Is It Possible to Reverse Periodontal Disease?

Yes, it is possible to reverse periodontal disease. However, before you know how to treat this oral health condition, you must first know what you are facing.  The first thing to know is that there are two types of gum disease: gingivitis and periodontitis.

Gingivitis is the swelling of the gums that is caused by the accumulation of bacteria along the gum line. If the gingivitis is left untreated, it leads to periodontitis. Symptoms of periodontal disease include receding gums, inflammation along the gum line, pain, and sensitivity to changes in temperature.

Prevention of Periodontal Disease

Ask any periodontal disease expert and they will tell you, proper dental hygiene is the best way to prevent periodontal disease from occurring. Brush your teeth at least twice a day. Flossing can also prevent plaque from forming. In addition a good antibacterial mouthwash can provide protection against plaque and gingivitis.

Smokers should quit their bad habit if they are concerned about their oral health as well as their general wellness. Aside from smoking-related symptoms such as bad breath and an unpleasant coating on the tongue, smoking increases the risk of gum disease because it damages gum tissues and promote inflammation.

Periodontal Disease Treatment

A periodontal disease expert can remove the accumulation of plaque along the gum line by scraping it away. This is one way to reverse periodontal disease when still in its early stages. To prevent gingivitis (or inflammation of the gums) from recurring, the patient should practice good oral hygiene by brushing, including regular flossing and brushing between the teeth with special little brushes.

Reversing Periodontitis

Once gingivitis has developed into the more advanced stages of Periodontitis, or advanced gum disease, this requires more complex treatments by a periodontal disease expert. Inflammation has already breached the gum line. Treatment at this stage will be a combination of regular treatment from your periodontist as well as doing your part at home.

To help combat and reverse periodontal disease, the dentist will remove tartar and plaque from below the gum line. This is known as scaling and root planing. Local anaesthesia is used because it would be painful without it. In addition, your periodontist will prescribe an antibiotic to limit the infection.

Some patients require oral surgery to fold back the gum tissue. A periodontal disease expert can also perform surgery to treat deeper pockets of infection. In extremely advanced cases, the periodontist can also do grafting, which is a procedure that involves taking tissue from one part of the mouth and replacing gum tissue that was damaged. Grafting covers up the exposed roots of the teeth. These procedures may seem extreme but can help save your original teeth and reverse the signs and symptoms of the disease. In many cases, contacting the right periodontal expert will mean that he or she can treat your teeth with without the need for surgery.

After your periodontal disease treatment, it is vital that you maintain good dental care to avoid further damage and inflammation. Your periodontist will also recommend regular visits to the hygienist and checkups and in order to monitor the health of the gums.

One of the often forgotten things is that a healthy diet is also part of the process to reverse periodontal disease. Eating the right food can help you maintain healthy gums. Omega 3 fatty acids found in fatty fish, flaxseed, and fish oil help decrease inflammation.

Summary

In summary, Periodontitis is a condition that can be reversed and prevented through proper dental care and regular monitoring by your hygienist and periodontist to sustain the health of the gums. Good periodontal disease treatment involves both a course of treatment with a good periodontal disease expert and the simple preventive dentistry steps you can practice at home.
If you would like to talk to a periodontal disease expert or if you would like your dentist to refer you to a periodontal specialist, please get in touch here
Dr Galgut is one of the UK’s leading periodontists. He was awarded Dentist of the Year in both 2010 and 2013 in recognition of his contributions to periodontal disease treatment. He runs his private practice clinic in North London. You can learn more about Dr Peter Galgut and his work here – About Dr Galgut

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18 Replies to “Is It Possible to Reverse Periodontal Disease?”

  1. I’ve been to see my dentist and it’s the first time ever that they’ve mentioned gum disease I’m 32 she said I need to brush between the teeth so she send me to see someone else which won’t be till September but hasn’t told me how to brush between my teeth , any help will be greatly received thank you.

