Stages of Periodontal Disease

Gingivitis and periodontitis are the two major forms of periodontal disease. Without treatment, periodontal disease advances in severity and can result in the loss of teeth.

Removing plaque through daily brushing, flossing, and professional cleaning is the best way to minimize your risk of periodontal disease. With proper treatment and regular home maintenance, your dentist can design a personalized program to meet your needs and increase the chances of keeping your natural teeth.


Gingivitis is the first stage of Periodontal disease. Plaque (a sticky substance filled with bacteria) settles along the gum line of the teeth and causes the gums to swell, become red in appearance, and bleed. If the plaque is not removed, bacteria settles around the roots of the teeth and starts to destroy the supporting bone. The bone loss is not reversible. The gums become infected and pull away from the teeth, forming pockets. Gingivitis is usually painless. With professional treatment and good oral hygiene, gingivitis is reversible.


Periodontitis is an inflammation or infection of the bone and ligaments surrounding the teeth. It is a more advanced stage of gum disease characterized by the separation of the gum from the tooth. Progression of periodontitis can be measured by the depth of pockets in the gums. As the pockets become deeper and the infection progresses, more bacteria accumulates and further bone loss occurs. The gums shrink away and the teeth start to become loose and may shift. Many people suffer from bad breath at this stage. In the beginning stages, pocket depth may be three to five millimeters.  As the disease progresses, teeth begin to drift and pockets may deepen to six millimeters and higher. Bad breath and swollen bleeding gums are common symptoms of periodontitis. If untreated, the bacterial infection can result in permanent bone and tissue loss.  In its final stages, the fibers and bone that support the teeth are destroyed causing teeth to become loose and move. This movement can affect your bite and create additional dental problems if steps are not taken to save these teeth. In some cases, teeth may need to be removed to prevent further damage.

First stage of Periodontitis Second stage of Periodontitis Third stage of Periodontitis Fourth stage of Periodontitis