Gum disease is a leading cause of adult tooth loss, yet many people don’t realize how common it is or how quietly it can advance. According to the Centers for Disease Control and Prevention, roughly half of adults over 30 show some form of periodontal disease. At Paparian Dental Associates, we focus on educating patients about prevention, early detection, and practical steps to preserve healthy gums and long-term oral function.
Periodontal disease refers to a range of conditions that affect the periodontium — the soft tissues and bone that anchor teeth in place. While plaque and tartar are the immediate culprits, the body’s inflammatory response to those bacteria is what ultimately damages tissue and bone over time. This is why gum disease is both a dental and a biological concern: it begins locally but can have broader health effects.
Because the early stages often produce mild or intermittent symptoms, many people only notice a problem once more obvious signs appear. Routine exams and professional cleanings are the most reliable ways to catch disease before it causes permanent damage. Regular checkups give clinicians the opportunity to measure pocket depths, evaluate bone support, and monitor changes from visit to visit.
Prevention centers on consistent home care and timely professional interventions. Brushing and flossing effectively every day limits the bacterial film that causes inflammation, while periodic deep cleanings can remove deposits that are out of reach for toothbrushes and floss alone. Together, these habits form the foundation of lasting periodontal health.
Signs that could indicate a problem include:
Red, swollen, or tender gums
Bleeding during or after brushing and flossing
Receding gum lines that reveal more of the tooth root
Sensitivity to hot, cold, or sweets
Persistent bad breath or an unpleasant taste in the mouth
Looseness or movement of teeth that used to feel stable
Noticeable gaps forming between teeth or changes in your bite
Partial dentures that no longer fit properly
Pus or discharge at the gumline
Discomfort when biting or chewing
Gum health plays a role beyond the mouth. Inflammation in the gums can influence systemic inflammation, and researchers continue to explore connections between periodontal disease and conditions such as diabetes, cardiovascular disease, and certain respiratory illnesses. Managing gum inflammation is therefore a meaningful step toward supporting overall well-being.
Maintaining periodontal health is not only about avoiding tooth loss; it’s also about minimizing chronic inflammation and preserving the function and aesthetics of your smile. Healthy gums protect exposed root surfaces, reduce sensitivity, and help teeth remain firmly anchored so you can eat, speak, and smile with confidence.
At routine visits, our clinical team evaluates more than just cavities. We look at gum contour, pocket depths, and bone support and combine those findings with your medical history to develop a plan that reflects both oral and general health considerations. Early intervention makes a measurable difference in outcomes.
Gingivitis is the initial, reversible stage of gum disease. It is characterized by redness, puffiness, and bleeding caused by plaque-induced inflammation of the gum tissue. Pain is often minimal, which is why many people overlook these early warning signs.
With timely attention, gingivitis is typically manageable through improved home care and professional cleaning. A focused program of daily brushing, interdental cleaning, and scheduled hygienist visits can restore healthy gum tissue and prevent progression to deeper, destructive disease.
When gingivitis is identified, clinicians may recommend an individualized maintenance plan that increases the frequency of cleanings and provides targeted instruction on technique and tools. Small, consistent changes in oral hygiene habits often yield noticeable improvements in tissue health within weeks.
Left unchecked, gingivitis can evolve into periodontitis — a stage in which the supporting connective tissue and bone begin to deteriorate. As pockets deepen around the teeth, bacteria and toxins become harder to remove with routine cleaning, and the structural support that keeps teeth stable can be compromised.
Progressive tissue loss may present as increased pocket depths, bone recession visible on X-rays, and changes in tooth position or bite. At this point, restoring the previous level of support may require more than conservative care; specialized periodontal procedures are often needed to halt progression and rebuild what has been lost.
Early diagnosis is still a major advantage. Even when some bone loss has occurred, contemporary treatment approaches can control infection, reduce pocket depths, and — in many cases — promote regeneration of soft tissue and bone using advanced grafting and biologic techniques.
Contemporary periodontal care blends time-tested mechanical therapies with newer adjuncts designed to reduce bacterial burden and foster healing. Our approach starts with a careful assessment and then prioritizes the least invasive option that will reliably achieve health. Treatment plans emphasize predictable outcomes and long-term maintenance.
