Medications that inhibit the body’s natural ability to fight infection (such as oral bisphosphonates used to treat osteoporosis) can increase your risk of periodontitis. Abnormal tooth structure that creates ledges or traps for plaque and debris (such as poorly contoured restorations) can also contribute to periodontitis. If you have gingivitis, which is the earliest stage of periodontal disease, your dentist may recommend regular dental cleanings and improved oral hygiene. This will remove harmful bacteria, and the inflammation associated with it.

This advanced stage of gum disease causes the bone and tissue that hold teeth in place to deteriorate. It can lead to loose teeth and bad breath.

Gingivitis

Gingivitis is the earliest stage of gum disease. It is characterized by red, puffy, and swollen gums that may bleed when brushed or flossed. It is usually painless, but some people may experience mild discomfort. The good news is that gingivitis is reversible with proper treatment and consistent oral hygiene.

Your dental team can help treat gingivitis and prevent it from progressing to the more serious stages of periodontitis. They will carefully examine your teeth and gums to determine the extent of bone loss. They will check for pockets around your teeth that collect food bits, bacteria, and plaque. They will also remove hardened plaque called calculus from your teeth.

Your dental team will recommend that you brush your teeth for at least two minutes twice a day, and to floss daily. They can show you how to use an interdental brush, a wood or plastic pick, and a “water flosser” that helps get between your teeth. They will also recommend regular cleanings, about every 6 to 12 months, depending on your risk factors for periodontitis.

Periodontitis

After gingivitis has progressed to periodontitis, the bacteria in plaque move beneath the gum line where they begin to irritate and damage the ligaments, soft tissues and bone that support your teeth. Eventually, these tissues detach from your teeth and form pockets that fill with debris and bacteria. This stage of periodontal disease usually has very mild symptoms.

Your dentist may measure the depth of these pockets using a periodontal probe and take dental X-rays to check for bone loss. Treatment options for this phase of gum disease focus on halting the progression of inflammation and encouraging natural tissue regeneration.

Your periodontist may prescribe oral antibiotics and use a deep cleaning technique called scaling and root planing to remove the bacteria hiding under your gums. He or she may also recommend gum grafting surgery to cover exposed tooth roots and add thickness to your gum tissue. This can help reduce inflammation and improve the appearance of your smile.

Bone Loss

Gingivitis is reversible, but it can progress to more serious gum disease if left untreated. At this point, the bacterial toxins destroy the bone and tissue that hold your teeth in place. This leads to loose teeth and tooth loss.

In some cases, a periodontist (a specialist in gum disease) may need to treat severe gum disease. They will use a periodontal probe that measures the depth of the pockets around your teeth, and may take X-rays to check the extent of the damage.

They may also perform gum graft surgery, where they add new tissue to cover exposed tooth roots and protect them from further decay and gum recession. They may use a grafting material that contains bone or other tissue from the roof of your mouth, or they might choose to use donated tissue from another area.

Tooth Loss

Leaving gum disease untreated destroys the bone and tissues that support your teeth. This leads to loose or lost teeth, and can also put you at greater risk for other serious health conditions.

Treatment options depend on the severity of your condition. Your dental team will clean the area around your teeth to remove plaque, bacteria and tartar. They will also measure the “cuff” of tissue around your teeth (using a periodontal probe), and take X-rays to see the extent of any bone loss. They may refer you to a periodontist, a specialist in treating gum disease.

You can reduce your chances of tooth loss by practicing good oral hygiene, eating a well-balanced diet and visiting your dental team for cleanings at the intervals recommended by your dentist. Avoiding tobacco use and certain health conditions like diabetes, hypertension or pregnancy can help as well. Injuries to the mouth from physical trauma can also cause tooth loss, and are especially common in younger people.