Periodontal disease: symptoms and stages, plus treatment and prevention

03 November · 4 minutes

Periodontitis, also known as periodontal disease or pyorrhea is an extremely common and potentially harmful gum disease. To protect and maintain our oral health, it’s vital that we understand what causes periodontal disease and how to prevent it.

What is periodontal disease?

Let’s start with the basics, what is periodontal disease or periodontitis? This is a gum disease that affects the periodontal pocket, ligament, and bone causing a loss of attachment. What does that mean? Well, it means that with time, periodontitis slowly detaches the tooth from the bone, causing teeth to become loose and in advanced cases, teeth can potentially fall out.

It is possible to stop the progression of periodontitis when it’s detected in its early stages, but unlike gingivitis, it’s not reversible. Once the attachment between the tooth and the bone is gone it can not be restored. This makes pyorrhea especially dangerous and is why it should be treated as early as possible.

Periodontal disease stages

Periodontitis progresses in stages. We can classify the degree of severity by the level of gum attachment loss. The stages of periodontitis are, early, moderate, and severe or advanced. In order to discover the periodontitis stage, you should see a periodontist who will determine the diagnosis based on the loss of attachment or the level of separation between the gum and tooth. It’s also important to keep in mind that pyorrhea is a recurrent disease so you’ll need to schedule check ups after treatment.

Specialist explaining X-ray results to a patient

Early stage periodontal disease

Periodontitis is considered early stage when the loss of periodontal attachment measures somewhere between 1-2 mm. This is the first of the periodontal diseases stages, and the least aggressive.

Moderate periodontitis

Moderate periodontal gum disease, being the next step after early stage, exhibits a 3-4 mm separation between the tooth and the bone. This is the stage where we tend to start seeing tooth mobility.

Severe or advanced periodontal disease

Severe or advanced periodontal disease can be classified as such when there is 5mm or more of lost gum attachment. This is the latest stage of pyorrhea. If the periodontal disease is very advanced, the patient can have considerable tooth mobility or even the loss of the tooth entirely.

What causes periodontal disease?

Now that we’ve broke down what periodontal disease is, let’s discuss what causes it. The truth is, periodontitis can be caused by a number of factors, like:

  • The accumulation of microbial plaque or dental tartar from poor oral hygiene and bad brushing. This is one of the most common causes of periodontal disease.
  • Other bad habits such as smoking, experiencing a lot of stress, and having a poor diet can attribute to periodontal disease. These habits directly impact the health of the periodontal pockets and elevate the risk of pyorrhea.
  • Genetics. Unfortunately for some, our genes can play a role in determining how periodontal gum disease develops.
  • Systemic diseases such as Diabetes can lead to a higher risk of periodontitis. Those who suffer from poor glucose control are more likely to face issues in maintaining their periodontal health.

Signs and symptoms of periodontitis

The symptoms of periodontal disease can vary between patients, but the most common include inflamed or bleeding gums. Some patients even notice a change in the colors of their gums, turning bright or dark red and purple. Some signs of periodontitis outside gum changes consist of:

  • Pain when chewing
  • Tooth mobility
  • Drainage from periodontal abscesses
  • Receding gums
  • Increased interdental spaces
Patient in pain experiencing oral discomfort

Periodontal disease treatment

When discussing how to treat periodontitis, the first step your doctor will take is creating a periodontal disease diagram, also known as periodontal charting or a perio chart. This study uses a periodontal probe to assess the level of gum recession and tooth detachment caused by periodontal pockets. The goal is to detect the level of separation and determine the periodontal stage, so your specialist will also need to take X-rays.

The next step in periodontitis treatment is a thorough oral cleaning to remove the accumulated bacteria. In addition to a traditional hygiene appointment, your dentist will also have to perform scaling and root planing, also known as periodontal or gingival curettage.

Sometimes the treatment of periodontal disease will consist of getting a prescription for antibiotics to ensure that all the bacteria in the periodontal pockets and abscesses has been eliminated.