For many patients, modern care means combining thorough debridement with targeted antimicrobial therapies and a personalized maintenance schedule. When structural damage is present, regenerative techniques — including bone and soft tissue grafts — can be part of a comprehensive strategy to rebuild support and improve the tooth’s prognosis.
Paparian Dental Associates uses evidence-based protocols and contemporary tools to tailor treatment to each patient’s needs. Our goal is to restore a healthy gum environment and to provide clear guidance so patients can preserve those results for years to come.
Choosing the right treatment begins with an accurate diagnosis. We evaluate the stage of disease, pocket depths, radiographic bone levels, tooth mobility, and your overall health to determine which therapies will be effective and appropriate. Shared decision-making is central: we explain options and prioritize approaches that align with your goals and medical profile.
Non-surgical therapy — when indicated — is often the first step. When deeper pockets or significant tissue loss are present, surgical intervention may be necessary to thoroughly clean affected root surfaces, reshape the supporting tissues, and create an environment that's easier to keep healthy. Laser technology and microsurgical techniques are available when clinically appropriate to enhance precision and recovery.
After active therapy, a tailored maintenance program is essential. Regular periodontal maintenance visits help prevent recurrence, monitor tissue stability, and reinforce effective home care. Long-term success depends on the partnership between clinician and patient.
When disease is detected early, conservative methods are usually effective. These include thorough scaling and root planing to remove plaque and calculus below the gumline and to smooth root surfaces so gums can reattach. Mechanical cleaning is often combined with localized antimicrobials to reduce the bacterial load in deep pockets.
The objective of non-surgical care is to reduce inflammation, decrease pocket depths, and stabilize the supporting tissues so that the disease no longer progresses. For many patients this approach restores health without the need for surgical procedures.
Success also depends on improving home care and following a maintenance schedule tailored to each patient’s risk level. With these elements in place, patients frequently enjoy durable results and improved oral comfort.
Surgery is reserved for cases where non-surgical measures cannot fully control the disease or where access to deep areas is limited. Periodontal surgery allows clinicians to directly visualize and clean root surfaces, reduce pocket depths, and reshape or repair damaged tissues and bone.
The goals of surgical therapy are straightforward: remove persistent bacteria, halt tissue destruction, and create conditions that make long-term maintenance simpler and more effective. Modern surgical techniques are refined to preserve tissue and encourage regeneration when possible.
Where appropriate, regenerative procedures such as bone grafting or connective tissue grafts may be used to rebuild lost structures and improve both function and appearance. When performed with careful planning and follow-up, these procedures can meaningfully enhance prognosis and patient satisfaction.
Surgical therapy is always followed by a clear maintenance plan to protect the investment of care and to reduce the chance of recurrence.
If you have questions about gum disease, want clarification about possible signs, or would like to discuss treatment options, please contact us for more information. Our team is happy to explain recommended steps and help you choose a path that protects your oral health for the long term.
Most people don’t realize that periodontal disease is the leading cause of tooth loss among adults. According to statistics from the Centers for Disease Control and Prevention, one out of every two adults over the age of 30 in the United States has periodontal disease.
You may be surprised to learn that the human mouth is home to a wide variety of microbes. The fact is that over 700 different strains of bacteria have been detected in the oral cavity. Although some of these bacteria are beneficial, others are harmful to oral health. Without proper oral hygiene and routine dental care, these harmful bacteria can cause tooth decay and gum disease, compromising both your oral health and overall wellbeing.
In addition to inadequate oral hygiene and infrequent professional care, other factors, including smoking, genetic tendencies, and unchecked diabetes, can contribute to the escalation of periodontal disease.
Your gums and teeth have an interdependent relationship, which means healthy teeth depend on the support of healthy gums. Also, taking care of your smile does more than keep your teeth and gums in optimal condition; good oral health also supports systemic health. In addition to being the leading cause of tooth loss in adults, researchers are finding more and more links between periodontal disease and a number of medical problems, including heart disease, stroke, diabetes, respiratory problems, and adverse pregnancy outcomes such as pre-term and low birth-weight babies.
