The 4 Stages of Periodontal Disease

1. Gingivitis: Gingivitis is the earliest, most common form of gum disease. There is frequently no pain or discomfort, and it is generally caused by poor oral hygiene. Seventy five percent of adults have gingivitis, and many aren't aware of it. The gums become inflamed, are red in appearance and bleed easily, and the person may experience persistent bad breath. The bone is not affected, and gingivitis can be reversed with simple professional treatments, appropriate oral hygiene instruction and effective homecare. If untreated, however, gingivitis can lead to more advanced stages of periodontal disease, irreversible bone loss, and ultimately, tooth loss. That's why it's vital that we treat gingivitis early, before it can progress.
2. Early Periodontal Disease: In this next stage, tartar accumulates around the roots of the teeth, causing the gums to bleed easily, and become inflamed and red in appearance. The gums start to pull away from the teeth, creating pockets of 3-4 millimeters with some that are 5 millimeters deep. There may be persistent bad breath or a bad taste. The bacteria in the plaque start to destroy the supporting bone around the roots of the teeth. Regular brushing and flossing cannot access bacteria at levels this far below the gum line. This bone loss cannot be reversed. However, effective, non-surgical gum therapies are available that can eliminate the bacterial infection, reduce or at least maintain the pocket depth and prevent further bone breakdown. Patients treated in this way can have their periodontal disease controlled indefinitely. If untreated, mild periodontal disease can lead to more advanced stages with more bone loss.
3. Moderate Periodontal Disease: The infectious process progresses around the roots of the teeth causing recession of the gums and further bone loss. Pockets of 4-6 millimeters are present. The teeth become loose and may shift. Bone loss cannot be reversed. As before, bad breath is common and there is usually no pain. Untreated, moderate periodontal disease can easily advance and lead to tooth loss, but even at this stage, non-surgical treatments are still possible. The infection can be controlled and pockets reduced or at least maintained.
4. Advanced Periodontal Disease: Pockets greater than 6 millimeters characterize the fourth stage. Painful abscesses can form in the gum. There is very little bone support left and teeth are loose, and may require removal. Surgery and/or complicated restorations may be necessary to preserve the teeth, or dental implants to replace them. Our goal is to prevent our patients from ever reaching this stage. Periodontal disease can never be cured. It can be controlled and managed. Bone loss is not inevitable. Early diagnosis, and diligent homecare, combined with some of the conservative therapies detailed in the following sections will enable our patients to keep their teeth for a lifetime.

Learn more about Periodontal Disease:

• How we diagnose periodontal disease
• Prevent gum disease
• 4 stages of periodontal disease
• Non-surgical gum treatment
• Arestin post-treatment
• Periodontal treatment