    1. Gum disease progresses very slowly, and the fact that you have to wait a couple of months to see someone who can help you get it under control is not actually too much for problem. What is a problem is that if you have gum disease, you need to know how severe it is now and after treatment. It is essential that before treatment you have a series of x-ray pictures taken (or what is called a panoral x-ray picture that is a view of all of your teeth and jaws,) and you need to have a charting done of your mouth that is specifically for gum problems. A very basic charting is called a BPE (Basic periodontal examination) or what is much more use, a charting of the amount of dental plaque and bleeding that is occurring in your mouth and where this is situated (called a plaque score and a gingivitis score), and a charting of the depths of the pockets of infection that are present before treatment.

      So, if the person whom you are going to see does not start off doing this, then you must insist on having these chartings and xray pictures done so that you have the baseline data before any treatment is carried out. If they cannot, or will not do this, you need to find someone else who can manage the condition for you.

      I hope that helps,

      Peter Galgut

    1. Hi there Michael,

      Mouthwashes to not cure periodontal disease. In fact they have no effect whatsoever. The reason why you have gum disease is you have accumulated debris and dental tartar underneath the gums that has to be professionally removed by means of deep cleaning. Mouthwashes only wash your mouth, and can’t get into these pockets of infection underneath the gums so they useless for this purpose.

      The way to prevent the problem from recurring, once you have had the pockets of infection eliminated by seeing a dentist/hygienist or a specialist dentist (periodontist) is to prevent the debris from accumulating again by cleaning your teeth properly and carefully and not missing out any places in your mouth. Using a mouthwash simply doesn’t do this cleaning and it is up to you brush your teeth properly and carefully twice a day your mouth clean.

      One other thing, you bring up the subject of alcohol in mouthwashes which is a lot of misguided nonsense. Alcohol is used in mouthwashes to dissolve substances that cannot be dissolved in water, so the alcohol is not free alcohol because it is combined chemically into the mouthwash. So in fact the alcohol is inactive and neutralised in the mouthwash.

      So to get your teeth and gums professionally cleaned as soon as possible to sort out the problem.

      Dr Peter Galgut

  2. I’m 18 and I have a permanent retainer and that’s where all my gums are receding. I have periodontitis thanks to this permanent retainer. I need help on how to reverse it because I refuse to have loose teeth anymore. I don’t want my teeth to fall out on my 23rd birthday so any help would be amazing. I’m stressing myself out about this when I’m stressing out about college. Please help!!

    1. Hi there Destiny,

      I’m afraid, the bad news is that you can’t reverse it. Once the teeth are loose, they will probably always be loose. The most important thing is preventing them from getting any looser. What you probably need most at this stage is to get some professional help from either a periodontist like myself, or a dentist who can advise you how best to prevent the receding gums and the looseness from getting worse with time. I’m sorry but I cannot be more specific than this unless I had the chance to see your mouth and assess the problem. So if you would like to make an appointment to see me, I am in North London and you can telephone my reception service on 03451645075 and ask for a consultation appointment and I will then be able to advise you more specifically as to what can and should be done.

      The good news is that it is highly unlikely that you will lose your teeth by the age of 23, but you really must get some professional help in preserving what you’ve got for as long as possible by an appropriate dental professional as soon as possible.

      I hope that helps,

      Dr Peter Galgut

    2. Hello Destiny,

      I’m sorry it’s taken me a while to reply to your enquiry but somehow or another got lost in my system and I’ve only found it now.

      Your diagnosis might be right in that the retainer is causing the gum recession, but usually the gum recession is caused by the orthodontic treatment that has aligned your teeth such a way that they are susceptible to gum recession. The good news is that it is massively unlikely that your teeth fall out by the time you’re 23, and in fact they will probably be around for a long time after that.

      Nevertheless it is important that you take this matter seriously and that you see your orthodontist for an opinion on the gum recession, as well as your dentist, and possibly ask to be referred to a periodontist, or someone with special expertise in gum conditions just to make sure that the condition is not going to progress to the nightmare scenario that you describe.

