Periodontal disease is a dental condition that’s best nipped in the bud early on. Luckily, that is also possible. To do that, it’s essential to recognize the five stages of periodontal disease.

In This Article:

1. What is periodontal disease exactly?
   1. The causes of gum disease vary. The main ones we see are:
   2. Early signs
2. The five stages of periodontal disease
   1. Stage 1: Bleeding gums
   2. Stage 2: Gingivitis
   3. Stage 3: Early periodontitis
   4. Stage 4: Moderate periodontitis
   5. Stage 5: Advanced periodontitis
3. Take gum health seriously to prevent periodontal disease
4. Keep your gums healthy
5. Bottom line

What is periodontal disease exactly?

Periodontal disease, often referred to as gum disease, is a prevalent oral health condition. This condition arises when the tissues surrounding the teeth, including the gums and bone, become compromised due to bacterial infection.

The causes of gum disease vary. The main ones we see are:

• poor oral hygiene
• smoking
• certain medical conditions
• genetic predisposition. 

Alarming data suggests that approximately 42% of dentate US adults of 30 years or older have periodontitis, with 7.8% having severe periodontitis*. The consequences of untreated gum disease can be challenging, ranging from tooth mobility and bone loss to tooth loss itself. 

Early signs

Neglecting early signs of gum disease, such as bleeding gums and gum inflammation, can lead to the progression of the disease through five main stages. These are:

• bleeding gums
• gingivitis periodontitis
• early periodontitis
• moderate periodontitis
• advanced periodontitis

However, you can prevent or combat periodontal disease in pretty much all of its five stages. Through consistent and meticulous oral care practices – like regular brushing, flossing, professional cleanings, and lifestyle adjustments – you can proactively take care of your gums and maintain optimal oral health.

The five stages of periodontal disease

These are the five stages of gum disease. Remember, during all of these stages, you can improve your gum health, with or without the help of your dentist. 

Stage 1: Bleeding gums

The very first sign that you may be developing periodontal disease is bleeding of the gums. It doesn’t mean you already have gum disease, but it is a sign that your gums aren’t healthy.

The symptoms are quite clear: your gums bleed when you’re brushing your teeth or flossing. If you’re biting something hard, like an apple, you may notice pink spots as well. 

Tiny bloodstains on your toothbrush or floss might seem harmless, but they’re a warning signal from your gums. This early stage often happens due to a buildup of plaque, a sticky film of bacteria that loves to camp out on your teeth. When plaque isn’t removed through regular brushing and flossing, it can irritate your gums. This will make them extra sensitive and more prone to bleeding.

Stage 2: Gingivitis

Gingivitis is like the early warning system of your gums. If not tended to, it can lead to periodontitis, which takes the gum issues up a notch. The bacterial plaque that builds up on your teeth’s surfaces can cause irritation, making your gums more vulnerable.

In this stage, there is some inflammation in the gums. Your gums can already be swollen and even a bit painful. The gums will bleed, probably more than in stage 1. 

Gingivitis doesn’t have to lead to periodontal disease. With a heightened focus on oral hygiene, brushing, and regular flossing, you may just be able to prevent that. 

Stage 3: Early periodontitis

In this next stage, gum inflammation extends beyond the surface. In fact, it slowly enters the supporting bone. It begins to damage the jaw. This subtle shift might not be immediately apparent, but your gums are starting to detach from your teeth, forming pockets. These pockets provide a perfect home for more plaque and bacteria. 

The symptoms are similar to those in gingivitis, just worse. You’ll notice more bleeding, persistent bad breath, and possibly discomfort and pain. 

At this stage, action is required. Aside from good dental hygiene, regular dentist checks to monitor the damage is necessary. Scaling and root planing, a deep cleaning procedure, become important at this stage. This dental cleaning targets plaque and tartar buildup beneath the gumline, curbing the progress of the disease.

