What is it?
Periodontitis is gum inflammation that has advanced into the bone surrounding the tooth. Pockets form between gum and tooth, and bacteria multiply inside them at depths no brush can reach, dissolving the bone.
Lost bone does not grow back on its own. The goal of treatment is to stop the loss, not reverse it, which is why early intervention changes everything. By the time a tooth loosens, the disease is already advanced.
Signs
You will not necessarily have all of these at once.
Why does it happen?
- 01
Untreated gingivitis
Almost every case of periodontitis is the continuation of a gingivitis ignored for years.
- 02
Smoking
The single strongest risk factor. It both accelerates the disease and markedly reduces the response to treatment.
- 03
Diabetes
The relationship runs both ways: uncontrolled diabetes worsens gum disease, and gum infection makes blood sugar harder to control.
- 04
Genetic predisposition
In some people the same amount of plaque triggers a far more destructive immune response. Those with early tooth loss in the family should be checked more often.
How does it progress?
- Stage 1
Early
Pocket depth 3–4 mm. Bleeding present, bone loss still limited. It can be halted at this stage.
- Stage 2
Moderate
Pocket depth 5–6 mm. Gums start receding and teeth begin to look longer.
- Stage 3
Advanced
Pockets of 7 mm and beyond. Teeth become mobile, drift, and are at risk of being lost.
How is it treated?
The first phase is non-surgical: deep cleaning of the gum pockets (root surface debridement). The area is numbed with local anaesthetic and the work is usually split across two to four sessions.
If pockets don't close, surgical treatment or bone grafting comes into play. Where teeth have already been lost, implants are an option, but the gum disease must be under control before any implant can be placed.
- Noticeable looseness or drifting of teeth
- Pus discharging from the gum on its own
How is it prevented?
- Never wait out bleeding gums; this is the road that leads to periodontitis
- Quitting smoking directly improves how you respond to treatment
- If you have diabetes, treat blood sugar control as part of your gum treatment
- After treatment, periodontal review every three to six months; the standard six-month check is not enough
Frequently asked questions
- Can lost bone grow back?
- Not on its own. In certain limited defects, grafting and regenerative techniques can recover some bone, but this isn't possible in every case.
- Is periodontitis contagious?
- The disease itself isn't transmitted, but the bacteria involved can pass through saliva. If one family member has advanced gum disease, it makes sense for the others to be checked.
- Can I have an implant with active gum disease?
- Not while it is active. The same bacteria cause bone loss around implants too (peri-implantitis). Gum health is established first, then the implant is planned.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.