The different stages of periodontal disease

Periodontal disease affects 50% of all Americans age 30 and older. It can result in tooth loss, the need for dentures, and an array of additional health issues. Because of its potential severity, it is important that it is treated seriously, despite how common the disease is reported to be. It does not discriminate and can affect anyone of any age or sex.

What Is Periodontal Disease?

Periodontal disease is a gum infection that is ongoing. It affects, not only the gums, but the jawbone as well and can lead to tooth loss, as well as overall systemic issues. Typically the result of poor brushing and flossing habits, periodontal disease occurs after plaque has built up and hardened. There are four overall stages of periodontal disease, with only one being reversible.

Causes of Periodontal Disease

Causes of periodontal disease all boil down to bacteria. If plaque and tartar are not regularly removed (using good daily flossing and brushing habits, as well as regular professional teeth cleanings), periodontal disease will occur. Smoking is the most significant risk factor and can make periodontal disease treatment less effective. Other factors that increase one’s risk for periodontal disease include diabetes, medications that reduce the natural flow of saliva, genetics, hormonal changes, and certain illnesses like AIDS.

Stages of Periodontal Disease

Periodontal disease is broken up into four separate stages: gingivitis, slight periodontal disease, moderate periodontal disease, and advanced periodontal disease.


Gingivitis is the only stage of periodontal disease that is reversible as it has not yet had time to attack the bones. It is the result of a buildup of plaque around the teeth. There are only a few signs at this stage and most are painless. This is what makes periodontal disease so common and so concerning. It is silent until it is not. Periodontal disease does not typically break its “silence” until the fourth and final stage. Beginning signs to watch out for include bad breath on occasion, swelling and redness of the gums, and bleeding when brushing or flossing. Good overall oral hygiene and regular checkups can treat and reverse gingivitis.

Slight Periodontal Disease

Slight periodontal disease is the second stage of periodontal disease. It is not reversible, but it is manageable. Once a patient reaches stage two, the infection has spread to the bone and begins its bone-destroying process. The bacteria evolves and becomes more aggressive, which is what causes the additional bone loss. Simple oral hygiene will no longer cut it. Signs include increased swelling or redness of the gums, bad breath, bleeding during brushing or flossing, and probing depths that are between four and five millimeters.

Moderate Periodontal Disease

Like slight periodontal disease, the third stage of periodontal disease cannot be reversed. At stage three, the same symptoms as stage two occur but probing depths are greater at six to seven millimeters which allows for even more bacteria to attack, not only your bones, but

your blood stream and immune system as well. Treatment for stage two and stage three periodontal disease consists of scaling and root planing. Scaling and root planing are forms of deep cleaning that remove the deposits of bacteria that are deeply rooted in your gums. If left untreated, these stages can progress to bone and tooth loss, gum sensitivity, increased bleeding, and the shifting of teeth.

Advanced Periodontal Disease

The final stage of periodontal disease occurs when the infection deepens even further and the bacteria, once again, evolves into disease-causing bacteria. You are now at a 50% – 90% risk of bone loss. In addition to bone loss, advanced periodontal disease causes red, swollen gums that ooze pus, cold sensitivity, further loosening of teeth, painful chewing, and severe halitosis. This stage requires periodontal surgery or periodontal laser therapy in order to clean the deep bacteria-filled pockets that have formed. If left untreated, stage four periodontal disease leads to spacing or gaps between the teeth, gum recession, patients needing dentures, and other overall health problems that can be serious.

Treating periodontal disease quickly is of the utmost importance. Scheduling regular check-ups and cleanings and practicing good, daily oral hygiene habits can keep one from suffering from periodontal disease and/or can help halt the progression of periodontal disease.