      Peter

  3. I’ve been seeing my dentist for a year – at this last appointment he informed me I’ve got bad periodontal disease and that I’m definitely going to lose all my teeth. I immediately stopped smoking – a week later I went back to see him, he seemed puzzled about why I was there. I told him I’d stopped smoking – he said why? There’s no point now.
    I’m having a nervous breakdown – I had no idea about this disease and I can’t understand why he only told me after I’d been his patient for a year. He only told me then because I asked about an implant for a cracked tooth. During this year he has never suggested routine visits, cleaning or anything. I’m so frightened I can’t sleep.

    1. I have a couple of points that I need to be made about your communication to me.

      You said that you’ve been going to your dentist for a year and he never told you that you had periodontal disease until your last appointment. Very dramatic, but bear in mind that advanced .periodontal disease takes 15 to 20 years to develop, the question to me is what about all the dentists that you saw before this one? Have you been looking after your teeth and seeing the dentist regularly for the last 20-years? If you haven’t then this dentist can hardly be blamed for the problem that you have, and if you have been seeing other dentists before this one you need to be looking at all the previous dentists that you have seen to establish why you have this problem.

      Also, you mentioned that you have a cracked tooth that needs to be removed. There are many reasons why teeth need to be removed, and one of them is that they break because people who are very tense and cannot relax easily tend to clench their teeth and eventually break them. If this applies to you you may need to see somebody to help you to break this bruxing habit.

      Finally as a practicing periodontist with many years of experience I have never ever recommended or even suggested to anyone that they need to lose their teeth because the gum condition has gone so far. I have treated many people with very advanced periodontal disease you still have most of their teeth. So maybe you not need to see a different dentist and possibly a specialist periodontist and make sure either or both of these people prioritise non-surgical treatment for this condition as opposed to surgery and implants which can lead to even bigger problems for you in the future.

      In the meantime hang on to the fact that most of your teeth are probably savable even if they have to be splinted together or restored after treatment and try not to panic too much about getting this problem sorted out.

  4. I went to see my dental nurse and she says my dental disease has got worse at the back of my teeth. The fronts are graded mostly a 2. But the back teeth – many are 3’s but one or two are 4’s! She advised dental scaling and polishing 4 times a year. I have promised now to brush twice a day and use interdental sticks twice a day and use a mouth wash as per her suggestion.
    But I have a feeling these wont work because surely if I have developed deep pockets, none of these measures (except going to the dentist for a good deep clean) will be able to get in them. Am I right or is my thinking wrong?

    One final question. What do you think of LANAP (laser gum surgery) for the treatment of peridontal disease?

    1. You are right and you are wrong.

      You write that whatever you do at home you cannot get into those pockets of infection and clear what is collecting there. That’s why you need to be going to the dentist or hygienist or even a specialist periodontist regularly. In severe cases, this might be as frequently as every 3 months.

      If you don’t clean your teeth and you allow food to build up and turn into dental plaque and it gets in under the gums then the condition can start up again very quickly.

      The answer is that you have to clean your teeth everywhere very well, including in between your teeth to minimise the amount of debris around that can cause the infection, so that when you go to your dentist only a minimal amount build-up of debris has got in under the gums and he/she can then remove that. So this is a team effort between you maintaining the best level of cleanliness that you can at home, and your dental team getting to the parts that you can’t reach. Also, if you can keep your mouth absolutely debris and plaque-free, it gives the tissues a chance to heal even though you can’t get into the pockets and if you’re lucky, you may find the condition slowly reverses itself in many, and if you’re very lucky, in all of the affected sites in your mouth.

      Your last question:- what I think of lasers? All of the research that has been published shows that they are not as good as scaling so they are in fact no more than expensive high-tech junk.

  5. Hi Dr.
    I had scaling & root planning treatment, but I was never given any medication in the form of antibiotics. And I do have a small amount of bone loss, my dentist said don’t worry about it. I’m confused, should I have been given antibiotics? Thanks!

