Periodontitis | advanced gum disease, bone loss and treatment in Bangalore
Periodontitis is a serious form of gum disease that slowly destroys the bone and tissues that hold your teeth in place. It usually progresses quietly, often without pain, so many people only notice it once their teeth start to feel loose or change position — by then, much of the support has already been lost. Even at this stage, many teeth can still be saved, and the disease can usually be brought under control with the right specialist treatment.
At Dental Solutions Clinic in Indiranagar, Bangalore, periodontitis is managed by Dr. Balasubramanya K V — MDS Periodontics, LANAP Certified Practitioner, Fotona LightWalker Certified Operator, with postgraduate laser training from the University of Vienna (SOLA) and LAHA Ljubljana. He is one of the few periodontists in South India formally certified in LANAP, a laser-based protocol with strong research support for rebuilding lost support in advanced gum disease.
What is periodontitis?
Periodontitis is an ongoing infection and inflammation of the gums and the deeper structures that support the teeth, including the ligament around the roots and the jawbone beneath the gums. Unlike gingivitis (early gum disease), which affects only the surface of the gums and is reversible, periodontitis causes permanent loss of attachment and bone, and is a major cause of tooth loss in adults.
Common causes and risk factors for periodontitis
Smoking and tobacco use
Smoking is one of the strongest risk factors for gum disease and makes treatment less effective. Smokers often have less gum bleeding even when the disease is severe, because nicotine reduces blood flow, so problems can be missed without detailed gum measurements. Stopping smoking significantly improves treatment results.
Poorly controlled diabetes
Diabetes and gum disease affect each other. High blood sugar weakens the body’s defence against infection and leads to more severe, longer-lasting gum inflammation. At the same time, untreated periodontitis can make blood sugar control worse; studies show that treating gum disease can help improve HbA1c in many diabetic patients.
Family tendency (genetics)
Some people are genetically more likely to over‑react to plaque with a strong inflammatory response and often have close relatives who lost teeth early due to gum problems. These patients can develop aggressive disease even with reasonable day‑to‑day brushing.
Stress and reduced immunity
Long‑term stress and illnesses or medicines that suppress the immune system (such as anti‑rejection drugs, some cancer treatments, or long‑term steroids) can make it harder to control gum infections.
Local plaque traps
Deep tartar under the gums, overhanging fillings or crowns, crowded or tilted teeth, and food‑trapping gaps all create spots where harmful plaque is hard to remove. These local factors often explain why some teeth are much worse than others.
When to seek urgent gum care
You should book a dental appointment soon if you notice:
You should seek same‑day or next‑day dental care if you notice a painful, swollen lump on the gum next to a tooth that may be tender or oozing pus — this is often a periodontal abscess. It is a dental emergency because the infection can spread quickly and cause rapid bone loss if not treated promptly.
How we diagnose and stage periodontitis at Dental Solutions Clinic
Diagnosis at DSC is detailed and structured so treatment can be matched to disease severity:
Full mouth gum charting
We measure the depth of the pockets around each tooth, record any gum recession, bleeding points, areas where the roots divide (furcations), and tooth looseness.
Full mouth digital X rays
A series of small periapical X‑rays around the mouth shows how much bone has been lost and whether the pattern is even (horizontal) or angular (vertical defects that may be rebuildable).
3D CBCT scans for complex cases
In advanced Stage 3–4 cases, a PLANMECA ProMax CBCT scan maps bone defects in three dimensions to plan precise regenerative surgery when indicated.
Staging and grading (2017 system)
We combine charting and X‑ray findings to assign a Stage (1–4) and Grade (A–C), which guides the intensity and type of treatment.
Medical and lifestyle risk review
We review diabetes control, smoking, medications, and family history so these can be addressed alongside the dental procedures for the best long‑term result.
Treatment options for periodontitis
Non surgical gum treatment (scaling and root planing)
For most early and moderate cases (Stages 1–3), the first step is a deep cleaning under local anaesthetic to remove tartar and plaque from under the gums and smooth the root surfaces (scaling and root planing). At DSC, this is combined with antibacterial rinses and laser decontamination of pockets using the Fotona LightWalker system. We then reassess in about 6–8 weeks, with repeat gum charting to measure healing and pocket depth.
