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Gum Disease/Bad Breath


What are gum disease, gingivitis, and periodontitis?

Gingivitis is a lot more common than you may think. About 50% of US adults have some form of gingivitis. While common, it may progress to a more serious condition called periodontitis, or gum disease, if left untreated.

Gum disease, also known as periodontal disease, is an infection of the gums that surround your teeth. It is one of the primary causes of tooth loss in adults. Because it is virtually pain-free, many patients do not know they have the disease. During each regular checkup, one of our dentists will check for signs of periodontal disease by measuring the space between your teeth and gums.



Just as the look of your gums plays a large role in the overall beauty of your smile, the health of your gums is critical to good overall dental health. Some studies have found links between periodontal disease and heart disease, difficulty managing blood sugars, and woman delivering preterm, low-birth-weight babies.

In its initial stages, gum disease may not seem like a serious problem, and you may not even notice it right away, or you may attribute it to some other irritant. However, gum disease is not something to take lightly. Over time it can cause serious health problems. Gum disease can cause:

  • Pain
  • Gum loss
  • Tooth loss
  • Bone loss

Good oral hygiene can help prevent gum disease, but other factors can play a role in causing the problem. Once bacteria invades your gums and creates pockets, oral hygiene alone cannot get rid of the problem.

Treatment options

If you’ve been diagnosed with gum disease, there are a variety of treatment options, depending on the details of your situation and the severity of the situation. We always start with the least invasive options, which are non-surgical. However, in more serious cases, surgery may be necessary. 

The Omaha family dentists at Premier Dental can remove this bacteria in a process called root planing. Once the bacteria are out of your gums, they can heal. You can maintain the results with proper brushing and flossing.

If gum disease has permanently marred the look of your gums, we can follow up with gum re-contouring to restore their natural beauty.

Non-surgical treatment

The first line of defense against gum disease is a unique type of cleaning called “scaling and root planing.” In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can’t reach: under the gum line, on the tooth, and around the root.

Then the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.

If you address your gum disease before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, after-care is vital. In order to keep your teeth in good shape and prevent future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups.

Even after a successful scaling and root planing, if you don’t attend to your teeth properly, it’s quite likely you’ll develop gum disease again.

Surgical treatment options

If the tissue or bone surrounding your teeth is too damaged to be repaired with non-surgical treatment, several surgical procedures are available to prevent severe damage and restore a healthy smile. We will recommend the procedure that is best suited to the condition of your teeth and gums. The following is a list of common types of periodontal surgery:

  • Pocket depth reduction
    In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually, the supportive structure degrades to the point that the tooth either falls out or needs to be removed.

    During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive. We then sew the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque, and tartar, and the pockets have been reduced, the gums can reattach to the teeth.

  • Regeneration
    When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque, and tartar. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may apply a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.

  • Soft-tissue graft
    A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease, as bacteria, plaque, and tartar attack the surface of the tooth and the root.

During a soft-tissue graft, tissue from the top of your mouth or another source is sewed to the gum area, covering the roots and restoring the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.


Bad breath treatment

Bad breath is embarrassing and can cause social and confidence issues. Most bad breath is caused by anaerobic bacteria in the mouth, harbored by the grooves of your tongue and pockets in your gums. In order to treat bad breath successfully, our Omaha general dentists will first determine the source.


Tongue scraping, called debridement, is a key component of breath treatment. The grooves of your tongue can harbor huge amounts of odor-producing bacteria, even if tongue brushing is a part of your normal daily regimen.

A toothbrush cannot reach into the deep grooves in the surface of your tongue. For this we use a special scraper that is both flexible and rippled.

Gum treatment

Gum disease creates pockets in your gums, which also harbor odor-causing bacteria. A gum cleaning will clean these pockets of bacteria and allow them to heal.

Long-term improvement

In order to eliminate bad breath in the long term, we must eliminate dental problems that provide a safe haven for odor-causing bacteria. Cavities and cracks in your teeth as well as any spaces created by poor dental work, such as poorly fit dental fillings or dental crowns, are oxygen-free environments that will continue to harbor and grow anaerobic bacteria.

Bad breath myths

Often in the attempt to cure bad breath, people are their own worst enemies. Alcohol-based products, such as mouthwash, only dry out your mouth and create an anaerobic, bacteria-friendly environment. Breath mints and chewing gum only mask the odor (if even that), and can lead to decay.



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