Periodontitis
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CDC periodontitis gum disease symptoms treatment
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Periodontitis is a chronic inflammatory gum disease that damages the tissues supporting teeth: the periodontal ligament, cementum, and alveolar bone. Untreated disease can cause gum recession, loose teeth, and eventual tooth loss. Robbins Pathology describes the associated shift from healthier flora toward anaerobic and microaerophilic gram-negative bacteria such as Porphyromonas gingivalis.
Common signs
- Bleeding gums, especially during brushing or flossing
- Red, swollen, or tender gums
- Persistent bad breath or unpleasant taste
- Gums pulling away from teeth
- Deep periodontal pockets
- Loose or drifting teeth, or bite changes
It may progress with few noticeable symptoms, so professional dental examinations are important. The CDC overview notes that periodontitis cannot be reversed, but its progression can be slowed and managed.
Risk factors
- Plaque and tartar accumulation
- Smoking or other tobacco use
- Diabetes, particularly if poorly controlled
- Poor oral hygiene or irregular dental care
- Genetic susceptibility
- Immune disorders or medications that reduce saliva
- Older age
Diagnosis
A dentist or periodontist assesses gum inflammation and bleeding, measures pocket depth and attachment loss around teeth, checks mobility, and usually takes dental X-rays to assess bone loss.
Treatment
Treatment aims to remove plaque biofilm and calculus and establish a condition that can be maintained long term, as outlined by the American Dental Association.
- Professional non-surgical therapy: scaling and root planing, often called deep cleaning.
- Daily home care: brush twice daily with fluoride toothpaste, clean between teeth daily using floss or interdental brushes, and follow the dental team's technique advice.
- Risk-factor control: stop tobacco use and optimize diabetes control if relevant.
- Periodontal surgery: may be needed for persistent deep pockets, significant bone loss, or regenerative treatment in selected sites.
- Maintenance visits: ongoing periodontal review and cleaning are needed because recurrence is common.
Seek prompt dental assessment if you have spontaneous bleeding, pus, facial swelling, severe pain, fever, or a loose tooth.
How is periodontitis different from gingivitis?
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gingivitis versus periodontitis CDC difference bone loss reversible
| Feature | Gingivitis | Periodontitis |
|---|---|---|
| Where inflammation occurs | Limited to the gums | Extends deeper to the tooth-supporting structures |
| Tissue and bone loss | No loss of periodontal ligament or jawbone | Destruction of periodontal ligament and alveolar bone |
| Reversibility | Usually reversible with effective daily cleaning and professional removal of plaque/tartar | Existing attachment and bone loss are generally irreversible, but further progression can be controlled |
| Typical signs | Red, swollen gums that bleed easily | Bleeding plus gum recession, deep pockets, bad breath, pus, loose or shifting teeth |
| Possible outcome if untreated | Can progress to periodontitis in susceptible people | Tooth loosening and tooth loss |
Both conditions arise from plaque-related inflammation. Gingivitis is the early, superficial stage, while periodontitis is the deeper destructive disease. The defining feature of periodontitis is loss of attachment and bone around teeth.
In the textbook description, gingivitis is inflammation surrounding the teeth and is reversible; periodontitis affects the periodontal ligament, alveolar bone, and cementum, potentially leading to tooth loss. Robbins, Cotran & Kumar Pathologic Basis of Disease, p. 665. The CDC guidance likewise identifies bone loss as a key feature of periodontitis.
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