LANAP — Laser Assisted New Attachment Procedure
LANAP is an FDA‑cleared laser protocol specifically developed to treat periodontitis and support new attachment and bone fill in many cases. Using a Nd:YAG laser on the Fotona platform, LANAP selectively removes diseased pocket lining and kills bacteria while preserving healthy tissue, usually without traditional cutting or stitches. It is typically recommended for moderate-to-advanced disease (Stages 2–4) to reduce pocket depth, improve support, and minimise gum recession.
WPT — Wavelength Optimised Periodontal Therapy
WPT is Fotona’s full‑mouth laser programme that combines two laser types (Er:YAG and Nd:YAG) to clean roots, disinfect pockets, and stimulate healing. It is used alongside scaling and root planing and can be a less invasive option for patients who prefer to avoid conventional surgery.
Periodontal surgery for advanced or non healing areas
If deep pockets (usually over 5–6 mm) remain after non‑surgical care, especially in Stage 3–4 disease, flap surgery may be needed to lift the gums, directly clean root surfaces, and shape bone defects. In suitable cases, vertical defects can be treated with bone grafts and special membranes to encourage regeneration. These surgeries are planned using detailed charting and, where needed, CBCT, and are performed by Dr. Balasubramanya.
Supportive periodontal therapy (maintenance)
After active treatment, long‑term stability depends on regular maintenance visits every 3–6 months for professional cleaning, pocket checks, and ongoing risk‑factor control. Periodontitis is a chronic condition; the bacteria can return, and pockets can deepen again if maintenance is neglected, but with consistent follow‑up, most treated teeth can be kept healthy and stable for many years.
Frequently Asked Questions
How is periodontitis different from gingivitis?
Gingivitis is early gum disease affecting only the gums and is reversible; periodontitis means the infection has damaged the bone and supporting tissues around the teeth. Once bone is lost, it usually cannot fully regenerate, so periodontitis requires more intensive, ongoing treatment and maintenance.
Can periodontitis be reversed or cured?
Existing bone loss usually cannot be fully reversed, but periodontitis can be brought under control so it stops getting worse. With deep cleaning, possible laser or surgical treatment, and regular maintenance visits, most patients can keep their treated teeth healthy for many years.
Is treatment for advanced gum disease painful?
Most periodontal treatments, including deep cleaning and LANAP, are done under local anaesthesia, so you should feel pressure but not pain. You may have some soreness for a few days afterwards, which is usually manageable with simple pain relief and careful home care.
Will I definitely lose teeth if I have periodontitis?
No. Tooth loss depends on how advanced the disease is when it is found, how well you respond to treatment, and whether you stick to regular maintenance and risk‑factor control. With good care and follow-up, many people keep most or all of their periodontally treated teeth long-term.
How is periodontitis treated?
Treatment usually starts with deep cleaning (scaling and root planing) to remove plaque and tartar under the gums. More advanced cases may also need laser therapy, such as LANAP, and sometimes gum surgery to clean deep pockets and, where possible, rebuild lost support.
How long will periodontal treatment and recovery take?
Deep cleaning is usually completed in 1–4 visits, and laser or surgical procedures are scheduled as needed. Initial healing is often a few days to a couple of weeks, but full response is assessed at 6–8 weeks, and long‑term maintenance visits every 3–6 months are essential.
Can advanced gum disease affect my overall health?
Yes. Periodontitis is linked with higher risks of heart disease, poorly controlled diabetes, adverse pregnancy outcomes, and some respiratory conditions. Treating gum disease helps reduce chronic inflammation in the body and is considered part of good overall health care.
What can I do at home to help manage periodontitis?
Brush twice daily with fluoride toothpaste, clean between teeth every day, follow your dentist’s instructions for any medicated mouthwashes, and avoid smoking. Keeping diabetes well-controlled and attending all scheduled maintenance visits are just as important as the initial treatment.