From gingivitis to periodontitis — symptoms, treatment and prevention.
Gum disease ranges from reversible gingivitis to serious periodontitis that can cause tooth loss. Early treatment is essential.

Professional cleaning, scaling and root planing, and periodontal treatment. Healthy gums are vital before implants.
Bleeding, swollen or receding gums and bad breath are warning signs.
This single distinction governs everything. Gingivitis is inflammation of the gum only: red, swollen, bleeding — and it resolves completely with cleaning. Periodontitis is what follows when it is ignored: the bone anchoring the tooth is destroyed. That bone does not come back.
Treatment then aims to stop the loss, not reverse it. The tooth you keep at forty depends on what you did at thirty.
Healthy gums do not bleed when brushed, any more than healthy skin bleeds when washed. Bleeding is inflammation, and inflammation is bacteria.
The cruel exception: smoking constricts the blood vessels and suppresses bleeding. Smokers often have no bleeding and worse disease. Absence of bleeding in a smoker is not reassurance.
Step 1 — Cause control: professional cleaning above and below the gum line (root surface debridement), under local anaesthetic where pockets are deep. This is not “a scale and polish”; it is the treatment.
Step 2 — Re-evaluation after 6–8 weeks: pockets are re-measured. Most respond.
Step 3 — Surgery only for residual deep pockets, to gain access or regenerate bone in selected defects.
Step 4 — Maintenance, for life: professional cleaning every 3–6 months. This is the step people abandon, and it is the step that determines the outcome.
Periodontitis and diabetes worsen one another in both directions: poorly controlled blood sugar drives gum destruction, and treating the gums improves glycaemic control. Associations with cardiovascular disease and adverse pregnancy outcomes are consistently reported.
It also decides implant eligibility. Untreated periodontitis dramatically raises the risk of peri-implantitis — bone loss around an implant. Any clinic offering you implants without first treating your gum disease is not planning your treatment. See implant success rates.
Interdental cleaning is not optional: brushing reaches roughly three surfaces of five. Use interdental brushes sized by your hygienist, daily. Stop smoking — it is the strongest modifiable risk factor. Attend maintenance appointments.
Early signs to act on: bleeding, persistent bad breath, gum recession, teeth that feel loose or have drifted, and a bad taste. See receding gums and bad breath.
This page provides general information and does not replace professional dental advice. Always consult a qualified dentist about your individual case.
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