GUM DISEASE TREATMENT AND GUM SURGERY IN GRANADA HILLS

What gum disease is, and why it's easy to miss

Your gums attach to your teeth just below the gumline, and under them is the bone that anchors each root. Gum disease starts when bacteria in plaque irritate that attachment. The gums become inflamed — gingivitis — and if the plaque hardens into tartar below the gumline, the attachment begins to separate from the tooth, creating a pocket. Bacteria colonize the pocket, the infection deepens, and the bone begins to dissolve. That's periodontitis.

The reason it's the leading cause of adult tooth loss is that it rarely hurts. Bleeding when you brush, gums that look a little red, breath that doesn't freshen — these are the early signs, and most people learn to ignore them. By the time a tooth feels loose, the bone that held it has been gone for years.

How to tell where you are

An exam measures the depth of the pockets around each tooth and reads bone levels on X-rays, which is the only way to know for certain. But the stages have recognizable signs:

Gingivitis. Gums bleed when you brush or floss, look red or puffy, and may be tender. No bone loss yet. Fully reversible with a professional cleaning and better home care.

Early periodontitis. Pockets have formed and bone loss has begun. Gums may be pulling back slightly from the teeth, and there's persistent bad breath. This is where a deep cleaning is the treatment, and it usually works.

Moderate to advanced periodontitis. Deeper pockets, noticeable recession, teeth that look longer, sometimes shifting or loosening. Bone loss is significant. This is where surgical treatment enters the picture — and where the difference between treating it and not treating it is keeping or losing the teeth.

If bleeding gums are the only symptom you have, you're likely early — and early is easy. An exam will tell you.

Stage one: deep cleaning (scaling and root planing)

This is the standard first step for gum disease at any stage beyond gingivitis, and often it's the only step needed. Our hygienist cleans below the gumline — scaling removes the tartar and bacteria from the root surfaces inside the pockets, and root planing smooths the roots so the gum can reattach and bacteria have nowhere to hold on.

The area is numbed, so it's comfortable, and it's usually done in one or two visits by quadrant. Afterward, the gums may be tender for a day or two and slightly sensitive to temperature for a short while as they heal and tighten back against the teeth.

What happens next. After healing, the pockets are re-measured. Most patients see them shrink to a healthy depth, and from there the goal is keeping them that way. That's periodontal maintenance: cleanings on a closer schedule than the usual six months — typically every three to four months — because once gum disease has been present, the bacteria return faster than in a mouth that's never had it. It replaces the standard cleaning, not adds to it.

Stage two: treating pockets that don't resolve

Some pockets are too deep for scaling to reach fully, or they don't close after cleaning. For those, the practice has three approaches, chosen by the pocket and the patient.

Laser pocket therapy. A dental laser is used inside the pocket to remove infected tissue and destroy bacteria, and to disinfect the root surface, without cutting the gum open. It's the least invasive of the surgical options — minimal bleeding, quick healing — and it's often enough for pockets that are stubborn but not yet severe.

Pocket reduction surgery. For deeper pockets, the gum is gently folded back so the roots and bone can be cleaned directly and completely, then secured snugly against the teeth so the pocket is eliminated rather than left to heal on its own. Where the bone around the teeth has developed irregular craters from the infection, it's reshaped at the same time — osseous surgery — using ultrasonic instruments that spare the surrounding soft tissue. A smooth bone contour gives bacteria fewer places to hide and makes the area far easier to keep clean afterward.

Medication. Occasionally an antibiotic placed directly into a pocket is used alongside cleaning. It's an adjunct, not a substitute — the bacteria live in the tartar, and the tartar has to come out.

Stage three: regrowing what's been lost

Bone and gum that periodontitis has destroyed don't grow back on their own. But they can be regenerated.

Bone grafting and guided tissue regeneration. Where the infection has left a defect in the bone around a tooth, the area is cleaned and bone graft material is placed into the defect, covered with a membrane that keeps the fast-growing gum tissue out so the slower-growing bone has room to fill in. Over months, new bone forms where the defect was, and the tooth regains its support.

Your own growth factors. In grafting and regeneration cases, the practice uses PRF or PRP — a small amount of your blood is drawn at the appointment and spun in a centrifuge to concentrate your own platelets and growth factors. Placed into the surgical site, it speeds healing, reduces swelling and discomfort, and improves how well the graft integrates. Nothing synthetic, nothing foreign — the material your body would send to the site anyway, concentrated and delivered directly.

Gum grafting for recession. When gums have receded and roots are exposed — from periodontitis, from aggressive brushing, or simply over time — a gum graft restores the tissue over the root. It covers the sensitive root surface, stops the recession from progressing, and returns the tooth to its proper length.

The tissue comes from one of two sources, and this is worth understanding before you choose. Traditionally it was taken from the roof of the patient's own mouth — which works, but leaves a second surgical site on the palate that is, frankly, the most painful part of the recovery. Viva Smile routinely uses processed donor tissue instead, which avoids the palate entirely and makes recovery considerably more comfortable. Your own palate tissue remains an option if you prefer it. The choice is yours, and the cost is the same either way.

Crown lengthening. When a tooth is broken or decayed below the gumline and there isn't enough structure showing to hold a crown, a small amount of gum and bone is reshaped to expose more tooth. It's a functional procedure that makes a restorable tooth out of one that otherwise couldn't be saved.

Frenectomy. A tight band of tissue pulling on the gumline — under the lip or tongue — can contribute to recession. Releasing it with the laser takes minutes and removes the pull.

Sedation for gum surgery

Many patients choose IV sedation for periodontal surgery, and it's a reasonable choice: the procedures are longer than a filling, and being relaxed makes them easier on everyone. Dr. Baghdasaryan trained in IV sedation at USC and serves as an evaluator for the Dental Board of California, conducting the site inspections and competency evaluations other dentists must pass to receive a moderate sedation permit. For patients who'd rather stay awake, The Wand makes the numbing itself barely felt.

Handled here, not referred out

Most general practices refer periodontal surgery to a periodontist. Viva Smile handles it in-house — the deep cleaning, the pocket surgery, the regeneration, the grafting — under one clinician who also does the restorative work that often follows. That continuity matters: a crown lengthening and the crown that goes on it, or a graft and the implant it prepares the site for, are planned as one sequence rather than coordinated between two offices.

Referral out is rare. When it happens, it's because we think a specialist's opinion would be more convincing to a particular patient, not because the case is beyond the practice.

Does insurance cover gum treatment?

Most PPO-type dental insurances cover periodontal treatment when it's medically necessary — deep cleaning, pocket surgery, and grafting to treat disease typically qualify. We verify your specific benefits before treatment so you know where you stand.

The teeth you keep are the ones with healthy gums

Gum disease takes teeth slowly and quietly, which is why it takes so many. It's also treatable at every stage — easily at the early ones, and effectively even after bone has been lost. If your gums bleed, look red, or seem to be pulling back, that's the moment to find out where you are. A dental exam measures it precisely, and you'll leave knowing what's needed and what isn't. Book online or call (818) 900-2800.