Gum disease is inflammation of the gum line that can progress to affect the bone that surrounds and supports your teeth. The three stages of gum disease — from least to most severe — are gingivitis, periodontitis, and advanced periodontitis.
Periodontitis, generally called gum disease or periodontal disease, begins with bacterial growth in your mouth and may end — if not properly treated — with tooth loss due to destruction of the tissue that surrounds your teeth.
What is the difference between gingivitis and periodontal disease?
While gingivitis is inflammation of the gums around the teeth, periodontal disease occurs when the bone below the gums gets inflamed or infected.
Gingivitis starts when food debris mixes with saliva and bacteria-forming plaque that sticks on the surfaces of teeth. If dental plaque and tartar aren’t removed by brushing with toothpaste and flossing, it can become mineralized and form tartar, or calculus. Tartar is very hard and can only be removed by a professional dental cleaning.
When gingivitis is left untreated, it can advance to periodontitis. In a person with periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.
Gum disease can be painless, so it is important to be aware of any of the following symptoms:
- Gums that easily bleed when brushing or flossing
- Swollen, red, or tender gums
- Gums that recede or move away from the tooth
- Persistent bad breath or bad taste in the mouth
- Loose teeth
- A change in the way your teeth come together
- A change in the fit of partial dentures
- Visible pus surrounding the teeth and gums
- Sharp or dull pains when chewing foods
- Teeth that are overly sensitive to cold or hot temperatures
A professional cleaning by your dentist or dental hygienist is the only way to remove plaque that has built up and hardened into tartar. By scheduling regular checkups — twice a year — early stage gum disease can be treated before it leads to a much more serious condition.
If gum disease is advanced, scaling and root planning can be performed to treat diseased periodontal pockets and gum infection. A dental hygienist uses an ultrasonic scaling device to remove plaque, tartar, and food debris above and below the gum line, and hand scales the tooth and root surfaces to make them smooth and disease free. Laser treatments are also sometimes used to remove tartar deposits. If periodontal pockets are more than 5 millimeters deep, that is, if you have moderate to severe periodontitis, gingival flap surgery may be performed by a periodontist to reduce periodontal pockets, as well as bone grafting to restore lost bone.
The goals of gum disease treatment are to promote reattachment of healthy gums to teeth, reduce swelling, depreciate the depth of pockets, decrease the risk of infection, and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues.