What are the Four Stages of Periodontal Disease?

stages of periodontal diseaseAccording to the American Academy of Periodontology, half of Americans have periodontal disease. Could you be one of them?

Before you start shaking your head, you need to ask yourself how much you really know about this common problem. Are you familiar with the signs of gum disease? Would you know how to spot them? Or how to treat them if you did?

In this article, we’ll lay it all out for you. Read on to find out all about the stages of periodontal disease and how to treat them.

The Main Stages of Periodontal Disease

1. Gingivitis

When your gums are healthy, there is no abnormal coloring or inflammation. They are firm, smooth, and fit snugly around the teeth.

Your dentist will usually use a probe to check the depth of the area between the gums and teeth, which is called the gingival sulcus. At this stage, it should only be 2 mm.

The benefits of healthy gums include tooth support, lack of discomfort or bleeding with cleaning and flossing, and better breath. Neglecting oral health will cause problems to arise in these areas. The first of these is plaque.

When plaque starts to build up between the gums and teeth, it causes inflammation. Over time, it can also turn to tartar, which will irritate the gums further.

If your gums are sore, swollen, and bleed when you brush your teeth, it could be a sign of gingivitis. This is usually accompanied by a bad smell or taste in the mouth.

At this early stage, dentists can treat and reverse the problem with a simple scaling and cleaning procedure. After that, regular brushing, flossing, and use of anti-microbial mouthwash will keep gingivitis at bay. This prevents it from developing into a more serious problem.

2. Early Periodontal Disease

The difference between the first and second stages of periodontal disease is the placement of plaque. With gingivitis, it’s found along the gum line. If it has progressed below the gum line, it indicates early periodontal disease.

The collection of plaque and calculus creates more space between the teeth and gums, which act as pockets collecting bacteria. Eventually, this can cause infection.

While this stage is more complicated to treat, it’s possible to reverse it if it’s caught early. However, if left untreated for too long, it could lead to bone loss.

3. Moderate Periodontal Disease

As periodontal disease develops, the gums begin to separate from the teeth, so much so that periodontal probe depth can reach up to 6 mm.

This makes it difficult to properly clean the teeth, as bacteria can collect in these areas, leading to the development of more plaque and calculus.

At this stage, the connective tissues that keep the tooth in place can become damaged. Unfortunately, this damage is irreversible, since these tissues can’t be rebuilt. As a result of this tissue loss, the gums start to recede further, making way for plaque to travel down to the bone.

In order to stop the disease from progressing further and causing more damage, root planing is required. This is a procedure by which a dentist meticulously cleans the teeth behind the gums to remove plaque and calculus. They also smooth any other irregularities on the surface of the teeth, making it more difficult for them to harbor more bacteria in the future.

This procedure can cause some discomfort, but dentists will usually use local anesthesia to numb the area beforehand. Afterwards, they apply antibiotic gel to the periodontal pockets to reduce their size and control the bacteria within them.

If this procedure is unsuccessful, you may need to undergo flap surgery. This involves lifting back the gums to remove tartar and stitching them back in place. After this, they fit tightly around the teeth once again.

4. Advanced Periodontal Disease

The final point on our list of stages of periodontal disease is advanced periodontis.

When the disease goes untreated for too long and reaches an advanced stage, it causes large amounts of irreparable damage to the teeth and gums. There can be a significant infection, and your dentist will extract the most severely affected teeth. Some patients even end up losing all their teeth to the disease.

Attachment loss means that teeth start to move as they is no longer enough tissue to hold them in place properly. This cause gaps to widen between the teeth. Patients may notice that their teeth don’t fit together the same way anymore when they bite.

Bone loss may occur, too. In fact, patients could lose anywhere between 50% and 85%! If this is the case, your dentist will need to use grafts to rectify the damage. This means that they’ll place either natural or synthetic bone in the affected area to promote the bone to regrow.

The depth of periodontal pockets is excessive at this stage, and this causes abscesses to form. In severe cases, pus may even appear between the teeth and gums. This causes bad breath and a constant bad taste in the mouth, and requires oral antibiotic treatment.

As a result of infection, gums become red, swollen and painful. Eating can be very difficult, and patients may have to stick to a diet of soft food.

The effects of this disease go beyond the mouth. Studies show that there are strong links between periodontal disease and cardiovascular disease. The chances of developing heart disease increase greatly, as do the risks of stroke and diabetes.

Keep on Top of Your Oral Health

In order to keep your teeth and gums in tip-top condition, it’s essential to brush and floss often and correctly. It’s also important to make regular visits to your dentist, even if you don’t spot any of the stages of periodontal disease.

At a dental check-up, your dentist will identify any problems that may lead to periodontal disease, and provide advise to combat any bad habits. As well as the health benefits, seeing your dentist could save you money in the long run, too.

For more information, see our post on 7 reasons to schedule a dental check-up.