Periodontitis is an advanced form of gum disease that is caused by a bacterial infection of the soft tissues surrounding the teeth. It can affect anyone with poor oral hygiene who fails to brush and floss regularly and can lead to tooth loss if left untreated. Periodontitis affects more than 47 percent of U.S. adults over the age of 30, and 70 percent of adults aged 65 and older.
A family history of gum disease can raise the risk of developing periodontitis. Other contributing factors include smoking, diabetes, hormonal changes from pregnancy or birth control pills, and inflammatory health conditions like arthritis and cardiovascular disease.
Stages of Periodontitis
Periodontitis is a progressive disease, meaning it advances to more serious levels when ignored.
There are four stages of periodontitis:
- Gingivitis – The earliest stage of the disease, the hallmark of gingivitis is red and swollen gums. Other symptoms include gums that bleed easily, especially when brushing, and sensitivity to hot or cold foods. You are not at risk of tooth loss at this stage, with gingivitis being reversible with proper oral care and regular cleanings with your dentist.
- Mild periodontitis – Periodontitis begins to set in when gingivitis is not addressed, with the gums beginning to pull away from the teeth and periodontal pockets beginning to form. This allows plaque, tarter, and bacteria to become easily lodged in those pockets, exacerbating the issue since neither a toothbrush nor floss can reach these spaces.
- Moderate periodontitis – Bone loss around the teeth progresses, and bacteria continue to erode the soft tissue that keeps your teeth healthy and in place. Mild pain, including sore and tender gums, is common at this stage. Moderate periodontal disease is usually identified by a dentist measuring the pockets around the teeth.
- Severe periodontitis – At this stage, teeth begin to loosen and fall out. Bleeding gums are common, and infections along the gum line can lead to other oral health issues such as halitosis. Severe periodontitis can also start to impact overall health when the bacterial infection travels to the bloodstream, leaving you susceptible to heart disease, stroke, and other serious health complications.
Symptoms of Periodontitis
Periodontitis is an oral health condition that often goes unnoticed, even though there are many signs indicating a worsening issue. Healthy gums should fit snugly around each tooth and feel firm, so any deviation from this should be discussed with your dentist.
Signs of periodontitis include:
- Red or purple gums, instead of the usual pink
- Swollen or tender gums
- Gums that bleed easily
- Bad breath
- Visible infection around the gumline
- Loose teeth or tooth loss
- Gum recession
- Painful chewing
- New spaces between teeth
To diagnose periodontitis, a dentist will visually examine your gums for signs of inflammation. They will then use a periodontal probe, similar to a small ruler, to measure the pockets around your teeth. Dental X-rays might also be taken to assess any bone loss. For more advanced cases, you may be referred to a gum disease specialist called a periodontist.
Periodontitis Treatment
Depending on the stage of periodontitis, several treatment options are available. For early stages, your dentist may recommend scaling and root planing—a deep cleaning procedure that removes plaque, tartar, and bacteria from the entire gum line. For moderate to severe cases, pocket reduction surgery may be needed. This surgical procedure involves lifting the gum tissue to clean the area beneath, then stitching the gum tissue back in place to prevent further disease progression.
If you have any additional questions about periodontitis and its various stages, contact us.