If the periodontal disease has reached a very advanced stage, sometimes treatment can require surgery, like soft tissue or bone grafting.

Periodontal maintenance and care

Visiting the dentist often, about every 4-6 months, is vital to maintaining good oral and periodontal health. These check ups will keep your mouth clean and allow the specialist to perform a periodontal maintenance, if necessary. On top of going to the dentist, it’s up to you to practice good periodontal care by brushing and flossing regularly.

Professional explaining the results of periodontal charting to a patient

How to prevent periodontal disease

Understanding how to prevent periodontal disease is of the utmost importance. The key to periodontal disease prevention is maintaining good oral hygiene. You should always brush and floss your teeth at least twice a day, preferably after each meal. You can also use an interproximal brush if you need to clean larger spaces between teeth. It’s essential to keep the periodontal pockets clean and free of bacteria, so as we mentioned, visiting your dentist for a cleaning is another important step in the prevention of periodontal disease. And lastly, you should avoid bad habits like smoking, having a poor diet, and suffering from excess stress as they all affect your oral and general health.

Orthodontic treatment in periodontal patients

If you’re thinking about starting orthodontic treatment, it’s important to understand the relationship between orthodontic devices, like braces or aligners, and periodontal disease. In order for orthodontic treatment to be successful, the patient needs to be in good periodontal health or have the disease under control. As you probably know, orthodontic treatment causes the teeth to move, so if the patient suffers from tooth mobility due to periodontal disease, it can cause complications. This doesn’t mean that periodontal disease and braces or aligners are incompatible, it just means to need to check with a specialist first.

Periodontitis, periodontal charting and Impress invisible orthodontics

As we noted above, starting orthodontic treatment in patients with periodontitis has its complexities. So to ensure that the patient’s oral health is in good standing, your Impress doctor may recommend seeing a specialist if they notice any signs of periodontitis during your free consultation.

Patient getting fitted with Impress aligners

As one of the most common pretreatments among our patients, we at Impress prioritize our patients’ health and ensure they’re ready for orthodontic treatment. To do so, we only use the latest medical technology and work with top-tier professionals, and collaborate care with experienced periodontists in all of our clinic cities.

So if you’re considering improving your smile and oral health, Impress is ready to help. Don’t hesitate to reach out to us, we’ll give you the details about our treatment and pretreatment options as well as our pricing system. You can get in touch with us by calling 888.490.1421, emailing careteam@uniformteeth.com or by booking your initial consultation online. Discover what Impress can do for you at your nearest clinic.

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Frequently asked questions about periodontitis

How do you know if you have periodontal disease?

If you’re wondering if you have periodontitis the only way to know for sure is by visiting a specialist. They’ll perform the appropriate tests and ensure you’re properly instructed on the next steps.

Gingivitis vs periodontitis - what's the difference?

It’s true that both gingivitis and periodontitis are gum diseases, but they aren’t quite the same. The bone loss that we see in periodontal disease doesn’t occur in gingivitis, making it possible to reverse.

Is periodontal disease curable?

Yes, periodontal disease is curable. But it requires a visit to a periodontist and periodontal charting to determine the stage of progression and develop a treatment plan. It’s important to note that although periodontitis can be cured, it can not be reversed. This is why bi-yearly check-ins with your dentist are incredibly important.

Is periodontal disease contagious?

Yes, periodontal disease is contagious and can be spread from one person to another. The pathogenic bacteria that causes periodontitis can migrate when it comes into contact with another person’s mouth.

Can I get braces with periodontal disease?

Yes, it’s possible for patients with periodontal disease to opt into orthodontic treatments. The eligibility is on a case to case basis and always at the discretion of a periodontist. If the patient gets the green light to start treatment, both their orthodontic and periodontal check ups should be more frequent and detailed.

Is periodontitis reversible?

No, periodontitis is not reversible. When treated correctly and quickly the bone loss can be slowed or stopped, but not recovered.


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