Gum disease—periodontal disease—affects nearly half of American adults over 30, according to the Centers for Disease Control and Prevention, and most people do not know they have it until it is well advanced.

A streak of pink in the sink when you brush, breath that mints cannot fix, gums that look a little puffy: these are the early signals. Caught at that stage, gum disease is reversible. Left alone, it quietly destroys the bone that holds your teeth in place.

At Alta Loma Dental Care in Rancho Cucamonga, Dr. Lee and our hygiene team check for gum disease at every routine exam and treat it at every stage—from a thorough cleaning for gingivitis to scaling and root planing and ongoing periodontal maintenance. This page explains the stages, the symptoms, how we treat it, what it costs, and how to keep it from coming back.

The Stages of Gum Disease

Gum disease is an infection of the tissues that support your teeth. It begins with plaque—the sticky film of bacteria that forms on teeth every day—and progresses in stages:

Gingivitis

Plaque along the gumline irritates the gums, which become red, swollen and prone to bleeding. There is no bone loss yet and no permanent damage. Gingivitis is fully reversible with a professional cleaning and better home care.

Early periodontitis

If plaque and tartar stay in place, the inflammation spreads below the gumline. The gums begin to pull away from the teeth, forming pockets that trap more bacteria, and the bone that supports the teeth starts to break down.

Moderate to advanced periodontitis

Pockets deepen, bone loss continues and teeth may loosen, shift or become sensitive as roots are exposed. Pus, persistent bad breath and a changing bite are common. Bone that has been lost does not grow back on its own, but treatment can stop the disease from progressing and save teeth.

Symptoms to Watch For

Gum disease often starts subtly. Watch for:

  • Red, swollen or tender gums—healthy gums are pale pink and firm
  • Bleeding when you brush or floss—this is never normal
  • Persistent bad breath or a bad taste that brushing does not fix
  • Receding gums, or teeth that look longer than they used to
  • Sensitivity to hot and cold as roots become exposed
  • Loose or shifting teeth, a changing bite, or pus between the teeth and gums

Many people notice slight bleeding during their morning routine and assume they brushed too hard. More often it is the first stage of gum disease. If symptoms persist for more than a few days or intensify, schedule an exam.

What Causes Gum Disease?

The primary cause is plaque that is not removed by brushing and flossing. Within days, plaque hardens into tartar, which can only be removed professionally and gives bacteria a permanent foothold along and below the gumline. Our guides to dental plaque and biofilm and tartar removal explain how this buildup happens.

Other factors raise your risk or speed the disease along:

  • Smoking or chewing tobacco—one of the strongest risk factors, and it also masks bleeding, hiding the warning signs
  • Diabetes, which makes infections harder to control (and gum disease in turn makes blood sugar harder to manage)
  • Hormonal changes during pregnancy, puberty and menopause
  • Medications that cause dry mouth
  • Genetics, stress, poor nutrition, and clenching or grinding

How We Diagnose Gum Disease

At every exam and cleaning, we measure the depth of the pockets around each tooth with a small probe, note any bleeding or recession, and review digital X-rays for bone loss. Deeper pockets and bleeding tell us where the disease is active. Those measurements guide your treatment plan and let us track your progress at later visits.

How We Treat Gum Disease

Treatment depends on the stage. We always start with the least invasive option that will work.

Professional cleaning (for gingivitis)

A thorough cleaning removes plaque and tartar above and just below the gumline, and your hygienist reviews brushing and flossing technique with you. For gingivitis, this—plus consistent home care—is usually all it takes, and bleeding typically settles within a week or two.

Scaling and root planing (for periodontitis)

Scaling and root planing, often called a deep cleaning, is the cornerstone of treatment for early to moderate periodontitis. Using ultrasonic and hand instruments, we remove tartar and bacteria from the tooth surfaces and roots below the gumline (scaling), then smooth the root surfaces so bacteria have a harder time reattaching and the gums can heal snugly against the teeth (root planing). We numb the area with local anesthetic, and the treatment is usually completed in one or two visits. Gums may feel tender for a few days; over-the-counter pain relievers and warm salt-water rinses help.

