Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
Gum disease is caused by a sticky film of bacteria called plaque. Plaque is always forming on your teeth, but if they aren’t cleaned well, the bacteria in plaque can cause your gums to become inflamed. When this happens, your gums will pull away from your teeth and form spaces called pockets. Plaque then gets trapped in these pockets and cannot be removed with regular brushing. If untreated, gum disease could lead to bone and tooth loss.
If gum disease is caught early and hasn’t damaged the structures below the gum line, a professional cleaning should do. If the pockets between your gums and teeth are too deep, however, scaling and root planing may be needed
This deep cleaning has two parts. Scaling is when your dentist removes all the plaque and tartar (hardened plaque) above and below the gumline, making sure to clean all the way down to the bottom of the pocket. Your dentist will then begin root planing, smoothing out your teeth roots to help your gums reattach to your teeth. Scaling and root planing may take more than one visit to complete and may require a local anesthetic.