    1. No, you don’t need any antibiotics or anything. Just keep your teeth as clean as you possibly can and see your dentist for a check-up regularly to make sure that the problem is not returning.

  6. Hi Dr.
    I had scaling & root planning treatment, but I was never given any medication in the form of antibiotics. And I do have a small amount of bone loss, my dentist said don’t worry about it. I’m confused, should I have been given antibiotics? Thank you!

    1. NO! Most definitely not! Your dentist gave you the right treatment, and you should now be seeing him regularly to check that the condition really is under control and you need to have your teeth professionally cleaned and you need to look after them as best as you can.

      Let me explain it to you in this way. If you have a trash can full of rubbish, you can sterilise the trash can and all you get is sterilised rubbish. If you really want a clean trash can you need to get rid of the rubbish first and then it is clean so you don’t need to sterilise it afterwards. Where you have pockets of infection underneath your gums, sterilising all of the accumulated debris in them like dental plaque, food debris and tartar is a waste of time and effort. Getting rid of all of the of irritating and infecting material that has accumulated underneath your gums will allow the gums to heal, and it is your job how to clean your teeth so well and so effectively that you prevent it from getting back in there again, supplemented with a professional top-up of cleaning or deep cleaning at regular intervals to prevent it from getting back in there again.

      Now that you know how to stop it from recurring, it’s your job to make sure that you keep your mouth and particularly your gum margins free of any plaque or food debris to make sure that the condition can’t return.

  7. Hi, im 20 and i recently went to the dentist and found out i had early periodontitis (gums a little slightly detached from some teeth i think?) along with gingivitis. They did the scaling and put antibiotics in between my teeth and sent me in my way. But i forgot a lot of what they were saying about what happens “after.” They said something about being fixed in a few years and i was so anxious i dont remember what that was relating to. After scaling and deep cleaning, do i just keep up good dental hygiene and it’ll go away? Is the periodontitis fixed with the scaling or do i meed to keep coming back for treatments?

    Sorry for so many questions, but during the whole shut down i haven’t been able to contact my dentist and I’m getting a little teeth anxious.

    1. Hello Diana,

      Yes, I understand! This is very scary stuff and I’m sure when you first heard about it and had the treatment done you panicked a bit and didn’t take in very much of what you were told. So let me give you a little summary of periodontal disease and how to manage it.

      Gum disease usually starts off is gingivitis (red bleeding gums), and continues, slowly getting underneath the gums and starts to damage the foundations of the teeth (periodontitis). So you have periodontal disease. How is this managed?

      Firstly you need to have your teeth and most importantly the roots of your teeth cleaned. This is called deep cleaning, descaling, debridement, or root planing. Sometimes dentists also put some antibiotics under the gums when they have finished the cleaning to get any bacteria that may have escaped the cleaning process, but I personally very seldom use these antibiotics because I find that healing usually occurs without the need for them. But that is only the beginning of the story.

      Is that once you have had .ontal disease you will have it for the rest of your life. Usually it comes and goes so you have good and bad patches and you will usually know when you have a bad patch when your gums start to get rid and / or bleeding. You should not go to the dentist very regularly to ensure that is the condition starts to recur that it’s not in the bed before it can do any further damage. Most people have to go to the dentist /hygienist every six months to manage this condition come on but if it is active, you may need to go as frequently as every 3 months especially during active matches to make sure that the condition doesn’t get going again.

      Diana you also have an additional problem because as a woman we know that the sex hormones do have an effect on gum disease. So if you have a few bad periods in a row, or you get pregnant, it will certainly set off an active patch of gum problems, so you need to make sure that you keep in touch with your dentist even more regularly, particularly if you notice that your gums are getting a bit red and bleeding at times like this.

      But the good news is that if you look after your teeth by cleaning them as well as you can and keeping in touch with your dental team regularly, you will probably keep your teeth for the rest of your life without much damage to them.

      I hope that helps you to cope with this problem.

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