Gingivitis & Periodontitis - Signs & Symptoms

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Gingivitis & Periodontitis - Signs & Symptoms

Gingivitis & Periodontitis - Signs & Symptoms

It may shock you to know that 90 per cent of people will have gum disease at some point in their lifetime.

But before that statistic scares you, dear reader, it’s important to know that when caught early enough, periodontitis and gingivitis are highly predictable if you take on board all the advice given.

Gingivitis is a totally reversible form of gum disease and periodontitis (which 90% of us will get at some point) is an irreversible gum disease. In this blog I’ll be exploring the differences and sharing everything you need to know to protect your healthy and beautiful smile.

The two types of gum disease:

In short, gum disease is caused by an immune reaction to bacteria in your mouth. But dependent on the type of gum disease, the way in which this occurs is very different.

Let’s dive in.


Gingivitis is a reversible gum disease. In this case, the immune system reacts to bacteria around the teeth; however, this reaction is restricted to the gums alone and does not affect the bone. There is no loss of supporting structures of the teeth, rather issues are restricted to the soft tissue. Resultant inflammation in the gums causes redness, swelling, and bleeding. Left untreated, gingivitis may – but not always – become periodontitis over a number of years.


Periodontitis is irreversible. In this case, the supporting structures of the teeth are destroyed. The rate of this destruction varies wildly between patients due to factors such as genetic makeup, smoking history, oral hygiene and other medical issues – for example, diabetes. Periodontitis occurs when the immune system tries to fight off bacteria in the mouth. As the body tries to defend itself, toxic by-products are released that destroy the connection between the gums and the teeth and can stimulate loss of bone structure.

What are the chances of getting periodontitis?

90% of human beings get periodontitis at some point in their life!!! Nobody knows why there is so much variation about when gingivitis becomes periodontitis. It is, however, important to point out that periodontitis is a more extreme version of gingivitis. It is always a result of untreated gingivitis.

In fact, a study conducted in the 1970s to the mid-80s aimed to understand the initiation and rate of progression of periodontal disease and subsequent tooth loss. The study was conducted on a group of 480 male labourers at two Sri Lankan tea plantations. The participants were between 14 and 46 years old, and did not practise any form of oral hygiene.

Interestingly, despite the fact that all participants lived very similar lifestyles and did not use any oral hygiene techniques at all, the results varied massively. They all had gingivitis, but some had more aggressive gum disease too.

  • 8 per cent of participants had rapid progression of periodontal disease
  • 81 per cent had moderate progression
  • 11 per cent had no progression of periodontal disease beyond gingivitis.

If all participants didn’t brush their teeth and lived very similar lifestyles, why were the results so varied? This study goes some way towards proving the importance of brushing your teeth, but it’s also important to remember that there are other factors at play that increase your risk of contracting gum disease.

Whilst there’s no hard evidence that gives us an exact list of what these other factors are, we can make some reasonable assumptions, such as:

  • Genetic makeup
  • Smoking
  • Diet
  • Lifestyle choices
  • Uncontrolled diabetes
  • Drug-induced gum overgrowth (DIGO), which is caused by certain classes of drugs. This swelling makes cleaning much more difficult and can lead to severe periodontitis. The classes of drugs include:
    • Immunosuppressants e.g. cyclosporin etc
    • Epilepsy drugs e.g. phenytoin etc
    • Calcium-channel blockers for the treatment of high blood pressure e.g. nifedipine etc

Let’s explore in more detail what you need to be aware of regarding the two forms of gum disease, and what you should do about it if you’re worried you’re showing symptoms.

Gingivitis – what to look out for

Bleeding gums must never be ignored. We’ve all seen the scary Cordodyl mouthwash or toothpaste adverts that claim a small sign of blood when you’re brushing your teeth could be a sign of gum disease. Unfortunately, whilst those adverts do tend towards hyperbole, they aren’t all scaremongering. If you’re seeing blood when you brush your teeth, you should absolutely see your hygienist or periodontist. Treating gum disease early increases your chances of protecting your healthy and beautiful smile.

The shocking statistic I shared at the start of this blog shouldn’t be taken lightly. Gum disease is serious, but in my blog series I’m aiming to reassure patients and make them feel confident, not make them more scared of dental professionals!

A dental professional can help you to figure out whether you’re experiencing gingivitis or periodontitis, and get started on a treatment plan that will minimise the negative symptoms. Think of it this way: you wouldn’t ignore it if your eye was bleeding! You certainly shouldn’t be ignoring bleeding from your mouth, either – assuming you’re planning on keeping your teeth for the rest of your life, that is!

Periodontitis – what to know

Statistics for the prevalence of periodontitis in adults vary from 19 per cent in adults over 30 to more than 70 per cent in adults over 65. Unfortunately, it is incredibly difficult to predict when periodontitis is going to occur. Periodontitis can only be diagnosed after destruction has occurred. This is why it’s so important to see an appropriately trained dental hygienist regularly, especially if you’re experiencing symptoms of gum disease, so that treatment can begin before it gets worse.

Even though periodontitis is irreversible, it is extremely beneficial to identify the disease before it causes looseness or movement of the teeth. This happens because the gaps between the teeth and the gums get too big. These are called periodontal pockets, and ideally they should measure four millimetres or less so that the immune system isn’t triggered to cause destruction.

In basic terms, this happens because if the pocket measures five millimetres or above, the good bacteria found in these spaces changes into bad bacteria. But fear not! There are steps that can be taken to minimise the negative effects of these bad bacteria.

The first thing to do in this case is to clean the periodontal pocket. Our job as dental professionals is to keep underneath the gum clean, and your job as the patient is to keep above the gum clean so that nothing gets back in!

If cleaning the periodontal pockets isn’t enough to reverse the immune response, there are more advanced surgical gum treatments to regenerate the bone that has been lost and cut away excess soft tissue.

However, this does not mean periodontitis has been cured. It cannot be cured because a cure would involve the suppression of the immune system (which is akin to using a sledge-hammer to crack a nut). Periodontitis is a chronic condition and maintenance is still required, but it can be controlled with regular cleaning of the gum pockets and practising good oral hygiene.

How to protect your smile against gum disease

Keeping the plan simple is always best namely:

  • Have an efficient cleaning routine
  • Use interdental brushes between the teeth
  • Stick to a healthy diet
  • Stay hydrated
  • Avoid smoking
  • Visit your dental hygienist regularly

Have a read of my previous blog where I explore in more detail how to maintain a good oral hygiene routine, and don’t forget to subscribe to my mailing list so you can be notified every time a new informative blog post goes out. If you’re worried about early signs of gum disease or are just seeking some reassurance please complete the form below and we will contact you promptly.

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