Often, it happens mid-cleaning—as you’re fully reclined, eyes closed under the bright lights, and trying to relax with someone else’s fingers in your mouth. Your hygienist starts calling out numbers: “Four… five… five… four…” You don’t fully understand what the numbers mean, but you may have heard someone say that under four is better.
It’s not long before someone mentions “periodontist” or “periodontal treatment” or “gum disease.”
This isn’t a judgment. Nearly half of all American adults have some form of gum disease, and that jumps to around 60% for adults over 65 years—so you’re far from alone. Fortunately, you have more options than you may think. Treatment doesn’t automatically mean surgery. And it certainly doesn’t mean you’re destined for dentures.
At Van Scoyoc Periodontics & Implants, our Southern Pines and Sanford periodontists’ approach to gum disease treatment comes down to four things:
- Precise diagnosis
- The most conservative yet effective treatment
- Keeping you relaxed and comfortable every step of the way
- Supporting your healthy smile long after your treatment ends
Here’s how that looks—from the first visit through follow-up maintenance.
Why Gum Disease Deserves a Specialist’s Attention
Gum disease has a reputation for being sneaky—for good reason. In the early stages, it rarely hurts. So, it’s easy to shrug off. A little bleeding when you floss? Gums that look a little puffy? Maybe you flossed too hard… Or got something stuck between…
Unfortunately, if left alone too long, gum disease leads to tooth loss. In fact, it’s the most common cause of tooth loss—well ahead of cavities and injuries.
Gum disease typically unfolds in stages, starting with gingivitis (when plaque bacteria cause gum inflammation). At this point, the damage is entirely reversible with proper cleaning and care.
Once it progresses to periodontitis—when the gums begin to pull away from the teeth, forming pockets that provide the perfect environment for bacteria to settle in and multiply—the repercussions are more serious. Over time, if not addressed, those deep pockets get deeper until they eventually allow the infection to reach the bone that holds your teeth firmly in place. Once that happens, the teeth can loosen and fall out. Not good.
While your general dentist is the first line of defense—and an important one—a periodontist has three additional years of specialized training that’s focused entirely on the gums and the bone that supports your teeth. The foundation of a strong, healthy smile. That means we can not only spot subtle changes but also see what’s driving them. In addition, we have a wider range of treatments to match what’s really going on in your mouth.
Step 1: Understanding Your Symptoms
Those numbers your hygienist calls out? Those are pocket measurements, in millimeters, of the space between each tooth and the gum around it. Healthy gums fit snugly—with pockets that measure between one and three millimeters. Once the measurements creep past four, though, it’s a sign that the gum disease is starting to take hold beneath the surface.
The measurements are just the beginning of the evaluation. Our periodontists then look at your gums and teeth, and the amount of hardened plaque (aka calculus or tartar) that’s found a home below the gum line where your toothbrush can’t quite reach.
Our office goes one step further with microbe testing to determine specific bacteria that are living in your gums. This is important as gum disease can be driven by different types of microbes—some are far more aggressive than others. This knowledge helps us choose the right treatment at the right time—rather than following a one-size-fits-all approach that may be more (or less) effective for other patients than for you.
Step 2: Conservative Care
Our goal is to do as little as possible. That surprises a lot of patients. We’re not trying to cut corners. We just want to pick the least invasive option to solve the problem. Surgery is usually the last option—and for many of our patients, it’s never even brought into the conversation.
Depending on what your exam and testing reveal, your treatment plan may include:
- Guided Biofilm Therapy (GBT): For both early signs of gum disease and ongoing maintenance, GBT uses a gentle stream of warm water, air, and a fine powder to clear away plaque and bacteria. No metal scraping required—something both our patients and we love.
- Scaling and Root Planing: Sometimes called “deep cleaning” by hygienists, this process removes built-up plaque and tartar, even below the gumline. It then smooths down the tooth, so the gums can more easily reattach and heal.
- Laser-Assisted Periodontal Therapy: This focused dental laser goes down deep into the gum pockets to clear bacteria and inflamed tissue while leaving healthy gums untouched. It’s typically paired with scaling and root planing. As a bonus, because the laser seals off tiny blood vessels and nerve endings, most patients notice less bleeding, swelling, and soreness after treatment.
