Quick answers
Gingivitis and periodontal disease are both infections of the gums. The main differences are:
- Gingivitis only affects the gums, while periodontal disease also damages the bones and connective tissues that support the teeth.
- Gingivitis is reversible with good oral hygiene, but periodontal disease causes permanent damage.
- Gingivitis causes mild inflammation and bleeding of the gums. Periodontal disease causes gum recession, tooth mobility, and abscesses.
- Gingivitis is very common and mild. Periodontal disease is a serious progressive condition that can lead to tooth loss if untreated.
Gingivitis is the early stage of gum disease. Without treatment, gingivitis can advance to periodontal disease. Anyone can develop gingivitis, but certain risk factors make periodontal disease more likely. Regular dental cleanings, brushing, flossing, and checkups allow early treatment of gingivitis before it turns into something more serious.
What causes gingivitis?
Gingivitis is inflammation and irritation of the gums caused by a buildup of plaque on the teeth. Plaque is a sticky film of bacteria that forms constantly on the teeth. Without regular removal by brushing and flossing, plaque hardens into tartar that irritates the gums.
The bacteria in plaque produce toxins that inflame the gums. This causes the common symptoms of gingivitis like red, swollen, or tender gums that may bleed during brushing.
Gingivitis is very common, and most people will experience it to some degree. Hormonal changes during puberty, pregnancy, or menopause can also increase inflammation and gum sensitivity.
Risk factors that make gum inflammation more likely include:
- Poor oral hygiene habits like infrequent or incorrect brushing and flossing
- Smoking, which irritates gums and limits blood flow
- Diabetes, cancer, and other conditions that hamper the immune system
- Medications such as oral contraceptives, calcium channel blockers, steroids, and some antidepressants
- Stress, which increases inflammation throughout the body
- Genetic susceptibility
Gingivitis typically causes irritation but no permanent damage. With good oral hygiene habits, the inflammation can be reversed.
What causes periodontal disease?
Periodontal disease, or periodontitis, occurs when gingivitis escalates and starts destroying the tissues and bone that support the teeth. The bacteria move down the tooth roots and multiply, producing inflammation that breaks down connective fibers and erodes bone.
As the disease advances, the pockets around teeth deepen, making them difficult to keep clean. More plaque collects leading to further inflammation and tissue destruction. Without treatment, the supportive structures weaken, teeth loosen and can eventually be lost.
Factors that increase the risk of periodontal disease include:
- Poor oral hygiene leading to gingivitis
- Smoking, which diminishes blood flow and healing
- Systemic diseases like diabetes that interfere with healing
- Medications such as vasodilators, antihypertensives, immunosuppressants
- Clenching or grinding teeth, which traumatizes gums
- Stress, which increases inflammation
- Older age
- Genetic factors
Periodontal disease is common, though not inevitable. According to the CDC, almost 50% of adults over 30 have some degree of periodontal disease. For smokers, the number may be as high as 75%. Unlike gingivitis, the destruction of periodontitis is irreversible. But progression can be halted with treatment.
Symptoms of gingivitis vs periodontitis
Gingivitis symptoms
Common signs of gingivitis include:
- Swollen, red, tender gums
- Gums that bleed when brushing or flossing
- Gums that have pulled away from the teeth
- Persistent bad breath
- Receding gums
- An indentation or change in the way the teeth fit together when biting
These symptoms are usually mild and develop slowly. Because gingivitis is reversible, prompt treatment can halt tissue damage and bone loss.
Periodontitis symptoms
As periodontal disease progresses, symptoms become more severe:
- Gums that bleed easily with brushing or when eating
- Bad breath that persists even with brushing
- Red, swollen gums
- Gums separating from the teeth, forming pockets
- Pus between the teeth and gums
- Loose or shifting teeth
- Receding gums resulting in apparent lengthening of teeth
- Abscesses in gum pockets
- New spaces developing between teeth
These signs indicate tissue and bone loss. Without treatment, teeth can loosen and fall out.
When to see a dentist
Schedule an appointment if you notice any signs of gum disease for more than a week or two. Red, swollen, bleeding gums indicate a problem. Even mild gingivitis should be evaluated and treated before it can progress.
See a dentist immediately if you experience:
- Bleeding or swollen gums
- Painful chewing
- Loose teeth
- Receding gums
- Persistent bad breath
- Pus around your gums or teeth
- Changes in your bite
These symptoms require prompt professional attention to halt permanent damage.
Risk factors
Several factors influence the likelihood of developing gum disease:
Oral hygiene habits
Poor oral hygiene allows plaque to build up on teeth. Infrequent or improper brushing and flossing leads to gingivitis.
Tobacco use
Tobacco use increases vulnerability by:
– Irritating gum tissues
– Reducing blood flow, slowing healing
– Altering oral bacteria
Smokers are 2-3 times more likely to have gum disease.
