Periodontitis

What is Periodontitis?

Periodontitis is a serious gum infection that damages the soft tissue around your teeth. Without treatment, it can destroy the bone that supports your teeth and lead to tooth loss. This condition develops when bacteria build up in plaque and tartar below the gumline.

The infection triggers your immune system to attack the bacteria. This immune response causes inflammation that breaks down gum tissue and bone over time. Periodontitis is common but largely preventable with good oral hygiene habits.

This condition affects nearly 50% of adults over age 30 in the United States. It starts as gingivitis, a milder form of gum disease. When gingivitis goes untreated, it can progress to periodontitis and cause permanent damage.

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Symptoms

Red, swollen, or tender gums that bleed easily when brushing
Gums that pull away from teeth, making teeth look longer
Pus between teeth and gums
Persistent bad breath or bad taste in mouth
Loose or shifting teeth
Pain when chewing food
Changes in how teeth fit together when biting
Spaces developing between teeth

Early periodontitis may not cause pain or obvious symptoms. Many people do not realize they have the condition until significant damage has occurred.

Causes and risk factors

Periodontitis begins with plaque, a sticky film of bacteria that forms on teeth. When plaque hardens into tartar, it creates a breeding ground for bacteria below the gumline. Your immune system fights these bacteria, which causes inflammation and tissue breakdown. Smoking is the biggest risk factor and makes treatment less effective.

Other risk factors include diabetes, poor nutrition, obesity, and certain medications that reduce saliva flow. Genetics also play a role in who develops periodontitis. Stress, hormonal changes, and conditions that weaken the immune system increase your risk. Poor oral hygiene habits allow plaque and tartar to accumulate more quickly.

How it's diagnosed

Dentists diagnose periodontitis through a clinical exam of your mouth. They measure the depth of pockets between your gums and teeth using a small probe. Healthy gums have pockets less than 3 millimeters deep. Deeper pockets indicate gum disease and bone loss.

Dental x-rays show bone loss around your teeth and help determine disease severity. Some blood tests can measure inflammatory markers like Interleukin-1 Beta that are associated with periodontal inflammation. Talk to your doctor or dentist about testing options that may help assess your overall inflammatory health and gum disease risk.

Treatment options

Professional dental cleaning to remove plaque and tartar above and below the gumline
Scaling and root planing, a deep cleaning procedure that smooths tooth roots
Antibiotics in oral or topical form to control bacterial infection
Surgical procedures like flap surgery or bone grafts for advanced cases
Daily brushing twice and flossing once to remove plaque
Using an antimicrobial mouthwash to reduce bacteria
Quitting smoking to improve treatment outcomes
Managing diabetes and other health conditions that affect gum health
Eating a nutrient-rich diet with plenty of vitamins C and D
Regular dental visits every 3 to 6 months for monitoring

Frequently asked questions

Gingivitis is mild gum inflammation that affects only the soft tissue. It causes redness and bleeding but does not damage the bone. Periodontitis is more severe and destroys both gum tissue and the bone supporting your teeth. Gingivitis is reversible with good oral care, while periodontitis causes permanent damage.

Periodontitis cannot be fully cured, but it can be controlled and stopped from progressing. Early treatment can halt bone loss and prevent tooth loss. With good oral hygiene and regular dental care, you can keep the condition in remission. The key is catching it early and maintaining consistent treatment.

Periodontitis typically develops over months to years if gingivitis goes untreated. The timeline varies based on oral hygiene habits, genetics, and risk factors like smoking. Some people progress quickly within months, while others may take years. Regular dental checkups help catch the disease early before major damage occurs.

Yes, periodontitis is linked to several systemic health conditions. Research shows connections to heart disease, diabetes, respiratory disease, and stroke. The inflammation and bacteria from gum disease can enter your bloodstream and affect other organs. Managing periodontitis may help reduce risk for these other health problems.

The bacteria that cause periodontitis can spread through saliva, but the disease itself is not directly contagious. Sharing utensils or kissing can transfer bacteria between people. However, whether someone develops periodontitis depends on their oral hygiene, immune system, and risk factors. Good oral care prevents bacteria from causing infection.

Blood tests can measure inflammatory markers associated with periodontal disease. Interleukin-1 Beta is a marker that shows elevated levels during the inflammatory response in periodontitis. These tests help assess your overall inflammatory health but do not replace a dental exam. Your dentist may recommend blood testing as part of a wider health assessment.

Not necessarily, if you get treatment early and maintain good oral care. Untreated periodontitis is a leading cause of tooth loss in adults. Professional treatment combined with daily oral hygiene can stop disease progression and save your teeth. The earlier you start treatment, the better your chances of keeping your natural teeth.

Most people with periodontitis need dental cleanings every 3 to 4 months. Your dentist may recommend more frequent visits depending on disease severity. Regular monitoring helps prevent the condition from worsening. These visits include deep cleaning below the gumline and checking pocket depths to track progress.

Yes, a nutrient-rich diet supports gum health and healing. Vitamin C helps repair connective tissue and reduce inflammation. Vitamin D and calcium support bone health. Foods high in omega-3 fatty acids may reduce inflammation. Avoiding excessive sugar reduces bacterial growth and plaque formation.

Early periodontitis often causes little or no pain, which is why many people miss the warning signs. As the disease progresses, you may experience gum tenderness, pain when chewing, or tooth sensitivity. Advanced periodontitis can cause significant pain and discomfort. Do not wait for pain to see a dentist, as damage may already be severe.