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Periodontitis: Causes, Risks, Symptoms, Treatment & Prevention

Written by Danica Lacson on September 22, 2018

What is Periodontitis

Known as the advanced form of periodontal disease, periodontitis causes damage to the soft tissues and supporting bones of the teeth which can lead to a loose tooth or, when left untreated, to tooth loss.

The gum tissue of people with periodontitis pulls away from the teeth and creates pockets which can serve as an additional area for bacteria to build up and for infection to occur.

This type of gum disease is mostly preventable, yet the Centers for Disease Control and Prevention reports that half of the adult population of the United States suffer from gum disease.

In a study conducted from 2009 to 2010 and published in the Journal of Dental Research, it was estimated that 47.2 percent or 64.7 million American adults have a mild, moderate, or advanced form of periodontal diseases.

How does Periodontitis develop?

Periodontitis does not develop overnight. It starts with bacteria building up on the teeth, causing the gums to be swollen and bleed easily and leading to an early form of gum disease called gingivitis.

Gum disease can stop in its mild form with proper oral care. However, when the inflammation was not immediately addressed, it can progress to periodontitis. In its early stages, a person with periodontitis will observe his or her gums receding or pulling away from the teeth, a formation of pockets between the teeth and gums, and bleeding gums.

At its moderate stages, periodontitis will result in bleeding and pain around the teeth. Gums will continue to recede, and the teeth will begin to loosen as bone support is starting to get lost.

When it progresses to an advanced stage, the tissue connecting and holding the teeth in place suffers, while the gums, bones, and other related tissues which serve as support for the teeth are now damaged. The likelihood of losing teeth is high along with pain in chewing, bad breath, and a foul taste in the mouth.

What are the causes of Periodontitis?

Like in gingivitis, poor oral hygiene is often blamed for the development of periodontitis. When proper oral care is disregarded, bacteria can accumulate and result in plaque and tartar buildup. Because of the high number of bacteria in the mouth, gums become irritated, swollen, and tend to bleed easily.

What are the Risk Factors for Periodontitis?

Although poor oral hygiene dramatically affects the development of periodontitis and gum disease in general, several other factors can contribute to and increase the risk of developing periodontitis.


According to studies, people who are 65 years old and older record the highest prevalence rates of periodontitis at 70.1 percent.


Aside from age, another risk factor that may be difficult to combat is genetics. Research suggests that some people are naturally susceptible to gum disease due to their genetic makeup.


Present day conditions call for stressful days ahead. But be wary of getting too stressed. Aside from being linked to severe health conditions like hypertension and cancer, stress is also a risk factor for periodontitis as it gives the body a more difficult time to combat infection.


Certain medications cause dry mouth which reduces saliva flow and increases the vulnerability of the mouth to infections.

Smoking and Tobacco Use

Smoking reduces the body's ability to fight off disease as it weakens the immune system. Because of this, tobacco users and smokers subject themselves to a heightened risk of developing gum disease like periodontitis.

Bruxism: Clenching and Grinding of Teeth

Excess force and pressure are exerted on the supporting tissues of the teeth which can speed up the damage periodontitis do to the teeth and gums.

Systemic Disease

Systemic diseases like cardiovascular disease, diabetes, and rheumatoid arthritis can interfere with the inflammatory system of the body and worsen the gum condition.

Poor Nutrition

Proper nutrition is vital to the immune system of the body which is in turn important in fighting off infection. With a poor diet, the body may lack the minerals and vitamins needed to support the body’s function such as the immune system.

What are the Signs and Symptoms of Periodontitis?

A person with periodontitis often experiences inflamed or swollen gums which are red or purple in color. There is also a tendency for the gums to be painful when touched, to recede and create extra spaces between the teeth.

Pus between the teeth and gums may also be observed, along with bleeding, loose teeth, bad breath, and metallic taste in the mouth.

How can Periodontitis be treated?


Periodontitis can be diagnosed through visual observation and physical examination of the signs and symptoms exhibited by the gum disease.

Visit your dentist for the most accurate diagnosis and for the right treatment to be done. At the dental office, your dentist will use a periodontal probe during the checkup. He or she will insert the instrument next to the tooth and under the gum line. A healthy tooth will not slide the probe below the gum line, while an infected gum will bring the probe deeper under the gum line. The depth will then be used to measure the extent of the gum disease.

Additionally, an X-ray may be used to assess the condition of the teeth and jaw bone.


Once diagnosed, your dentist will craft a treatment plan based on your needs and conditions with the aim to remove plaque and bacteria deposits which lingered on your teeth and gums, causing gum disease.

Treatment options may include proper oral hygiene practices, professional teeth cleaning, antibiotics, and surgery.

Proper Oral Care

Gum disease like periodontitis is often caused by poor oral hygiene. The first step usually recommended to combat gum disease is to practice proper oral hygiene to minimize bacteria accumulation.

Proper oral care is simple and straightforward. You need to brush your teeth at least twice a day, floss to remove plaque or food particles between the teeth and a biannual visit to the dentist.

Moreover, aside from primary oral hygiene practice, it is advised to stay away from tobacco or alcohol as they can intervene with the healing process and heighten periodontitis.

Professional Teeth Cleaning

Plaque and tartar buildup will be difficult to clean with simple brushing. Professional teeth cleaning will be needed to ensure that no plaque or tartar is left behind.


Aside from professional teeth cleaning, your dentist may also prescribe antibiotics, especially for persistent gum infections.


To clean deposits under your gums, a flap surgery may be done mainly in areas where inflammation persists. Your dentist will administer anesthesia, lift your gums, and clean your tooth roots. Next, the gums will be stitched back into place.

For patients who experienced bone loss, a bone grafting can also be done to regenerate the bones.

How Can Periodontitis Be Prevented?

Periodontitis is preventable. When early signs of gingivitis are observed, it is best to get treated as soon as possible to prevent the condition from advancing into periodontitis.

But even before any gum disease is experience, there are ways you can do to ensure that gum disease will not be a problem for you, your teeth, and gums including proper oral hygiene and regular dental visits.

With proper oral hygiene, you rid your teeth and mouth from harmful bacteria that can accumulate and develop into gum disease. Meanwhile, visiting your dentist regularly helps detect early signs of dental problems including gum disease. When detected early, you can prevent gingivitis from progressing into periodontitis.

Disclaimer: The oral health information published on this web page is solely intended for educational purposes. Hawaii Family Dental strongly recommends to always consult licensed dentists or other qualified health care professionals for any questions concerning your oral health.

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