Periodontal Disease

Periodontal Disease Stages

Periodontal disease or periodontitis (per-e-o-don-TIE-tis) occurs due to a bacterial infection in the gums, resulting in inflamed soft tissue around the teeth. Without treatment, it can damage the bone that supports the teeth, which can then make the teeth loose. Sadly, periodontal disease is very common with over 47% of adults over 30 and 70% of adults over 65 suffering from this often-preventable condition. 

At the first sign of red, sore, or bleeding gums, you’ll want to schedule an appointment with your dentist to prevent further damage. 

Periodontal disease is more common in people as they age, but it can happen to anyone who neglects regular brushing and flossing. It also has a genetic component, with some people having a greater risk than others. However, it’s most often due to bacteria leading to increased plaque and tartar on the surface of teeth. The bacteria can then infect the gumline where the bristles from a toothbrush and floss don’t reach. Over time, teeth and bone slowly wear away, leading to greater infection and potentially loss. 

Other conditions can increase the risk of periodontal disease, including: 

  • Poor dental hygiene
  • Smoking, which lowers the body’s ability to fight infection
  • Diabetes, which also leads to a greater risk of infection
  • Family history and genetics, especially if dental care wasn’t prioritized
  • Hormonal changes, such as during pregnancy, due to the use of birth control pills, or due to menopause
  • Inflammation due to a poor diet, arthritis, cardiovascular disease, and other conditions
  • Recreational drug use
  • Low vitamin C levels
  • Obesity
  • Certain medications, especially those that cause dry mouth

Periodontal Disease Symptoms

Healthy and happy gums are evident by their firmness and how well they fit against the teeth. The color of healthy gums can range from light pink to dark pink to brown. Symptoms of periodontal disease, in contrast, are evident by:

  • Dark red or purple, swollen, or puffy gums, especially if they bleed easily
  • Tender, receding gums
  • Bad breath that doesn’t go away after brushing
  • Infection (e.g., pus) around the gumline
  • Loose teeth or gaps between teeth
  • Pain when chewing
  • Changes in how the teeth fit together

Stages of Periodontal Disease

Periodontal disease is progressive. That is, the stages of periodontal disease start fairly mild and then become more problematic if left untreated. 

The cause of periodontitis is plaque that builds up. Plaque is a sticky film caused by bacteria combined with sugars and starches on the teeth. Plaque can be removed by brushing and flossing, but it rapidly rebuilds and hardens into tartar, which can only be removed by a professional dental cleaning. Unfortunately, the longer plaque and tartar are left on the teeth, the more damage they can cause. 

Stage 1: Gingivitis – this early stage of gum disease is evident by red, swollen gums. However, the teeth and bone around the gum haven’t been affected. With proper dental hygiene (including brushing at least twice daily and flossing daily along with regular dental cleanings), this stage of periodontal disease is reversible.

Stage 2: Mild periodontitis – is evident as the gums are beginning to pull away from the teeth, affecting the bone. Periodontal pockets—where plaque, tartar, and bacteria are trapped in the gums where the toothbrush and floss don’t reach—begin to form. 

Stage 3: Moderate periodontitis results in even greater bone loss around the teeth. The bacteria in the mouth begin to erode the ligaments and soft tissues that support the teeth. You may notice your gums are sore or tender.

Stage 4: Severe periodontitis – if untreated, periodontitis becomes more severe, resulting in increased bone loss until the teeth become loose and may even fall out. Along with bleeding gums, there are usually signs of infection around the gumline and persistent bad breath.

Periodontitis isn’t just about the health of the mouth. It can impact the entire body. There are links between gum disease and a higher risk of heart disease, stroke, dementia, and other health issues. 

Periodontist Diagnosis and Treatment

If your dentist notices signs of periodontal disease (such as gum inflammation) during an examination, they can use a probe to measure the pockets around the teeth. They also look for bone loss through dental X-rays. 

Depending on how severe the gum disease is, the dentist may:

  • Prescribe antibiotics to fight the infection. They may also use a topical antibiotic on the affected gum area.
  • Perform scaling or root planing, which is a deeper dental cleaning to remove bacteria and infection from the gumline. The roots are also smoothed to prevent the further accumulation of plaque and bacteria.
  • For more severe cases, surgery may be recommended. This includes:
    • Flap surgery, where the gum tissue is moved away from the teeth for an even deeper clean and to assess if there’s been bone loss.
    • Dental bone grafts if bone tissue has been lost.
    • Gum grafts to cover any exposed roots and prevent further recession.
    • Guided tissue regeneration, where a special membrane is placed to encourage bone regrowth.
    • Platelet-rich plasma to help regenerate bone or gum tissue. 

Once periodontal disease has been diagnosed, your dentist will likely recommend more frequent teeth cleaning for optimal dental health. Unfortunately, the condition isn’t curable, but it can be managed with a personalized plan. 

To prevent or reduce periodontitis: 

  • Brush your teeth at least twice a day for two full minutes. Better yet, brush after all meals or snacks
  • Only brush with a soft-bristled toothbrush—replacing the brush at least every three months
  • Use an electric toothbrush, as they can be more effective when it comes to removing tartar and plaque
  • Floss daily with standard floss, a floss holder, interdental brushes, or water flossers to thoroughly clean between the teeth. 
  • Ask your dentist if they recommend a mouth rise as well
  • Get regular, professional dental cleanings.
  • Avoid cigarettes or chewing tobacco.

If you are concerned about the health of your gums, contact our High Point Cosmetic Dentistry Practice at (366) 841-0000 to make an appointment today to improve the health and appearance of your smile.