Medication

Medication can support cleaning and deep cleaning when infection is stubborn:

  • Antibiotics—a gel placed directly into gum pockets, or a short course of oral antibiotics
  • Antiseptic mouth rinses—a prescription chlorhexidine rinse to reduce plaque and inflammation while gums heal

We prescribe these only when they add real benefit, and always alongside mechanical cleaning.

Periodontal maintenance

After deep cleaning, we schedule maintenance cleanings every three to four months instead of every six. These shorter intervals keep bacteria from re-establishing in the pockets, and at each visit we re-measure pocket depths to confirm the disease is under control.

Surgical treatment for advanced disease

When pockets are too deep to clean non-surgically or bone loss is significant, surgical options include:

  • Flap (pocket-reduction) surgery—the gums are gently lifted to clean the roots thoroughly, then repositioned to reduce pocket depth
  • Bone grafts—to rebuild bone destroyed by the infection and stabilize teeth
  • Soft tissue grafts—to cover exposed roots where gums have receded

Recovery generally means a few days of rest, soft foods and a gentle hygiene routine, with full healing over several weeks. We will explain whether any of these procedures is recommended in your case and what to expect.

What to Expect After Treatment

Your gums may be sore and slightly sensitive for several days after a deep cleaning. Rinse with warm salt water two to three times a day, brush with a soft-bristled brush, keep flossing gently, and avoid hard or crunchy foods until tenderness passes. Our oral hygiene routine guide includes specific tips for the days after scaling and root planing. Keep your follow-up appointment so we can confirm the pockets are shrinking.

Cost of Gum Disease Treatment

  • Regular cleaning (gingivitis): $75–$200, usually covered at or near 100 percent by insurance
  • Scaling and root planing: $200–$400 per quadrant, typically covered at 50–80 percent
  • Periodontal maintenance: $100–$200 per visit, every three to four months
  • Gum surgery: $1,000–$3,000 or more, typically covered at about 50 percent

These are typical ranges; your written estimate depends on the exam, X-rays and your insurance. We verify your benefits, explain your out-of-pocket costs and, where possible, stage treatment so it fits your budget. Early treatment is always far less expensive than treating advanced disease.

Gum Disease and Your Overall Health

The inflammation and bacteria of gum disease do not stay in the mouth. Research links periodontitis with heart disease and stroke, poorly controlled diabetes, respiratory infections, pregnancy complications such as preterm birth and low birth weight, and rheumatoid arthritis. Treating gum disease is one of the most practical things you can do for your general health, especially if you have diabetes or heart disease.

Preventing Gum Disease

Healthy gums come down to consistent habits:

  • Brush twice a day for two minutes with a soft brush and fluoride toothpaste, angling the bristles toward the gumline. An electric toothbrush helps most people remove more plaque.
  • Clean between your teeth every day. Floss, interdental brushes or a water flosser all work; gum disease almost always starts between teeth.
  • Don’t smoke or use tobacco.
  • Eat for your gums. Limit sugary snacks; vitamin C, calcium and omega-3 fats support gum tissue. See our nutrition guide for healthy teeth and gums.
  • Manage diabetes and stress, and tell us about medications that dry your mouth.
  • Keep your cleanings—every six months, or every three to four months if you have had gum disease.

When to Call

If your gums bleed, look swollen or have started to pull away from your teeth, do not wait for pain—gum disease rarely hurts until it is advanced. Call us during office hours (Mon–Fri, 9 AM–5 PM) at (909) 987-6268 and we will fit urgent cases in the same day whenever possible. For severe swelling, uncontrolled bleeding or facial trauma after hours, go to the nearest emergency room.

Alta Loma Dental Care is located at 7283 Carnelian St, Rancho Cucamonga, CA 91701.

Note: This article is for informational purposes only and does not substitute professional dental advice.