What is periodontitis?

Periodontitis is a disease in which the gums and bones (periodontal tissue) that support the teeth get lost due to inflammation. Periodontitis is when inflammation passes through the gums and goes into the bone that supports the teeth. The symptoms such as swelling and bleeding of the gums appear, and when it gets worse, you will feel loose teeth or the teeth start to move or shift.

Although gingivitis can be cured by appropriate oral care and regular dentist visit for dental cleaning, once you have periodontitis it is almost impossible to completely cure back to the original condition. In most cases, gum treatments can stop the progress of the periodontal disease. As periodontitis becomes more severe, you will notice tooth mobility and eventually lose your teeth.

Periodontal disease is considered one of the two major oral problems, along with tooth decay. And it is a common disease that anyone can suffer from it. The Guinness record recognizes it as the most common infectious disease in the world (about 80% of adults).

Periodontal disease does not show any noticeable symptoms until the disease has progressed significantly. When you notice symptoms such as "pain when chewing" or "difficult to chew due to the teeth mobility," it is already advanced periodontal disease. It is sad for me as a dentist to say to a patient, "It's too late to get better. Your teeth need to go." If you already have some minor symptoms even bleeding gums or bad breath, consult your dentist before it's too late. It may save your teeth.

Worst-case or when you have to remove your teeth

If you have to remove your teeth, you will probably need implant treatment. Dental implant treatment is a method in which an artificial tooth root (implant body) is placed into the bone.

Since the implant body is directly fused to the bone, it feels like you are biting with your teeth and has the advantage of getting a more stable bite than a regular denture.

There is no need to shave off the teeth on both sides of the missing tooth area like a dental bridge. Although implant treatment is a little more expensive option than bridges, you will be able to bite and chew just like your own teeth. Many insurance companies pay for implant treatments. Of course, having your teeth makes your eating experience better and happy.

With periodontitis, also known as periodontal disease, tooth support is weak, and tooth flare can occur prematurely. You must first see a periodontist and treat gum disease before engaging in orthodontics and cosmetic dental care if you have gum disease.

It's usually too late when you notice. The horror of periodontal disease

Periodontal disease checklist

  • The swollen gums (red color).
  • Purplish red gums (healthy gums are light pink with no spots).
  • Bleeding from the gums (when brushing teeth, chewing apples, etc.).
  • My gums feel itchy.
  • When I feel sick, I feel like my teeth are floating.
  • Bad breath.
  • The mouth is sticky.
  • Pus comes out of the gums.
  • Loose teeth. Teeth sway or hard to bite.
  • Teeth look longer than before.
  • The gap between the teeth becomes larger.
  • Teeth alignment becomes off.
  • I haven't had a teeth cleaning for over a year.
  • Have a smoking habit.
  • Have or had diabetes.

What does gingivitis and periodontitis treatment do?

Removing plaque and calculus (tartar) is the basis of the treatment. Dentists use special tools to remove tartar that cannot be removed with a toothbrush or floss. As periodontal disease progresses, the groove or the gap between the teeth and gums becomes deeper. It forms a "periodontal pocket." Plaque in these deep pockets is tough to remove with regular toothbrushes and floss.

So, dentists and dental hygienists must remove and clean them. In many cases, this alone can improve periodontal disease. Still, additional treatment may be necessary due to various factors such as the location, shape of the teeth, existing restoration, and the depth of the pocket.

In such cases, periodontal surgery may be offered as a more in-depth option to thoroughly eliminate the cause of periodontal disease. The progression of periodontal disease is not always uniform throughout the mouth because of other factors such as occlusion and previous dental treatment such as fillings, crowns, and dentures.

Therefore, it is crucial to measure periodontal pocket depths and bleeding spots at each stage of treatment and record them to assess accurate oral conditions. Even treating periodontal disease may recur if you do not brush or floss your teeth well. Please continue regular examinations and checkups to maintain your oral health.

How to prevent periodontal disease

Brushing your teeth carefully every day and using dental floss to remove plaque from between teeth is essential. Bacteria that cause caries or tooth decay is called Streptococcus mutans. It decomposes sugar and dissolves teeth by making acid. Periodontal infections are usually mixed, often involving anaerobes such as Treponema denticola and Porphyromonas gingivalis.

Maintaining good oral hygiene and every six months dental cleaning results in the prevention of gum disease and other problems in the mouth, such as tooth decay. In addition, fluoride toothpaste restricts sugar intake, and chewing xylitol gum prevents tooth decay.


Dr. Shimizu is an accredited member of the American Academy of Cosmetic Dentistry. There are 419 dental professionals worldwide (Only four in Houston) as of 2022 who have achieved this prestigious honor.