Understanding the Stages of Periodontal Disease

As we wrapped up National Dental Hygiene Month in October, it’s a great time to revisit the different stages of gum disease. During your wellness visit  your hygienist has probably discussed with you the need to take measurements of the gums, these help determine what stage of health your gums and bone are at. This is part of the periodontal assessment which includes but is not limited to: pocket depths, recession, bleeding, mobility, and root furcation involvement. This tool along with x rays helps us decide what treatment will be best for you.

Inflamed bleeding gums are indicative of disease.

Healthy Gums: Gum tissue is pink and firm, with no bleeding present and 2-3mm gum pockets. The teeth are firmly supported by the surrounding bone and gums. 

Gingivitis: Pockets are slightly deeper, usually 4mm. Gingivitis is caused by an accumulation of bacteria. Gums become visibly swollen and usually bleed easily with brushing and flossing. At this stage the inflammation is reversible as it is limited to the gum tissue. If the bacteria are not disrupted and the plaque removed, gingivitis will progress to gum disease.

-Once gingivitis has progressed to periodontitis, we use categories to express the severity.

Early Periodontitis: The inflammation in the gums progresses and the gums start to pull away from the teeth forming pockets that further trap plaque, bacteria and food leading to the infection in the gums. The bacterial toxins as well as the body’s own immune response will begin the process of bone loss. 

Moderate Periodontitis:  As the infection worsens, inflammation will become more pronounced and bleeding more severe. You may begin to experience discomfort as further damage is done to the bone and gums continue to recede. 

Advanced Periodontitis:  As gum disease advances, pockets will deepen and periodontal abscesses will begin to form. These will cause pain and a repugnant taste.  At this stage enough bone has been lost that the teeth will  be significantly mobile and have a poor prognosis. 

Among adults the most common cause of tooth loss is gum disease,  but this can be prevented with good oral hygiene. If you’re beyond the prevention stage and have already been diagnosed with gum disease, don’t despair! The progression can be slowed significantly when caught early enough. With proper therapy, regular wellness visits and good home care it’s very much manageable! Our hygienists are highly trained professionals who pride themselves on their care for patients, so regardless of your state of gum health, we are your partner toward a healthier mouth!


American Academy of Periodontology


Marlborough Associates

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