Periodontal disease (pyorrhea) is the breakdown of the bone that supports the teeth in the jaw. It is caused by bacteria that hide beneath the gum and often times is not removed by the patient on a daily basis. In the early phase of periodontal disease, the gums will bleed very easily when brushing, flossing or during the dental examination. This phase is called gingivitis and is reversible if proper oral hygiene habits are put into place.
Gingivitis vs. Periodontists : What’s the Difference?
Periodontal disease exists on a spectrum, and understanding where a case falls on that spectrum matters for treatment.
| Stage | Pocket Depth | Symptoms | Reversible? |
|---|---|---|---|
| Healthy gums | 1 to 3mm | No bleeding, no swelling | N/A |
| Gingivitis | 4mm, mild inflammation | Bleeding when brushing or flossing, mild redness | Yes, with improved oral hygiene |
| Early to moderate periodontitis | 5 to 6mm | Bleeding, gum recession beginning, some bone loss | No, but progression can be managed and slowed |
| Advanced periodontitis | 7mm or more | Loose teeth, significant bone loss, possible tooth loss | No, requires ongoing management and possibly surgery |
The key takeaway is that gingivitis is your window to reverse things before any permanent damage occurs. Once the disease progresses into periodontitis, the goal shifts from reversal to management, which is why early detection through regular checkups matters so much.
How Do Dentists Find Periodontal Disease?
All thorough dental exams should include a probing, which simply involves measuring the depth of the gum pockets and noting if they bleed when probed. This is usually performed by the hygienist or the doctor on the initial visit. Periodontal measurements from 1-3mm are considered healthy. Four(4) mm pockets are noted as gingivitis and pockets over 5mm are considered periodontal disease and are associated with bone loss due to the bacteria in that area.
In addition to probing, your dentist may take X-rays to check for bone loss that isn’t visible during a standard exam. This is an important step, since bone loss is one of the clearest signs of how far periodontal disease has progressed and helps guide the right treatment approach. If gum recession has already started, it’s worth reading more about what causes receding gums, since periodontal disease is one of the most common culprits behind it.
What Causes Periodontal Disease?
While bacteria and plaque buildup are the direct cause, several factors make some people more prone to developing gum disease than others.
- Inconsistent brushing and flossing, which allows plaque to harden into tartar that only a professional cleaning can remove.
- Smoking or tobacco use, which is one of the strongest risk factors for gum disease and also slows healing after treatment. If you’re a smoker preparing for a dental procedure, our guide on smoking after a tooth extraction covers related healing considerations worth knowing.
- Hormonal changes, including those during pregnancy, which can make gums more sensitive and prone to inflammation. Expecting patients can find more guidance in our article on dental guidelines for pregnant patients.
- Certain medications, some of which reduce saliva flow or cause gum tissue changes as a side effect.
- Genetics, since some people are simply more susceptible to gum disease even with reasonably good oral hygiene.
- Chronic conditions like diabetes, which can make it harder for the body to fight off the bacterial infection driving gum disease.
How Do You Treat Periodontal Disease?
The deeper pockets should be treated more aggressively with scaling and root planing (deep cleaning) with anesthesia, to make the patient comfortable. This procedure allows the hygienist to go deep beneath the gums to the base of the pocket with powerful tools and hand scalers to remove the tartar (calculus) and bacteria from the roots. This jump starts the healing process and helps to reduce the pocket depth.
For cases that don’t fully respond to scaling and root planing, additional treatment may be recommended, including localized antibiotic therapy placed directly into deep pockets, or in more advanced cases, periodontal surgery to reduce pocket depth and help regenerate lost bone and tissue. Most patients, however, see meaningful improvement from deep cleaning alone when it’s combined with consistent home care afterward. Maintenance cleanings, often scheduled every three to four months rather than the standard six, are typically recommended following periodontal treatment to keep the disease from returning.
What Happens If Periodontal Disease Goes Untreated?
Left untreated, periodontal disease doesn’t stay contained to the gums. Continued bone loss around the teeth eventually leads to loose teeth and, in advanced cases, tooth loss altogether. This is one of the reasons periodontal disease is considered one of the leading causes of adult tooth loss. If enough bone has been lost by the time a tooth is extracted or falls out, that bone loss can also affect whether a patient qualifies for a dental implant without additional bone grafting. Our article on how dental implants support jaw bone health explains this bone connection in more detail, which is part of why treating gum disease early is worth prioritizing even before tooth loss becomes a concern.
Research has also linked periodontal disease to broader health concerns, including cardiovascular disease and complications with diabetes management, since chronic inflammation in the mouth doesn’t necessarily stay isolated there.
Preventing Periodontal Disease at Home
A solid daily routine goes a long way toward keeping gum disease from developing in the first place.
- Brush twice daily for two minutes with a soft-bristled toothbrush.
- Floss once a day to remove plaque between teeth, where a toothbrush can’t reach.
- Use an antimicrobial or fluoride mouthwash if recommended by your dentist.
- Avoid tobacco products, which significantly increase your risk.
- Eat a balanced diet and limit sugary snacks and drinks that feed harmful bacteria.
- Keep up with your six-month cleanings, even if your gums feel fine, since gum disease often develops without pain.
Frequently Asked Questions About Periodontal Disease
Is periodontal disease reversible?
Gingivitis, the earliest stage, is reversible with improved oral hygiene and a professional cleaning. Once it progresses into periodontitis and bone loss occurs, it’s no longer reversible, though it can be managed and slowed with treatment.
Does periodontal disease hurt?
Usually not, at least not in the early stages. This is exactly why regular dental checkups matter so much, since many patients have no idea they have gum disease until a dentist identifies it through probing and X-rays.
Can periodontal disease cause tooth loss?
Yes. It’s one of the leading causes of adult tooth loss, since ongoing bone loss around the teeth eventually leaves them without enough support to stay in place.
How often should I get a cleaning if I have gum disease?
Many patients with a history of periodontal disease are recommended more frequent cleanings, often every three to four months, rather than the standard six-month interval, to help keep the condition from progressing.
Can periodontal disease come back after treatment?
Yes, which is why consistent home care and regular maintenance cleanings are so important after treatment. Without them, bacteria can recolonize the gum pockets and the disease can return.
Contact Us Today
It is important to remember that periodontal disease (gum disease) does not cause any pain so most people would not know they have it unless a Raleigh dentist checks for it with specific dental tools and radiographs. Visit your dental office twice per year and remember not every dental problem will cause pain. We are here to help you stay dentally healthy. Contact us today to make an appointment.
