Gum Disease: From Gingivitis to Periodontitis

Gum disease is a progressive infection of the gums and other tissues that hold your teeth in place. It’s characterized by inflammation of the gums, which is the body's way of shielding, guarding, and protecting itself from infection. Think of it as a blowfish puffing up to scare away predators! 

Gum disease happens in two main stages: gingivitis and periodontitis. Here’s what each of those stages involve…

What is gingivitis?

The first stage of gum disease, gingivitis develops when plaque builds up on the teeth and around the gum line. Plaque contains bacteria, which produce acid that irritates the gum tissue. This triggers an immune response from the body, which includes inflammation. When gingivitis is left untreated, it can develop into periodontitis.

What is periodontitis?

Chronic inflammation causes the gum tissue to start to separate from the root of the tooth, marking the beginning of periodontitis. This creates pockets under the gum line where plaque and bacteria can hide. As a result, infection and inflammation spreads to the ligaments and bone underneath the gums, and starts to break them down. This causes the teeth to loosen over time, which can eventually lead to tooth loss. 

Symptoms of Periodontal Disease

The first sign of early gum disease (gingivitis) is swollen, red, inflamed gums that may bleed when brushing or flossing. Recognizing and treating these early signs of gingivitis allows you to stop it in its tracks before it develops into periodontitis. Signs that gum disease may have advanced to periodontitis include:

  • Visible roots at the base of your teeth, making them appear longer.
  • Gums that appear to be shrinking.   
  • Changes in how your teeth fit together (your bite). 
  • Shifting or loose teeth. 
  • Bad breath.
  • Heavy tartar build-up.
  • Sensitive teeth.

What Causes Periodontitis?

Gum disease is caused by a build-up of plaque and tartar, which in turn is typically caused by poor oral hygiene habits and a high-sugar diet. Other risk factors for periodontitis include:

  • Smoking or using tobacco.
  • Hormonal changes in girls or women, such as puberty, pregnancy or menopause.
  • Medications that cause dry mouth. and 
  • Diabetes.
  • Genetic influences.

At-Home Treatment and Prevention of Periodontitis

You're probably wondering, "is periodontal disease reversible?" In some cases, yes! Let’s talk about how to fix periodontal disease…

While advanced gum disease (periodontitis) may need more complex interventions, you do have the power to reverse your gingivitis. You can do this with daily brushing and flossing and regular professional dental care, as confirmed by the National Institute of Dental and Craniofacial Research (NIDCR)

Since your at-home oral care routine is pivotal to preventing and fighting gum disease, you should use the products that best suit you. For example, not everyone is a fan of flossing (also known as interdental cleaning). The NIDCR notes you can use water flossers for cleaning between your teeth instead. There are also mouthwashes meant to treat gingivitis, so swish around with one after you brush. Your dental professional may recommend a prescription-strength antimicrobial mouthwash to help reduce bacteria in hard-to-reach areas. 

Lastly, consider your diet. Avoid sugary foods and drinks as they contribute to plaque, gum disease, and tooth decay. Instead, build a well-balanced diet consisting of plenty of water, vegetables, fruits, whole grains, meats, and dairy to make a robust immune system ready to fight disease!

Professional Treatment Options for Advanced Periodontal Disease

Non-Surgical Treatment

Your first step in treating periodontal disease treatment is a conservative, non-surgical approach called scaling and root planing (SRP). A dentist or dental hygienist scrapes and removes the plaque and tartar from your teeth and root surfaces with specialist instruments, then smooths the surfaces. This prevents bacteria from gathering again and helps your gums reattach to the tooth. 

This procedure can sometimes take more than one visit. You’ll be given a local anesthetic to help avoid any discomfort. Within a few weeks, your dentist will examine your gums to see how well they’ve healed and decide if further treatment is necessary.

Pocket Reduction Procedure

If you have more severe periodontitis, you probably have questions about getting your teeth clean again and how to fix loose teeth from gum disease. If the gum tissue is not fitting snugly around the tooth after scaling and planing, you may not be able to keep the deep pocket area of your gums clean. This means you're a candidate for periodontal pocket reduction or flap surgery. By folding back the gum tissue, your dental professional can remove infectious bacteria and smooth areas of damaged bone. Your gum tissue will then reattach to healthy bone.

Gum Grafts

If you have exposed roots due to gum recession, brought on by gum disease, gum grafts can cover them. Your dental professional takes gum tissue from your palate or another source and uses it to cover the roots of one or more teeth. Covering exposed roots helps reduce sensitivity and protects your roots from decay while stopping further gum recession and bone loss.

Laser Therapy

Lasers have revolutionized multiple industries, and oral care is no exception. Although laser periodontal therapy is still in its infancy, it shows promising results for eligible patients. There are a few apparent benefits of this novel therapy. They include the laser's ability to target the disease precisely, in a less invasive nature, and shorter recovery time. There is insufficient evidence demonstrating that laser therapy is better than other gum disease therapy forms. It would help if you spoke with your dentist about all available therapy options. It's always best to err on the side of caution with dental decisions.

Clearing a Periodontal Abscess

A periodontal abscess can sometimes occur from advanced gum disease. This abscess appears as a red, swollen lesion on the gumline. If you suddenly feel a sharp pain in your gums, it's best to see a dentist quickly, as the sooner an abscess gets treatment, the better! Gum infection treatment in this situation usually involves draining the abscess and deep-cleaning the area. Antibiotics can also help make sure the infection is clear.


Some gum infections can develop when a tooth (usually a wisdom tooth) tries to erupt but becomes stuck or impacted. A small flap forms over the trapped tooth. If food becomes lodged in this gum flap, bacteria can soon follow, leading to pericoronitis infection. Your dentist will usually instruct you to rinse out your gums with salt water to remove any trapped food or debris. They may then prescribe a round of antibiotics if bacteria lingers.

Regenerative Procedures

Bone grafting is a surgical procedure that promotes bone growth in an area where gum disease has impacted the bone. During this type of treatment, your dentist will clean out the bacteria and then place either natural or synthetic bone in the area to replace lost bone. They will include tissue-stimulating proteins in this procedure to help your body effectively regrow bone and tissue.

Why Acting Fast on Gum Disease Treatment Is Important

If you've made it through reading all of these treatments, we're impressed! It's no doubt a lot of information to take in at once, especially on top of a gum disease diagnosis. But we believe that knowledge is power, and being able to ask your dentist about the full array of gum disease therapies will help you in the long run.

The sooner you seek treatment, the better your chances are of saving your teeth and your oral health. While insurance often covers gum disease therapy, many options are available for people without dental insurance. It will just take a little research! For example, dental and dental hygienist schools have clinics to gain practical experience performing various procedures. These take place under the supervision of an experienced, licensed dentist, and are offered at a reduced rate. Also, federally funded health centers offer affordable dental services based on your income.

When dealing with periodontal disease, "an ounce of prevention is worth a pound of cure.” Besides implementing healthy lifestyle habits like cutting down on sugar and practicing a thorough daily oral hygiene routine, your dentist will recommend keeping a close eye on your periodontal health with more frequent checkups and oral care appointments.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.


What's behind your smile?

Take our Oral Health assessment to get the most from your oral care routine


2.3 billion

people worldwide suffer from tooth decay


What's behind your smile?

Take our Oral Health assessment to get the most from your oral care routine


2.3 billion

people worldwide suffer from tooth decay