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Periodontitis: What It Is and How To Treat It

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Periodontitis is a severe gum disease that progressively destroys the tooth supporting structures. This is caused by bacteria that has been allowed to accumulate in the teeth and gums. Although the presence of bacteria in the mouth is normal, it may become harmful when conditions allow them to increase dramatically.

Signs of periodontitis

  • Reddish swollen gums
  • Bleeding gums
  • Gum recession
  • Loose teeth
  • Pain upon chewing
  • Spaces between teeth
  • Presence of pus
  • Halitosis/bad breath

Stages of Periodontitis

Stage 1: Gingivitis
Gingivitis is the early stage of gum disease. this is a result of plaque build up around the teeth causing bad breath, and bleeding and redness of gums. At this stage only the gums are affected which means it is still reversible through oral prophylaxis and good oral hygiene.

Stage 2: Mild/Slight Periodontitis
Once the disease progresses past gingivitis, a more aggressive bacteria starts to attack the bone. At this stage more bleeding and redness is observed and gums start to pull away from the teeth, forming spaces called “periodontal pockets”. Normal pocket depth is 1-3mm. at this stage the depth is at 4-5mm.

Stage 3: Moderate Periodontitis
Symptoms at this stage are about the same as the earlier stage of periodontitis but the pockets are deeper at 6-7mm, bleeding is more severe, gums recede even further, and teeth are starting to mobilize.  At this stage, bacteria can make its into the bloodstream and immune system, compromising your overall health.

Stage 4: Advanced/Severe Periodontitis
If earlier stages are ignored and not treated, the most advanced stage threatens a 50-90% chance of irreversible bone loss. Symptoms at this stage include the same symptoms in the earlier stages but are much more severe. Pocket depth is above 7mm. Pus oozing out of the gums is present at this stage and so is pain.


  • Scaling – scaling removes plaque and bacteria around your tooth and beneath the surface of the gums This is done with the use of instruments, ultrasonic scaler, or laser.
  • Root Planing – root planing smoothens the root surface to decrease plaque build up. The bacteria causing inflammation, delayed healing, and reattachment of gums is also removed through root planing.
  • Antibiotics – oral antibiotics may be taken to eliminate infection-causing bacteria. topical antibiotics can also be inserted in pockets to control the infection.
  • Surgery – in the advanced stage of periodontitis, surgery may be the only way to manage the disease. flap surgery, soft tissue grafts, bone grafts, and tissue regeneration are different surgical procedures done to help reattach tissues, stabilize teeth, and make room for natural bone growth.

Unlike gingivitis, periodontitis cannot be completely cured, but it is very much preventable and manageable. It is highly important to follow good oral hygiene by brushing at least twice a day and flossing daily. A visit to the dentist every 6 months is also recommended to monitor your overall oral health.

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