What periodontitis is
Periodontitis is a bacterial inflammation of the tooth-supporting tissues, meaning the tissue and bone that anchor the tooth in the jaw. It begins as gum inflammation, gingivitis, and, untreated, spreads to the bone. Pockets form between tooth and gum where deposits collect that can no longer be reached with a toothbrush. Inside these pockets bacteria multiply undisturbed, and the inflammation slowly advances.
The distinction from gingivitis is important:
- Gingivitis is a pure gum inflammation without bone loss. It is fully reversible with good cleaning and leaves no lasting damage.
- Periodontitis develops when the inflammation persists and spreads to the bone. The bone lost in the process does not come back on its own.
The transition is gradual and usually goes unnoticed. That is precisely why the early phase matters so much: gingivitis can still be resolved without consequences, whereas periodontitis has to be controlled for life.
The early signs
Periodontitis progresses without pain for a long time, which is why it is often noticed late. These signs are worth watching for:
- Bleeding gums when brushing or flossing
- Reddened or swollen gums, often a little darker than healthy, pale-pink gums
- Receding gums, so the teeth appear longer and the tooth necks become exposed
- Persistent bad breath or a bad taste that returns after brushing
- Sensitive tooth necks, for example to cold or sweet things
- Loose or shifting teeth at an advanced stage
Bleeding gums are not a harmless detail but the most common early warning sign. If you notice it, have it checked by a dentist rather than waiting for it to stop on its own. The persistent bad breath often has the same cause, because bacteria collect in the gum pockets. You can read more in our article on bad breath and halitosis.
How periodontitis develops
The trigger is bacterial deposits at the gumline, the so-called biofilm. If this is not removed regularly, the gums respond with inflammation. Over time, soft deposits harden into tartar, which further shields the bacteria and can only be removed professionally.
Various factors increase the risk and accelerate the course:
- Smoking is one of the strongest risk factors. It reduces blood flow to the gums, masks bleeding as a warning sign and delays healing.
- Diabetes, especially when poorly controlled. High blood sugar promotes inflammation, and in turn periodontitis makes blood sugar harder to control.
- Genetic predisposition. Some people respond to the same amount of deposit with stronger inflammation.
- A weakened immune system, for example during periods of stress or with certain illnesses.
- Hormonal phases such as pregnancy, when the gums react more sensitively.
The deposits are the precondition, while the remaining factors determine how quickly and how severely the disease progresses.
Why acting early matters
The earlier periodontitis is recognised, the more gently it can be treated and the more bone is preserved. In the early stage a thorough cleaning of the root surfaces is often enough. At an advanced stage the procedures become more extensive, and the support already lost cannot be brought back. Untreated, periodontitis is the most common cause of tooth loss in adulthood.
Its significance reaches beyond the mouth. There are interactions with the rest of the body, best documented with diabetes, where the two conditions worsen one another. Links with cardiovascular disease and with complications in pregnancy are also described. Controlled periodontitis therefore eases the burden not only on the teeth. If you wear implants, you should also know that a similar inflammation can occur around an implant. You can read about this in our article on peri-implantitis.
How we make the diagnosis
It begins with a complete set of findings. This includes:
- Measuring the pocket depths with a fine, millimetre-graded probe at every tooth. Healthy grooves are shallow, while deeper pockets point to bone loss.
- Assessing the tendency to bleed, because bleeding on probing is a reliable sign of active inflammation.
- X-rays, which make the bone level visible and show how much bone has already been lost.
- Checking tooth mobility and recession at the gumline.
These findings give a clear picture of severity and extent. Treatment can then be planned precisely, rather than just fighting the symptom.
How it is treated
Treatment proceeds in stages that build on one another:
- Preparation and cleaning. First the visible deposits and tartar are removed and home care is optimised. Regular dental hygiene provides this foundation.
- Cleaning the root surfaces. At the core of treatment, the deposits below the gumline are removed from the pockets, under local anaesthesia if needed. The gums can then reattach to the tooth.
- A surgical step if needed. In advanced cases a small procedure may be necessary to make deep pockets accessible.
- Maintenance therapy (recall). Decisive for long-term success are regular check-ups at set intervals. They keep the inflammation in check for good.
We describe the exact process on our periodontics page. For the costs we draw up a written estimate based on the SSO tariff before treatment begins, so you have clarity.
What you can do yourself
The most effective prevention is consistent home care:
- Daily cleaning of the interdental spaces with floss or interdental brushes, complemented by brushing in the morning and evening.
- Regular dental hygiene, which removes stubborn deposits and tartar where the toothbrush cannot reach.
- Stopping smoking, which significantly lowers the risk and noticeably improves the chances of healing.
- Well-controlled diabetes, which has a favourable effect on inflammation in the mouth.
When to come to us
Bleeding gums that do not stop after a few days of good cleaning should be assessed. The same applies to receding gums, persistent bad breath or teeth that feel loose. The earlier we recognise the disease, the more support is preserved. If you are unsure, book an appointment. We take a complete set of findings and discuss the right steps with you.