Good oral hygiene isn't just about keeping teeth clean. The supporting structures (periodontal system) are also very important and require as much care and attention as the teeth. The periodontal system consists mainly of the gums (or gingivae) and the underlying bone.

If this system is compromised through disease or neglect, the gums may bleed easily and become swollen. Left untreated, bone loss will result and the gums may ultimately "shrink" away from the tooth surfaces. This will lead to teeth sensitivity and loosening of the teeth themselves. A lot of teeth are lost because of gum disease. This is unfortunate as maintaining the gums and bone is a matter of brushing and flossing.

In older patients, gum disease rather than decay is more prevalent. More teeth in the older population are lost due to poor bone support than cavities

Regular check-ups and scalings will also minimise any gum problems. If gum problems are already present, then deep scaling or root planing may be needed. In severe cases, minor surgery may have to be carried out to solve the problem and halt or slow down further gum recession and bone loss. Bone augmentation or grafts may become necessary in some situations to delay or prevent the loss of compromised teeth