The word periodontal means “around the tooth.” Periodontal disease attacks the gums and the bone support around the teeth. Plaque is a sticky film of food or debris, bacteria and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone around the teeth. Periodontal disease is characterized initially by red, swollen, and bleeding gums. However, as periodontal disease progresses, less redness and bleeding are seen, as the gums become fibrotic.

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

Dr. Knochel will use pocket depths, amount of bleeding, inflammation, tooth mobility, radiographs, etc., to make a diagnosis that will fall into a category below:


Gingivitis is the first stage of periodontal disease. Plaque and bacteria irritate the gums, making them tender, inflamed, and likely to bleed. There is not yet bone loss around your teeth at this stage.


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

Signs & Symptoms of Periodontal Disease

  • Bleeding gums: Gums should never bleed, even when you brush vigorously or use dental floss.
  • New spacing between teeth: Caused by bone loss and drifting of teeth.
  • Persistent bad breath: Caused by bacteria in the mouth.
  • Pus around the teeth and gums: Sign that there is an infection present.
  • Red and puffy gums: Gums should never be red or swollen.
  • Tenderness or discomfort: Plaque, calculus and bacteria irritate the gums and teeth.

Periodontics focuses on the many aspects of periodontal, or gum, disease. Everything from prevention to treatment, Dr. Knochel can treat it all. You can see the respect and appreciation Dr. Knochel has for your time during every visit. Please call our office at 520-747-7944 to learn more about periodontics or explore the following pages: