Periodontal Therapy


Periodontal disease is diagnosed by Dr. Kreuz and the dental hygienist during a periodontal examination.

A periodontal probe (small dental instrument) is gently used to measure the space between the tooth and the gums. A healthy depth measures 3mm or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than 3mm. As periodontal disease progresses, the pockets usually get deeper.

Dr. Kreuz and the dental hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:


Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.


Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and sometimes pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.


Periodontal treatment methods depend upon the type and severity of the disease. Dr. Kreuz and the dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!


It only takes 24 hours for plaque that is not removed from your teeth to harden into calculus (tartar)! Daily home care helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, Dr. Kreuz and the dental hygienist will recommend that you have regular periodontal maintenance. At these appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your hygiene care and evaluations, your appointment may include the following:

  • Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
  • Examination of existing restorations: Check current fillings, crowns, etc.
  • Examination of tooth decay: Check all tooth surfaces for decay.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
  • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and regular hygiene care are essential in maintaining dental health and keeping periodontal disease under control.

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