Dr. Robert L. Mandell

Periodontal disease is the number-one cause of tooth loss in America. One hundred million Americans suffer from periodontal disease signs that may include bad breath, gingivitis, malocclusion and tooth loss. Prompt treatment can control the severity of gum disease and save the teeth.

Gum disease begins with the accumulation of plaque at the gum line. Plaque is composed of bacteria or “germs” that can irritate the gums, causing swelling and redness. Often the gums bleed when brushed. This is a condition known as gingivitis, the earliest sign of gum disease.

Gum disease leads to tooth loss

If the plaque is not removed with good brushing and flossing techniques, it may harden into tartar, or calculus. This substance accumulates below the gum line, causing gums to pull away from teeth and create a “periodontal pocket.” This pocket accumulates more food particles and bacteria. Eventually the supporting bone is infected, leading to a loss of tooth support and finally tooth loss. This infection often spreads into the tooth roots and jawbone as well as between the teeth, a condition known as periodontitis. Bad breath may develop or pus may be present among your signs of periodontal disease.

Inadequate brushing and flossing is the most common cause of periodontal disease. Most people require thorough brushing and flossing, and professional dental cleaning at least twice a year is required. Some people need more frequent cleanings. Even people with outstanding oral hygiene can get gum disease. Certain people are more susceptible than others. Diabetics and those with certain blood disorders appear to be at higher risk. Smoking also contributes to gum disease by working against even the best teeth cleaning practices.

Malocclusion, or “bad bite,” can make oral hygiene more difficult and increase the chance of pockets and infections developing. Clenching or teeth grinding may damage the oral tissues and make them more susceptible to periodontal disease. Once periodontal disease has passed beyond its initial stages, we can prescribe a variety of therapies. We use deep scaling and subgingival curettage to remove plaque and calculus from the surface of the roots and the soft tissue next to the teeth. This allows healthy gums to reattach themselves to the teeth.

Periodontal therapy

We may remove diseased gum or bone tissue surgically, via a number of different procedures performed by our oral surgeon periodontist, or gum specialist. Periodontal therapy has proven successful at preventing tooth loss. To ensure continued healthy gums, you must follow a daily program of brushing and flossing to prevent reoccurrence of disease. You should have frequent recall appointments and checkups. Like high blood pressure, periodontal disease is a silent killer. People often ignore periodontal disease signs because they are mostly painless. Early detection and treatment are essential if you wish to avoid tooth loss and other more serious health problems. A periodontal examination is simple and painless.

Symptoms and signs of periodontal disease

Healthy gums

  • Gums have healthy pink color
  • Gum line hugs teeth tightly
  • No bleeding
  • Periodontal pockets 1-3 mm


  • Gums bleed easily when you brush, floss or when probed during exam
  • Gums are inflamed and sensitive to touch
  • Possible bad breath and bad taste
  • Gums between teeth may look blue-red in color
  • Periodontal pockets 3-4 mm

Advanced periodontitis

  • Teeth may become mobile or loose
  • Bad breath, bad taste constant
  • Roots may be exposed and sensitive to hot and cold
  • Severe horizontal and angular bone loss on X-ray
  • Pockets between teeth and gums now over 6mm

Protect your teeth and overall health by having your gums checked as soon as possible. If you are searching for a “periodontist near me,” learn more by calling (978) 649-3058 or use our convenient Request an Appointment form. We welcome patients from Chelmsford, Dracut, Lowell, Westford, Tyngsborough and surrounding communities.

Request an Appointment READY TO MAKE AN APPOINTMENT?