerate lost tissue. Surgical options our Houston periodontists perform include pocket reduction surgery (osseous surgery), gingivectomy, and bone grafting and regeneration. These procedures are performed under local anesthesia with sedation options available. The goal is always to preserve your natural teeth and restore a stable, healthy foundation. For patients who arrive early — before disease has progressed to severe stages — non-surgical treatment is frequently sufficient. Whether surgery is required in your case can only be determined through a clinical evaluation conducted privately at our office.

• Does gum disease affect my overall health — not just my teeth?

  Research has established meaningful associations between periodontal disease and several systemic health conditions. Chronic gum disease involves persistent bacterial infection and inflammation that does not remain confined to the mouth — the bacteria and inflammatory markers can enter the bloodstream and have been linked to increased risk of cardiovascular disease, stroke, poorly controlled diabetes, adverse pregnancy outcomes, and respiratory conditions. This bidirectional relationship is especially relevant for patients with diabetes, as high blood sugar promotes gum disease progression, and gum disease in turn makes blood sugar more difficult to control. At Periodontal and Implant Surgeons of Houston, our periodontists take a whole-body approach to gum disease treatment, recognizing that healthy gums contribute to overall systemic health. If you have a systemic health condition that may relate to your gum health, please disclose this privately to your treating periodontist during your consultation — not through public inquiry forms.

• What is gum grafting, and when is it recommended over other gum recession treatments?

  Gum grafting is a surgical procedure in which tissue — typically taken from the roof of the mouth or sourced from a donor tissue bank — is used to rebuild gum coverage over exposed tooth roots caused by gum recession. It is recommended when recession has progressed to the point where the root surface is significantly exposed, causing sensitivity, increased risk of root decay, compromised aesthetics, or ongoing tissue loss that non-surgical approaches cannot reverse. Milder cases of gum recession may first be managed with scaling and root planing, occlusal adjustments, or changes in brushing technique. However, once the recession threshold is crossed, grafting is typically the most effective long-term solution for restoring gum volume and protecting the underlying tooth structure. Our Houston periodontists at 2600 S. Gessner Rd. perform gum grafting for patients across the greater Houston area, including Sugar Land, Katy, and Bellaire. The appropriate treatment for gum recession varies significantly between patients and is assessed during a private clinical evaluation.