Symptoms, Diagnosis, Treatment

periodontitis-symptomsWhat Are the Symptoms of Periodontitis?

Signs and symptoms of periodontitis can include:

  • Swollen gums
  • Sensitive teeth /painful chewing
  • New spaces developing between teeth
  • Loose teeth
  • Bright red or purple colored gums (healthy gums are firm and pale pink)
  • Gums that are tender to the touch
  • Gums that pull away from teeth, making teeth appear longer than normal
  • Pus between teeth and gums
  • Bad breath
  • Bad taste in the mouth
  • A change in the way teeth fit together when you bite
  • A change in the fit of partial dentures

If you have any of these symptoms or if your gums are puffy, red and prone to bleeding make an appointment to see your dentist. Untreated periodontitis can lead to tooth loss and has also been associated with other serious health conditions like coronary artery disease1, stroke2, low birth weight babies3, poorly controlled diabetes4 and respiratory disease5. The sooner you seek dental care, the better your chances for reversing tissue damage and preventing other serious health complications.

periodontitis-landing-image-2How is Periodontitis Diagnosed?

Periodontitis is diagnosed based on your symptoms and an exam of your mouth. A dentist will look for a buildup of plaque and tartar and will also check to see how easily your gums bleed. A dentist may also use a special metal probe to measure the depth of the groove between your teeth and your gums. Several measurements are typically taken at different sites in the mouth to determine the severity of periodontitis. X-rays may also be taken to look for evidence of bone loss.

How is Periodontitis Treated?

There are a variety of options available for the treatment of periodontitis, depending on the severity. The goal of any treatment for periodontitis is to thoroughly clean pockets of bacteria and to prevent further damage. Treatment for periodontitis may be performed by a periodontist, a dentist or a dental hygienist. A periodontist is a dentist who specializes in the treatment of gum disease.

Treatments For Periodontitis

Less invasive, non-surgical treatments are an option for mild cases of periodontitis. Non-surgical treatments include:

  • Scaling – Instruments or ultrasonic devices are used to remove tartar and bacteria from the surface of teeth and beneath the gums.
  • Root planing – Root planing smoothes the surface of roots to discourage further tartar accumulation.
  • Antibiotics – Topical or oral antibiotics may be recommended to help control infection causing bacteria. Antibiotics can be applied topically by using a mouth rinse or by inserting gels or threads containing antibiotics into the space between teeth and gums or into pockets after cleaning.

Advanced cases of periodontitis may require one of the following surgical interventions:

  • Flap surgery (pocket reduction surgery) – A periodontist makes very small incisions in the gum so that a section of the gum can be pulled back exposing the roots. This allows for better scaling and planing. If needed, the underlying bone may be re-contoured before the gum tissue is stitched back into place.
  • Soft tissue grafting – A small amount of tissue from the roof of your mouth or another donor source is attached to the site where the gum has been damaged or has receded. A soft tissue graft can cover exposed roots, reduce further gum recession, and improves the appearance of the teeth.
  • Bone grafting – A small fragment of either your own bone, donated bone or synthetic bone is attached to the site where the bone surrounding the roots of the teeth have been damaged by periodontitis. A bone graft can help prevent tooth loss by holding the tooth in place and can provide a platform for the re-growth of natural bone.
  • Guided tissue regeneration – Guided tissue regeneration is a procedure that can be performed during bone grafting which involves the insertion of a small piece of mesh-like material between the bone and gum tissue. This mesh prevents gum tissue from growing into areas where bone should be, allowing the bone to re-grow properly.
  • Enamel matrix derivative application – This technique involves the application of a gel containing the same proteins found in developing tooth enamel to a diseased tooth root to help stimulate the re-growth of healthy bone.
Where Can I Get More Information?

The Coriell Personalized Medicine Collaborative research study has a board-certified genetic counselor that is available to talk with you about the information you may learn as a result of being in the study. Click here for more information. If you would like to talk with a CPMC genetic counselor, email us at This email address is being protected from spambots. You need JavaScript enabled to view it. . For more information about periodontitis:

American Dental Association – Periodontal Disease
Centers for Disease Control and Prevention – Periodontal Disease

Page References

1. Mucci LA, et al. (2009). Do genetic factors explain the association between poor oral health and cardiovascular disease? A prospective study among Swedish twins. Am J Epidemiol. 170:615-621.
2. Janket, SJ et al. (2003). Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 May; 95(5):559-69.
3. Shanthi V et al. (2012). Association of pregnant women periodontal status to preterm and low-birth weight babies: A systematic and evidence-based review. Dent Res J (Isfahan). Jul; 9(4):368-80.
4. Chapple IL et al. (2013). Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases.J Periodontol. Apr;84(4 Suppl):S106-12.
5. Scannapieco FA et al. (2003). Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review. Ann Periodontol. 2003 Dec; 8(1):54-69.