I was dx this week with periodontal disease, however the main locations are my molars. Surgery wass recommended however I asked to have my molars removed by which partials could made for replacements if needed.
Cause of periodontal disease = Plaque, Calculus (tartar) and anything else that irritates the gums.
Treatment = Remove the irritating factors.
ie Good home cleaning, Proper professional cleaning (dentist or hygienist) and correction of other irritating factors (rough edges of fillings/crowns etc which are close to and irritating the gum, teeth with akward occlusion, smoking has to be stopped too - its a big irritating factor))
Other factors exist but basics need to be addressed properly first. There are some helpful treatments beyond removal of irritating factors but they are appropriate once the basics have been completed satisfactorily.
When to loose teeth? when the remainging teeth are hopeless, have no benefit overall, the patient is not interested, the patient is not complying with the strict dental hygiene care required to get a result.
there are too many possible diagnosis' that could be made. you need a full set of xrays, a complete exam with perio probings and charting for mobility. then your dds can let you know if he can treat you or refer you to a periodontist.
That is a very difficult question to answer without any diagnostic tools(medical histiory,xrays,oral exam etc.)You need to see a periodontist in association with your general dentist so that a diagnosis and treatment plan can be formulated for you.