Stage 4: Moderate periodontitis

This stage signifies a significant progression of gum disease. The inflammation and infection that began subtly have now gained momentum, causing noticeable damage to the bone supporting your teeth.

In moderate periodontitis, the bone loss becomes more pronounced, leading to increased pocket depth between your gums and teeth. As we already learned, these pockets house bacteria. Deeper pockets mean more bacteria, unfortunately. Your teeth can start to feel slightly loose. In some cases, they might shift a bit, as the bone structure weakens. 

The signs are more apparent compared to the previous stage. Gum recession, persistent bad breath, and potential pus formation near the affected area occur.

At this stage, besides scaling and root planing, we may consider localized antibiotic treatments or more advanced periodontal procedures. 

Stage 5: Advanced periodontitis

In advanced periodontitis, lasting damage occurs. The pockets between your gums and teeth deepen, accelerating bone loss. This has significant consequences. Your teeth may feel increasingly loose, impacting your bite and possibly causing discomfort. Gum recession advances, often leading to tooth sensitivity. The – now even deeper – pockets with bacteria cause chronic inflammation and potential abscesses.

Advanced periodontitis is serious and requires a multifaceted approach. Without intervention, you are likely to lose teeth. Timely and decisive measures are essential to halt further progression. Your dentist’s role expands. We might recommend more advanced treatments such as gum grafts to address receding gums or even surgical procedures to access and cleanse deeper pockets. This will be done to preserve your jawbone and prevent irreparable damage.

Take gum health seriously to prevent periodontal disease

When you think of oral care and dentistry, teeth often take the spotlight. But gums play a supporting role that’s equally crucial. 

Your gums, or gingiva, serve as the protective barrier for the sensitive roots of your teeth and the underlying bone. Healthy gums ensure a tight fit around your teeth, preventing bacteria from infiltrating the supporting structures. 

Ignoring gum health can have profound repercussions – unchecked inflammation and infection can pave the way for gum recession, bone loss, and eventually tooth mobility and tooth loss. Just as a solid foundation is imperative for a stable structure, healthy gums are the cornerstone of a solid oral foundation. 

Keep your gums healthy

Keeping your gums in optimal condition is important for your oral health, as we’ve seen. It can prevent periodontal disease and help maintain a beautiful smile. This is how you take great care of your gums:

• Oral hygiene. Brush your teeth at least twice a day, using fluoride toothpaste and a soft-bristle toothbrush. Don’t forget to gently brush your gums. Consider even scrubbing your tongue, it houses bacteria!
• Floss. Daily flossing helps remove food particles and plaque from between your teeth and along the gum line, where a toothbrush might not reach effectively. This is so important for your gum health, as these are places where bacteria thrive. Don’t forget the inside of your back teeth. Flossing also gently massages your gums. Who doesn’t benefit from a massage now and then?
• Rinse with mouthwash. Use an antimicrobial or fluoride mouthwash to help reduce bacteria and promote gum health. They can help prevent or reduce gingivitis, stage 2 of gum disease. It removes debris after brushing and flossing, so it is the perfect closure to your routine.
• Diet. A diet rich in vitamins and minerals supports gum health. Vitamins like vitamin C are thought to influence gum health.
• Stay hydrated. Drinking plenty of water washes food particles away, along with bacteria that contribute to gum disease.
• No smoking. Smoking and using other tobacco products increase the risk of gum disease. 
• Regular dental visits. Professional cleanings remove tartar buildup and detect early signs of gum issues.
• Reduce stress. Chronic stress weakens your immune system, which makes you more susceptible to gum infections. 
• Manage medical conditions. Certain medical conditions, such as diabetes, can affect gum health. Work with your healthcare provider to manage these conditions effectively.

Bottom line

Did you recently get your wisdom tooth removed? Maybe that’s the cause of your bad breath. Read our article on what to do if you have a bad breath after your wisdom tooth removal!

Of course, at Mint Dental, we are happy to assist you with any gum problem. We can schedule a checkup, or cleaning, or even explain the best flossing technique.