Systemic diseases
Conditions like diabetes and cancer impair immune function and healing. Medications that cause dry mouth also increase risk.
Genetics
Research shows 30% inherited susceptibility to severe gum disease. Ethnic background influences risk.
Stress
Chronic stress affects the immune response and increases inflammation. Financial, work, and family pressures contribute.
Hormonal changes
puberty, pregnancy, and menopause increase inflammation and gum sensitivity due to fluctuating hormones.
Drugs
Many common medications impact oral health. Drugs to treat mental health disorders, high blood pressure, allergies, and more influence gum disease risk.
Age
Gum disease becomes more common with age due to longer exposure. Almost 75% of adults over 55 show some signs.
Poor nutrition
Deficiencies of vitamin C and other nutrients that support wound healing and fight inflammation raise risk.
Diagnosis
Dentists diagnose gum disease through:
– Medical and dental history
– Oral exam checking for signs like swelling, redness, loose teeth
– Deep cleanings to measure gum pockets around teeth
– X-rays showing bone loss around teeth
– Evaluation of risk factors like smoking status
Key diagnostic tests
Probing depths
Probing measures the depth of gum pockets around each tooth. Deeper pockets indicate more advanced disease.
Clinical attachment loss
This measures how much connective tissue and bone support have been destroyed.
Radiographs
X-rays show bone levels and areas of damage. They help determine prognosis and treatment.
Gingivitis vs periodontitis treatment
Treating gingivitis
Since gingivitis is reversible, basic oral hygiene can resolve symptoms:
– Brush gently 2x daily
– Floss between teeth daily
– Seek regular professional cleanings every 6 months
– Use antiseptic mouthwash
– Address risk factors like diabetes or quit smoking
More advanced cases may also require:
– Deep cleanings to remove plaque and tartar
– Antibiotic or antimicrobial rinses
– Oral antibiotics if infection is extensive
With appropriate homecare and dental visits, gingivitis typically clears up. But without treatment, it can progress to periodontitis.
Treating periodontal disease
Treatment aims to halt tissue and bone loss before teeth become unstable. Options include:
Nonsurgical treatments
– Extensive plaque removal and tooth scaling/root planing
– Antibiotics or oral rinses to reduce bacteria
– Laser treatments to kill bacteria
Surgical treatments
– Flap surgery to clean roots and regenerate lost bone
– Grafts to rebuild areas of bone loss
– Extractions of hopeless teeth
At home care
– Consistent brushing and flossing
– Using prescribed medicated rinses
– Practicing good nutrition
– Avoiding tobacco
– Managing stress
Even with treatment, some bone loss is permanent in periodontitis. But halting its progression and maintaining diligent oral care can keep teeth healthy.
Prevention
Preventing gum disease centers on removing plaque before it can harden into tartar that inflames gums:
- Brush teeth – Gently brush twice daily at a 45-degree angle along the gumline.
- Floss daily – Floss along the sides of each tooth to clear away debris.
- Regular cleanings – Professional cleanings every 6 months prevent buildup.
- Don’t smoke – Tobacco greatly increases risk.
- Watch sugar – Bacteria feed on sugars and starches.
- Reduce stress – Chronic stress amplifies inflammation.
With diligent hygiene and dental care, most cases of gingivitis can be avoided or resolved before they progress to something more serious. But periodontal disease can’t always be prevented. Even with great habits, some individuals are at higher risk. That’s why regular dental examinations are important for prompt treatment.
When to see a periodontist
A periodontist is a dentist who specializes in treating gum disease. See a specialist if:
- You have signs of moderate-severe gum disease like loose teeth, pus, or receding gums
- General dentists refer you after basic treatments like scaling/root planing don’t resolve symptoms
- You want to discuss advanced regenerative procedures to limit bone loss
- You have a complex condition requiring expertise
- You need evaluation about options like dental implants
Periodontists have advanced training, techniques, and technologies to manage challenging cases of gum disease. They can provide a comprehensive assessment and customized treatment plan. Your dentist can give you a referral.
Key points about gingivitis and periodontitis
- Gingivitis causes inflammation and bleeding while periodontitis damages bone and connective tissues.
- Good oral hygiene can reverse gingivitis but periodontitis requires professional treatment.
- Common symptoms are red, tender, swollen gums that bleed easily.
- Periodontitis also causes receding gums, tooth loss, pockets around teeth.
- Have regular professional cleanings and dental checkups to allow early intervention.
- Monitor for signs like sore, bleeding gums, receding gums, and loose teeth.
Gum disease develops slowly and often without pain. That’s why routine dental examinations are critical to detecting and treating it early. Don’t ignore bleeding gums that can signal a problem needing prompt attention. With active participation in oral care and dental treatment when necessary, the effects of gum disease can be minimized.