Gum Disease

The word “periodontal” means “around the tooth.” Periodontal disease (also known as periodontitis or gum disease) is a common condition that causes inflammation that affects the supporting and surrounding soft tissues of the tooth and, in its most advanced stages, the jawbone itself. Because it is usually painless in the early stages, most people are not aware they are living with the disease. In fact, four out of five people have periodontal disease and don’t know it! If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.

Periodontal disease starts showing signs after gingivitis, which is a bacterial infection of the gum tissue. Once this bacterial infection gets into the gum pockets between the teeth, it becomes much more difficult to remove and treat, and it can eventually destroy the connective tissue and jawbone. 

Periodontal disease is not only the number one reason for tooth loss—research also suggests there may be a link between periodontal disease and other diseases such as stroke, bacterial pneumonia, diabetes, cardiovascular disease and increased risk during pregnancy. Smoking also increases the risk of periodontal disease. Good oral hygiene, a balanced diet and regular dental visits can help reduce your risk of developing periodontal disease.

Signs and Symptoms of Periodontal Disease

  • Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss
  • Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth’s connection to the bone)
  • New spacing between teeth – Caused by bone loss
  • Persistent bad breath – Caused by bacteria in the mouth
  • Pus around the teeth and gums – Sign that there is an infection present
  • Receding gums – Loss of gum around a tooth
  • Red and puffy gums – Gums should never be red or swollen
  • Tenderness or discomfort – Plaque, calculus and bacteria irritate the gums and teeth

Types of Periodontal Disease

Gingivitis is the first stage of periodontal disease. Plaque and its toxic by-products irritate the gums, making them tender, inflamed and likely to bleed.

Plaque hardens into calculus. As calculus and plaque continue to build up, the gums 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 may be present.

The teeth lose more support as the gums, bone and periodontal ligament (the soft tissue between your teeth and bones) 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.

Inflammation within supporting tissues causes deep pockets and gum recession. It may appear the teeth are lengthening, but the gums (gingiva) are actually receding. This is the most common form of periodontal disease and is characterized by progressive loss of gum attachment with periods of rapid progression.

This form of gum disease occurs in an otherwise clinically healthy individual. It is characterized by rapid loss of gum attachment, chronic bone destruction and family genetic history.

This form of periodontal disease most often occurs in individuals suffering from systemic conditions (conditions that affect the entire body) such as HIV, immunosuppression and malnutrition. Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.

This form of gum disease often begins at an early age. Medical conditions such as respiratory disease, diabetes and heart disease are common cofactors.

Diagnosis of Periodontal Disease

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up. You may be screened for periodontal disease by our team during your check-up.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus 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 usually get deeper.

Treatment for Gum Disease

Our dental staff is trained and experienced in evaluating the health of your gums and determining which treatment option will provide the best results. Taking care of gum problems early is your best chance at a successful outcome, so we encourage you to call us as quickly as possible so you can enjoy a beautiful, healthy smile.

There are many surgical and nonsurgical treatments we may recommend depending on the exact condition of your teeth, gums and jawbone. We will do a complete periodontal exam of your mouth before any treatment is performed or recommended.

Here are some of the more common treatments for periodontal disease:

Scaling and root planing
In order to preserve the health of gum tissue, the bacteria and calculus (tartar) which initially caused the infection must be removed. The gum pockets will be cleaned and treated with antibiotics as needed to help alleviate the infection. A prescription mouthwash may be added into daily cleaning routines.

Tissue regeneration
When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to help the regeneration process.

Pocket elimination surgery
Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option to get rid of indentations in the bone that can cause bacteria growth.

Dental implants
When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.

Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment or dental implants.


It only takes 24 hours for plaque that is not removed from your teeth to turn into calculus! Daily home cleaning helps control plaque and tartar formation, but those hard-to-reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gumline.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

  • Examination of diagnostic X-rays (radiographs) – Essential for detection of decay, tumors, cysts and bone loss (X-rays also help determine tooth and root positions)
  • Examination of existing restorations – Check current fillings, crowns, etc
  • Examination of tooth decay – Check all tooth surfaces for decay
  • Oral cancer screening – Check the face, neck, lips, tongue, throat, cheek tissues and gums for any signs of oral cancer
  • Oral hygiene recommendations – Review and recommend oral hygiene aids as needed (electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
  • Teeth polishing – Remove stains and plaque that is not otherwise removed during tooth brushing and scaling


Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

Periodontal Scaling and Root Planing

When patients suffer from gingivitis and other gum problems, root planing is often the best solution. The process removes disease-causing substances from the teeth, such as plaque and tartar. Although the procedure cleans the roots of the teeth, it is a non-surgical procedure with no downtime to effectively treat gingivitis and periodontal disease.