If you notice that your gums are bleeding with the slightest pressure while brushing or flossing, it’s a sign of gingivitis. Although gingivitis is the earliest stage of gum disease, it can easily be reversed with deeper cleanings as well as an improved regimen of oral hygiene at home.
In the absence of professional treatment and better home care, gingivitis progresses to the next stage, which is known as periodontitis. In this stage, the connective tissue and bone that hold the teeth in place begin to break down with an increase in pocketing between the teeth and bone, gum recession, and bone loss. Without proper treatment by your dentist, periodontitis will progress from a mild to moderate loss of supporting tissue to the destruction of the bone around the teeth.
Although gingivitis can often be reversed with improved oral hygiene and professional cleanings, as periodontal disease advances, more extensive procedures are required to halt its progression. Based on a complete assessment of your periodontal health and a review of possible contributing factors, our office will recommend the best options in care. Treatment for periodontitis may include a series of deeper cleanings known as root planing and scaling, surgical procedures to reduce pocket depth, bone or tissue grafts, laser procedures, or antimicrobial medications.
The cost of care depends on the type of procedures required to restore your periodontal health. If you have dental insurance, plans often cover treatment to prevent gum disease as well as many procedures to treat the various stages of gum disease. Our goal is to help patients restore and maintain good oral health. We do all we can to help you begin care without additional stress or delay. Our business office works with you to maximize your benefits and provide easier, more convenient payment options.
By seeing our office regularly for care and doing your best to eat a healthy diet and practice good oral hygiene, you can keep your smile in tip-top shape as well as protect your overall wellbeing.
At the office of Paparian Dental Associates, we provide a comprehensive range of services to address all your oral healthcare needs. You can rest assured that your smile is in the best of hands at our office. Our skilled and experienced team maintains a position at the forefront of advances in care and remains dedicated to providing the highest quality of skilled and compassionate treatment.
Periodontal disease begins with the accumulation of plaque, a sticky film of bacteria that forms on tooth surfaces. When plaque is not removed regularly, it hardens into tartar and triggers an inflammatory response in the gums that can damage soft tissue and bone. Genetics, tobacco use, poor oral hygiene and certain medications can increase susceptibility by altering the mouth’s environment and the immune response.
Other risk factors include systemic conditions such as diabetes and hormonal changes that affect gum health, as well as stress and nutritional deficiencies that impair healing. Identifying and managing these contributing factors is an important part of any prevention or treatment plan. Early detection and consistent care reduce the chance that localized inflammation will progress to destructive disease.
Early gum disease, or gingivitis, often produces subtle signs such as red or swollen gums and bleeding during brushing or flossing. Many people experience minimal pain in the early stages, which is why routine dental exams and cleanings are essential for detection. Persistent bad breath, increased tooth sensitivity, and minor gum recession can also signal that inflammation is present.
If you notice any of these symptoms, scheduling an evaluation is important because gingivitis is typically reversible with improved home care and professional cleaning. During an exam, the clinician will assess pocket depths and tissue appearance to determine the next steps. Prompt attention makes it far easier to restore healthy gum tissue and prevent further damage.
Gingivitis is the initial, reversible stage of gum disease characterized by inflammation of the gum tissue without loss of supporting bone. It usually responds well to enhanced brushing, interdental cleaning and professional scaling to remove plaque and calculus. Pain is often minimal, which is why many cases go unnoticed without routine dental care.
Periodontitis occurs when inflammation extends below the gumline and begins to destroy the connective tissue and bone that support teeth. In this stage, pockets deepen and bacteria become harder to remove with home care alone, often requiring more advanced non-surgical or surgical therapies. Managing periodontitis focuses on controlling infection, reducing pocket depths and restoring a maintainable environment for long-term health.
A comprehensive periodontal evaluation includes measuring pocket depths around each tooth, checking gum tissue for inflammation and mobility, and reviewing medical and dental history to identify risk factors. Dental X-rays are used to assess bone levels and detect areas of recession or bone loss that are not visible during a clinical exam. These findings are combined to stage the disease and guide treatment decisions.
Clinicians also evaluate the patient’s oral hygiene habits and may perform bacterial testing or other adjunctive assessments when indicated. This thorough diagnostic approach ensures that treatment is tailored to the severity and pattern of disease. Regular reassessment during and after therapy helps track progress and informs maintenance frequency.
