Gum Diseases and Periodontitis

Gum disease progresses to periodontitis as the inflammatory response destroys gum tissue and bone that supports teeth. Symptoms are often mild initially, and the disease can be reversed with proper oral care, including regular dental visits.

Gingivitis is fully reversible if you have a good home oral care routine, including brushing and flossing. Your dentist or hygienist will remove plaque and tartar and teach you how to clean your teeth properly. Click to learn more.


Almost everyone experiences gingivitis at least once in their adult life. It’s an inflammation of the gum tissue caused by bacteria-containing plaque and can eventually affect the supportive structure that keeps your teeth in place. Gingivitis is a fairly easy disease to treat when caught early. It is normally reversible with regular dental cleanings by a hygienist and a commitment to good oral hygiene at home.

The first step in treating gingivitis is to remove bacteria-containing plaque accumulated on the tooth surface and within the small spaces between the teeth. Several methods are used, including scaling and root planing, curettage, and mouthwash containing chlorhexidine or hydrogen peroxide. Regular brushing and flossing and removing any food particles that may get stuck in the gum pockets (called plaque traps) will minimize bacteria and prevent further damage to the teeth and gums.

If gingivitis is not treated, it can progress to periodontitis — an infection of the gum tissues that destroys the supporting structures that hold your teeth in place. Symptoms of advanced periodontitis include loose and shifting teeth, persistent bad breath, and pus formation in the gum pockets. Eventually, the gums recede from the teeth and form deep crevices that expose tooth roots to additional infection.

In some cases, gingivitis may also be linked to systemic diseases such as cardiovascular disease and diabetes. Researchers have discovered that the bacteria associated with gum disease, such as Fusobacterium nucleatum and Lachnospiraceae, enter the bloodstream and travel to other parts of the body, where they can cause damage or trigger health problems.

Many risk factors for gingivitis include poor oral hygiene, smoking, and hormonal changes such as those experienced during pregnancy or puberty. Certain medications can also contribute to gum disease, particularly those that are taken to control high blood pressure or heart conditions.

Fortunately, gingivitis is one of the easiest gum diseases to treat when detected in the early stages. Patients who commit to good oral hygiene practices and schedule regular visits with a dentist or dental hygienist can usually expect to see their symptoms clear up within days or weeks. During these appointments, the dentist or hygienist will clean and polish the teeth, discuss effective at-home oral hygiene practices, and provide instructions for a daily routine of brushing, flossing, and using an antimicrobial mouthwash. They will also recommend corrective measures for dental restorations that may cause irritation or act as plaque traps, such as bulky or overhanging fillings or poorly fitting crowns. They may also suggest that the patient seek a physician or dentist specializing in gum disease (periodontist) for further evaluation and treatment. This is particularly important if you are experiencing bleeding or swelling of the gums. For more information, please visit Gum Disease – the silent epidemic.

When gingivitis is left untreated, it can progress to periodontitis. The bacteria in plaque irritate gum tissue and trigger a chronic inflammatory response in the body, which turns the immune system on itself, breaking down and destroying bone and soft tissue. As the infection deepens, pockets form between teeth and gums that harbor food, plaque, and harmful bacteria. The pockets become deeper over time, and the gums begin pulling away from the teeth, exposing more roots to decay. The tooth root becomes encased in a thick bacterial film that brushing and flossing cannot remove. This ruins the tooth-supporting apparatus and can cause loose and shifting teeth and jawbone loss.

The damage from periodontitis is irreversible and can only be stopped with comprehensive dental treatment. This includes a thorough scaling and root planing, a detailed cleaning procedure designed to access the area below the gum line where the bacteria hide. During this treatment, we will remove the unhealthy deposits and smooth the tooth surface to prevent future accumulations. We will also take X-rays of the mouth to assess the extent of the damage and determine the best course of action for your situation.

Some patients can reverse the progression to periodontitis with prompt and consistent professional treatment, including proper home care. This includes regular brushing, flossing, and using an antibacterial mouthwash daily. See your dentist and dental hygienist for routine cleanings, which is also important.

Other symptoms of gum disease include:

  • Swollen or puffy gums.
  • Red, white, or pink discoloration on the gums.
  • Gums that bleed easily, including when you brush or floss.
  • Teeth that feel loose or seem to fit together differently when you bite.
  • Persistent bad breath or a foul taste in the mouth.

Some health conditions can also increase the risk of gum disease, such as a low level of saliva, certain medications (including oral contraceptives), pregnancy and menopause, a weakened immune system, or diseases like leukemia and AIDS.

If you notice any of these warning signs, it is important to call our office right away. Gingivitis can be reversed with early intervention, and the more advanced stages of gum disease are treatable with various techniques. Your dentist and dental hygienist will customize a gum disease treatment plan that suits your condition and needs. We will make every effort to restore the function and beauty of your natural teeth and your self-esteem. The long-term prognosis for healthy gums is excellent if you follow your treatment plan.