Why is root planing necessary?

Root planing can be used as a preventive or a standalone treatment. Some of the reasons you may need this treatment include:

  • Disease prevention – Those who are more likely to develop periodontal disease or gingivitis may benefit from root planing to help slow down or even stop the development of the disease.
  • Tooth protection – Pockets can develop that separate the gums from the teeth. When this happens, cavities and other problems below the surface are more likely to occur. Root planing can resolve this issue.
  • Aesthetics – In addition to removing plaque and tartar, this procedure can also remove some staining from the teeth, leaving you with a brighter smile.
  • Better breath – Bad breath can sometimes be caused by bacteria and food particles that may be trapped below the gumline. Root planing can remove this debris and give you better breath.


What does periodontal scaling and root planing involve?

First, the dentist will take X-rays and complete a thorough examination. Depending on the amount of cleaning required, a local anesthetic may be used during the procedure.

  • Scaling – Scaling uses special dental tools and even an ultrasonic scaling tool to remove plaque and debris from the crown and root of the tooth. A water-flushing process may also be used to apply antibiotics below the gumline.
  • Planing – Root planing goes a bit deeper, removing the surface dentin and cementum (hard tissues found in your teeth) that contain toxins, tartar and microorganisms. The surface is then smoothed to prevent the growth of more bacteria.


After treatment, gum pockets may be treated with antibiotics, and a follow-up will ensure the pockets are healing properly.

“This was my first visit, and everyone at the office was so nice and friendly. They were understanding about underlying issues and helpful, and not at all judgmental. I really feel like I’m at the best possible dentist and they provide the best care. Even my daughter, who hates going to the dentist, couldn’t stop talking about how great her experience was.”

Eric K



Meet Ashley, our dedicated Patient Care Coordinator at Cary Dental. With over a decade of experience, Ashley’s journey with our practice began as an assistant, showcasing her commitment to dental care. After a hiatus to nurture her growing family, Ashley has returned to our team in a new role, bringing a wealth of knowledge and a passion for patient well-being. 

Ashley is not just a professional; she’s a proud mother of two wonderful children, a son, and a daughter. Her first-hand experience with balancing family life uniquely positions her to understand the diverse needs of our patients. As a Patient Care Coordinator, Ashley leverages her profound understanding of dental procedures to educate and comfort patients. Her warm and compassionate approach creates a welcoming atmosphere, ensuring that each patient feels at ease throughout their dental journey.

In her role, Ashley is dedicated to guiding patients through their treatment plans, facilitating appointments and addressing any questions or concerns they may have. Her commitment to excellent patient care is reflected in her ability to establish strong connections and provide personalized support.

Outside of the office, Ashley finds joy in spending quality time with her children. Additionally, she shares her passion for dance by coaching the Woodstock High School dance team. Showcasing her involvement and leadership in the community. 

With Ashley on board, you can trust that your dental experience at Cary Dental will be not only professional but also caring and supportive. She looks forward to assisting you on your journey to optimal oral health. 


Welcome to our office, where Tiffany is one of the warm and welcoming faces that greets you as you walk through the door. Born and raised in Cary, Tiffany has deep roots in the community. She shares her home with her loving husband, Derek, and two energetic sons, Tyler and Ryder. 

Beyond the office walls, Tiffany’s adventurous spirit comes to life during the summer months. She has a passion for boating, spending lazy afternoons on the water, and creating cherished memories with her family. Whether it’s cheering on her favorite sports teams or actively participating in games with her sons, Tiffany is a true sports enthusiast.

In the office, Tiffany wears many hats, handling front desk duties with a smile and providing essential support for various tasks around the office. Her friendly demeanor and attention to detail make her an invaluable member of our team. Outside of work, Tiffany values the importance of friendships and relishes in spending quality time with her dear friends.

Tiffany’s dedication to her family, love for her community, and commitment to excellence in her role make her an integral part of our office. Next time you visit, be sure to say hello to Tiffany and experience the warmth and efficiency she brings to our workplace.


Dental hygienist Trisha believes in educating each patient about their oral health and individualizing treatment to cater to every patient’s current needs. She does this by gathering a full medical history and performing an oral cancer screening, periodontal measurements and a full oral exam. With this information, she makes a unique, personalized treatment for each patient. Skills she performs in the office include detailed cleanings, sealants, fluoride, periodontal deep cleanings, and impressions for whitening.