- Localized Antibiotics: When bacteria are especially stubborn, antibiotics can be directly applied to deeper gum pockets to eliminate lingering infections.
- Perioscopy: Using a tiny camera inside the gum pockets, your periodontist can see and remove hidden deposits with precision. For some patients with moderate and even advanced gum disease, this treatment may help avoid surgery.
Can Gum Disease Be Reversed?
In the case of gingivitis—the earliest stage—the answer is usually yes with a combination of professional treatment and a consistent at-home routine. Periodontitis usually can’t be fully reversed—but in most cases, it can be kept under control to protect your teeth, gums, and bone for years to come.
Step 4: When More Is Needed
Sometimes gum disease progresses further than anyone wants. Pockets are deep. Infection is persistent. And the bone around the teeth is showing signs of breakdown. In those cases, we often turn to the LANAP® Protocol. That stands for Laser-Assisted New Attachment Procedure. It’s a more advanced laser treatment that’s designed specifically for moderate to severe periodontitis.
Using the PerioLase® laser—the only FDA-cleared laser for this procedure—we remove the diseased tissue, reduce pocket depth, and stimulate the bone beneath to regrow. All without scalpels or stitches, which makes recovery easier than traditional osseous surgery. Dr. Van Scoyoc has performed LANAP since 2009, transforming more than 2,000 patients’ smiles.
When gum disease has already led to gum recession or bone loss, treatment goes beyond halting damage to regeneration. Both of our periodontists have a special interest in rebuilding lost bone and restoring gum tissue with gum recession treatment options.
Step 4: Ongoing Treatment
Gum disease is a chronic condition—a bit like high blood pressure. The first goal of treatment is to get it under control. Once it is under control, ongoing care keeps it there.
After LANAP, for example, you’ll come back two to three weeks later, so we can ensure everything is healing well and your at-home routine doesn’t need adjustments. Periodontal cleanings will happen more frequently—every three to six months. And after nine months, we’ll fully evaluate the results.
From there, we can build a long-term maintenance schedule. This varies by patient, depending on their specific needs, goals, and risk factors. However, it usually means three to four professional cleanings a year—with either your general dentist or our periodontal office—to prevent bacteria from repopulating gum pockets.
Comfort and Kindness Come First
For many people, the hardest part of seeing a periodontist is the dread before the first appointment. Maybe because of a rough dental experience in the past. Or maybe just because it’s not always comfortable to keep your mouth open for a long time.
We understand. If you feel anxious about dental care, our goal is to keep you as relaxed and comfortable as possible. We offer sedation dentistry to help. You can also split more extensive treatment into shorter visits if you’d like.
Most importantly, we’ll explain what’s happening and why—with no pressure, lectures, or judgment. Our patients regularly tell us that having someone take the time to walk them through their options and answer all of their questions puts them more at ease than our advanced technology.
As one patient, Paul, shared: “All the staff was very patient and accommodating with my questions regarding different options. Dr. Van Scoyoc took the time to explain how those options would impact my dental health in the near term and over the long run. He was extremely informative without being pushy and he understood my circumstances. I was very appreciative with the whole experience.”
Gum Disease Treatment in Southern Pines
Behind the gum disease treatment steps are the periodontists who have dedicated their careers to saving natural teeth: Dr. Steven Van Scoyoc and Dr. Chandler Conner.
They joined together with the same philosophy: start by understanding exactly what’s happening, choose the gentlest, most effective treatment, and ensure you’re comfort to protect your smile for the long term.
If you’ve noticed bleeding, tenderness, receding gums, or just heard more alarming numbers called out during your last dental examination—and especially if your dentist recommends a periodontal evaluation—please don’t put it off until it gets worse. Gum disease is easier to manage when caught and treated early. And your natural teeth are worth protecting.
Schedule your visit to our Southern Pines office or our Sanford office at (910) 692-6270 or book online. We’d love to help you get back to healthy teeth, gums, and a smile you feel good about.