Non-surgical therapy typically begins with scaling and root planing, a deep-cleaning procedure that removes plaque and calculus from below the gumline and smooths root surfaces so gums can reattach. This mechanical approach reduces bacterial load and inflammation, often combined with localized antimicrobials to target persistent organisms in deep pockets. Improved home care and an individualized maintenance schedule are essential complements to professional debridement.
For many patients, these measures successfully reduce pocket depths, stabilize tissues and restore a healthy environment without the need for surgery. Response to non-surgical therapy is monitored through follow-up exams and measurements, and clinicians will adjust the plan if deeper intervention becomes necessary. The goal is predictable control of infection and preservation of supporting structures.
Surgical periodontal therapy is considered when non-surgical measures cannot adequately control disease or when pocket depths and anatomic factors limit access to root surfaces. Surgery allows the clinician to visualize and thoroughly clean affected areas, reposition tissues to reduce pocket depth, and perform regenerative procedures to rebuild lost bone and soft tissue. Modern techniques prioritize tissue preservation and predictable healing.
Common surgical options include flap procedures, guided tissue regeneration and grafting of bone or connective tissue to restore support and contour. These interventions are followed by careful post-operative care and a tailored maintenance plan to protect the results. Your clinician will explain the expected outcomes, recovery timeline and home-care requirements so you can make an informed decision.
In many cases, contemporary regenerative techniques can promote partial restoration of lost bone and soft tissue when conditions are favorable. Procedures such as bone grafting, guided tissue regeneration and connective tissue grafts aim to rebuild structure and improve both function and appearance. Success depends on factors like the extent of loss, patient health, smoking status and the ability to maintain excellent oral hygiene.
Regeneration is not guaranteed in every case, but these procedures have improved outcomes for many patients when combined with thorough infection control and diligent maintenance. Clinicians will evaluate each situation to determine whether regenerative therapy is appropriate and to estimate realistic expectations for recovery and long-term stability. Careful follow-up is essential to protect and preserve the regenerated tissues.
Systemic conditions such as diabetes, autoimmune disorders and cardiovascular disease can influence the course of periodontal disease by affecting inflammation and healing. Poorly controlled diabetes, for example, is associated with increased severity and progression of gum disease, so collaboration with medical providers is often recommended. A complete medical history helps clinicians identify factors that may alter treatment planning or outcomes.
Certain medications can also impact gum health by causing dry mouth, altering tissue response or inducing gingival overgrowth, which may complicate plaque control. When medications are implicated, clinicians can advise on strategies to manage side effects and tailor periodontal therapy accordingly. Clear communication between patient and dental team supports safer and more effective care.
Periodontal maintenance is a lifelong program of professional care and improved home hygiene designed to prevent recurrence of disease and to monitor tissue stability. Maintenance visits typically include thorough cleaning below the gumline, reassessment of pocket depths and periodic radiographs to evaluate bone levels. The frequency of visits is customized based on individual risk, healing response and disease history.
Success depends on the partnership between clinician and patient, with consistent daily oral hygiene and adherence to the recommended maintenance schedule. During maintenance appointments, clinicians will reinforce technique, address emerging concerns early, and modify the plan as needed to preserve long-term results. Early detection of changes allows for prompt, less invasive interventions.
Our Salem, N.H., practice emphasizes education, conservative first-line treatments and evidence-based protocols to restore and maintain periodontal health. We begin with a comprehensive evaluation, discuss all appropriate options and prioritize minimally invasive therapies that reliably achieve health whenever possible. Shared decision-making ensures treatment aligns with each patient’s goals and overall medical profile.
When advanced care is required, we employ modern surgical and regenerative techniques and create tailored maintenance plans to protect the investment of care. Throughout treatment and follow-up, our team focuses on clear communication and practical guidance so patients understand how to preserve their results for years to come. If you have questions about signs, testing or treatment choices, our office staff can arrange an evaluation to review your individual needs.
Our mission is simple: to deliver great oral health and the beautiful smile you deserve. We value your trust and are committed to exceeding your expectations with every solution we provide.