Trisha attended Marquette University in Milwaukee, WI. She graduated with a Bachelor of Science in dental hygiene and a minor in biomedical sciences. She holds a certification for local anesthesia and has been trained using Biolase lasers. She completes at least 36 hours of continuing education every three years. Trisha also has experience as a dental assistant starting at the age of 15. She assisted for three years in general dentistry prior to attending Marquette University and assisted as a periodontal surgical assistant and pathology assistant while attending Marquette.

Trisha grew up in Crystal Lake, IL. She now lives in Huntley with her husband Ryan and their two boys, Mason and Chase. Trisha enjoys hiking with her dogs, fishing, going on adventures and spending time watching her boys play football and baseball. She is very involved with her boys’ school, holding the position of president of the home and school association and running the school lunchroom. When it’s time to unwind she loves spending time with friends and family.


Jen has been a dental assistant since she was 21. She enjoys assisting Dr. Brewer and is dedicated to ensuring that procedures go smoothly and patients are comfortable and relaxed. Jen will always greet you with a smile and make sure you feel welcome. She is certified in coronal polishing and sealants. Jen lives in McHenry with her husband Rob, their dog Sarika and their cat Puddy. They have a son and two daughters. When not at work, Jen enjoys working out, reading, knitting and spending time with her kids.


Renae joined the exciting world of dentistry in 2004, and it wasn’t long before she realized this was the career path she would follow. Renae joined the Cary Dental Associates Team in August of 2016.

As our office manager, insurance coordinator and implant coordinator, Renae has her hands full, but you’ll always see her smiling and she wouldn’t have it any other way. She enjoys educating patients about their dental benefits to help them make decisions to receive the best possible care. She oversees the submission of insurance claims along with the processing of insurance payments. She is always up for a challenge when it comes to appealing claims that may have been denied by an insurance company. Renae also enjoys working with patients and our specialists when it comes to implant treatment. She makes sure patients understand their treatment from start to finish and thoroughly explains the financial aspect of the implant process along with any applicable insurance benefits. Renae will happily go the extra mile to help any and all patients in the practice.

Renae grew up in Crystal Lake and still calls it home. Renae enjoys spending time outside with her two sons, Cameron and Christian. She loves watching Cameron play baseball and considers herself his biggest fan.


Tracy is our social media and marketing coordinator. You may see her in and out of the office throughout the week. Tracy enjoys working out of her home creating content for Cary Dental Associates’ Facebook and Instagram pages.

Tracy has lived in the Crystal Lake area for over 40 years, and she and her husband, Dr. Skleba, currently reside in Prairie Grove where they raised their family. In her free time, she enjoys anything that has to do with being outside and spending time with family, especially playing with her grandchildren. Tracy loves to travel to new and exciting places where she can play golf and hike.


As an assistant to Dr. Brewer, Marisa focuses on helping patients achieve brighter smiles along with utilizing her certificate for sealants and coronal polishing to help keep patients’ teeth healthy. Marisa is always smiling because she’s able to help patients feel confident in their own smiles. She’s been working in the dental field since 2006 and recalls getting so excited to go to the dentist as a child.

When she isn’t working, Marisa enjoys traveling, boating or simply spending time outside in the sun with her children, Brayden and McKenzie. If Marisa could spend a year doing anything, she would spend as much time as possible traveling with family and friends.


Debbie has been part of our dental hygiene team since 2007. She obtained her Associate of Applied Science in dental hygiene from Harper College. She has been practicing dental hygiene since 1983 and has years of experience in both periodontal and orthodontic offices. She is thrilled to be part of such a great team with incredibly wonderful patients.

When not at work, Debbie’s favorite thing to do is spend time with her husband, their three daughters and four grandchildren. She also volunteers at her church with the PADS program.


Dental hygienist Bonnie’s priority is to work in tandem with the rest of the dental team to provide full oral health care. Her training lets her specialize in the treatment and prevention of oral diseases such as periodontal disease and dental decay. She evaluates potential risk factors for these diseases by taking a full medical history and performing an oral cancer exam, a dentition exam and a periodontal exam. She then follows up with treatment, which can include removal of plaque, calculus and biofilm, as well as any necessary radiographs, fluoride treatments and sealants.

Bonnie lives in Ringwood, IL, and has resided in McHenry County her whole life. In 1988, she obtained her Associate of Applied Science from Harper College in Palatine, IL, and holds local anesthesia and diode laser certifications. She maintains 36 hours of continuing education every three years for licensure. Originally an oral surgery assistant, Bonnie realized she had a very real desire to learn more about other forms of dentistry and decided to turn her attention toward the prevention of oral diseases.

When she isn’t keeping patients’ mouths healthy and shining, Bonnie is spending time with her husband Derek and their three children, Grace, Gretchen and Griffin. She enjoys coffee on the porch, swimming and boating on the lake.


As the insurance and scheduling coordinator, Terri is always willing to go the extra mile for our patients. Terri works directly with insurance companies to verify patients’ coverage and obtain detailed benefit information. When she’s not on the phone with insurance companies, she helps patients book appointments, checks them in and out and keeps up with patient relations. Terri has been working in the dental field on and off since 2000. She loves helping people and educating them on how to achieve their best smiles. Terri loves working at Cary Dental Associates and with everyone in the office.

When she is not working, Terri enjoys spending time with her family. She has been married for over 35 years and has three daughters. She loves spending time with her grandchildren, Simon and Winnie, who live in Holland, MI. Terri loves playing with her 2 grandpuppies, a golden retriever, Rudy, and a Bernedoodle, Riley. She also loves cooking, watching movies and seeing live shows.


Bridget has worked in the dental field since 2005. She has been both a dental assistant and a front desk coordinator. Bridget joined the Cary Dental Associates team in June 2021. As the scheduling coordinator, she oversees scheduling appointments, checks patients in and out of the office and keeps up with patient accounts. Bridget enjoys helping people find their way to a brighter smile.

Bridget was born and raised in Chicago and moved to McHenry in 1993 with her husband Rob. She has three children, twins Jimmy and Joey, a daughter Brianna and a beloved dog, Phebe. When Bridget is not working at the office, she loves to spend time with family and friends. She is always on the go and loves to be busy and active. She’s an avid sports fan and loves the Chicago Cubs, Blackhawks and the Bears.

Dr Katarina Crause

Dr. Katarina Crause grew up in Ann Arbor, MI. She completed her Bachelor of Science in evolutionary anthropology with a minor in biochemistry at the University of Michigan.

Having always wanted to work in healthcare, her family dentist convinced her to consider dentistry, and she was inspired by the amount of hands-on patient care, precision and artistry involved in the field. She received her DDS from the University of Michigan School of Dentistry in 2021 and then moved to Chicago, completing her general practice residency at Advocate Illinois Masonic Medical Center in 2022.

Dr. Crause is a member of the Chicago Dental Society, the Illinois State Dental Society, the American Dental Association, and the Academy of General Dentistry. She has participated in various volunteer events, including Give Kids a Smile and Mission of Mercy.

When not caring for patients, Dr. Crause enjoys exercising, traveling, watching Broadway shows and dancing with friends. You might also find her walking along Lake Shore Drive or trying a new restaurant in Chicago!

Dr Sarah Brewer

Dr. Sarah Brewer always loved puzzles as a child, and seeing how pieces fit together to make a functioning and visually pleasing whole.

“When I started college, I had no idea what I planned to do, but the brother of a friend of mine started talking to me about dentistry. I quickly saw it was the perfect blend of medicine and creativity for me!”

A Bloomingfield, MI, native, Dr. Brewer did her undergraduate work at Indiana University, achieving a Bachelor of Science in biology and a minor in chemistry and graduating with honors. She followed up her undergraduate with dental school, attending Boston University for her DMD and graduating magna cum laude in 2006 before completing her residency at Illinois Masonic Medical Center.

“There are two ‘best parts’ of my daily job,” Dr. Brewer says. “The first is working with patients who call themselves ‘flight risks.’ They are so scared of the dentist that they literally want to jump out of the chair and run. When I am able to successfully treat them and they say to me, ‘Wow, I’m not scared anymore!’—well, that’s a great feeling. The second is working with patients who tell me they are embarrassed to smile because of the way their teeth look. When we do restorative work and they are able to smile again, you can see what a difference you’ve made in their life. It’s transformative.”

When she’s not guiding patients toward a happier, healthier approach to dentistry, Dr. Brewer can be found at her Cary, IL, home with her three children, Lucas, Dylan and Beckett. She enjoys relaxing in warm weather and going to the beach to build sandcastles with the kids, and confides that her dream vacation would definitely involve travel to Europe with friends, family and a babysitter!