4 Periodontal Disease Stages: What You Need to Know

Around 50% of adults have gum disease. This might not seem like a big deal, but gum disease increases your risk of heart attacks, stroke, pneumonia, and diabetes. Scary stuff!

What’s even worse is if you let gum disease progress, it’ll lead to advanced periodontal disease, which is irreversible and leads to tooth loss and jaw damage.

There are 4 stages of gum disease but luckily, if you catch it during an early stage, it is reversible. Everybody wants healthy gums as it prevents plaque buildup and other serious issues. In this post we’ll discuss the 4 stages of periodontal disease so you can avoid problems. Here’s to healthy gums!

What Is Periodontal Disease?

Before we can understand the 4 stages of periodontal disease, we must first understand what it is. 

Periodontal disease is a bacterial infection of the gum, bone, and ligament tissue around the teeth. During this stage of gum disease the bacteria around your gum tissue cause your body to trigger inflammation. Inflammation makes your gums look red, puffy, and swollen.

This can even lead to bleeding gums. Other symptoms of periodontal disease include:

Over time, if you don’t treat this condition, it’ll cause bone loss, tooth loss, and it’ll start attacking your jaw.

The 4 Stages Of Periodontal Disease

Gum tissue also called gingiva is the tissue that keeps your teeth in place. It also has bone underneath that anchors and supports the root of your teeth. If you have unhealthy gums, the bones under your teeth also become unhealthy and it won’t support your teeth.

Periodontal Disease Stages

Gum recession also occurs with gum disease. Gums recede when the tissue surrounding the teeth wears away, leaving the tooth exposed and causing pockets to form. These pockets are an invitation for disease causing bacteria and can destroy the supporting bone of the teeth. Indeed, deep bacteria filled pockets can cause many issues such as swollen gums, bad breath, and teeth loosen when exposed to bacteria. These are some of the same symptoms you’ll see below for advanced periodontitis. Proper treatment is required.

Gingivitis Gum Disease

Early periodontitis is called gingivitis and is the earliest stage of periodontal disease. It’s also the only stage that’s reversible since bacteria never attacked the bone yet. That’s why it’s important if you suspect you have gum disease, to visit a dental office immediately. You’ll save your teeth and lots of money. It’s best to treat periodontal disease in the early stages for the best chance of reversal.

Gingiva means gums and it is is a medical term for inflammation. So if you put those two terms together, it means inflamed gums or swollen gums. 

Neglecting your oral health causes gingivitis. Sugary foods, processed carbs, and smoking are also culprits of gum disease. This causes plaque, tartar, and other bacteria to build up in your mouth. The edge of your gums becomes red and inflamed.

This is the most crucial stage since it’s painless. Most of the symptoms you see seem normal and that’s why it spreads to stage 2. Early stage gum disease is not easy to detect. You won’t see serious signs until the 3rd or advanced stages.

Slight Periodontal Disease

Slight periodontal disease is the second stage of periodontitis. This is the first stage where bacteria starts attacking the bone causing permanent bone loss. Bacteria also start getting more aggressive. Luckily, it’s still quite easy to manage slight periodontal disease.

First, you’ll need to make an appointment at your local dentist’s office. They’ll recommend you get a deep cleaning. Deep cleaning is different to a normal cleaning since it removes deposits of bacteria that are trapped under your gums. Normal cleaning and flossing can’t remove these pockets of bacteria.

Your dentist will also recommend that you floss and brush twice a day and avoid sugary foods.

If you’re in the second stage of periodontal disease, you’ll experience increased gum swelling, sensitivity, and bleeding.

Moderate Periodontal Disease

Moderate periodontitis is the third stage of the disease. You can’t reverse moderate periodontal disease. This is when your chance of tooth loss shoots through the roof. The periodontal pockets reach depths around 6 to 7 millimeters and this allows more bad bacteria to attack your gums and the bone structures supporting your teeth.

But your teeth and gums aren’t the only victims of bad bacteria. This is the stage when bacteria start attacking your immune system and entering your blood stream. This increases your chance of heart disease, stroke, and diabetes.

The amount of plaque, bacteria, and tartar starts increasing during moderate periodontitis, and this makes it difficult to manage. You’ll need to go to a dentist and have scaling and rooting. This deep cleaning reduces the number of deposits of bacteria sitting under your teeth.

At this stage, even if you have your teeth professionally cleaned, there’s a chance of tooth loss. Teeth loosen when exposed to bacteria, plaque, and receding gums.

progression of periodontal disease

Advanced Periodontal Disease

Advanced periodontitis is the last stage of gum disease. In this final stage, the infection goes deeper and this allows more bacteria to destroy the bone supporting your teeth. It’s estimated that you have a 50% to 90% chance of experiencing bone loss, depending on how severe your gum disease is.

This is when you’ll start seeing pus coming out of your gums. Bleeding also becomes more intense and your gums always feel sore and inflamed. Your teeth start falling out and there’s a need to remedy your bad breath as it becomes a problem for those around you.

A normal deep cleaning won’t help. Your dentist needs to go even deeper to remove tartar, plaque, and bacteria from under your gum line. In some cases, this stage requires periodontal surgery. Periodontal laser therapy can also help clean bacteria in your deposits.

In severe cases, your dentist may suggest scaling and root planing (SRP). Root planing is a procedure to minimize the size the pockets and encourage regeneration of reattachment of gum tissue. Antibiotics are typically given to manage the infection and heal the tissue.

If left untreated and professional action isn’t taken, your gum health will only get worse until you lose all your teeth. Advanced periodontitis also tends to destroy the jawbone and can cause serious jaw problems.

This is why it’s important to visit a dentist as soon as possible and schedule regular checkups. Also, brushing and flossing twice a day and eating healthy foods is important for beating advanced periodontitis and advanced stages of gum disease.

Here’s What Causes Periodontal Disease

Periodontal disease doesn’t happen overnight. It develops over years of negligence and poor oral hygiene. The 3 biggest causes of periodontal disease are:

  • Neglecting basic oral hygiene
  • Not visiting the dentist regularly
  • Eating unhealthy foods

Neglecting Basic Oral Hygiene

Periodontal disease is caused by buildup of plaque on teeth and under your gums. One of the best ways to take care of your teeth and gums is to brush your teeth and floss twice a day. When you don’t do this, you give bacteria time to settle in and it becomes impossible to remove without professional help. Proper brushing is essential to avoid progression.

To avoid this, brush your teeth, floss, and use mouthwash. This way you don’t give food particles time to stick to your teeth and cause unnecessary damage. 

Not Visiting The Dentist Regularly

Brushing and flossing won’t remove all the bacteria in your mouth and this is where your local dentist can help.

Visiting the dentist every six months is crucial for keeping your mouth clean and healthy. Even if you’re brushing and flossing twice a day, you won’t be able to get rid of all the bad bacteria.

But if you visit a dentist regularly, they’ll clean your mouth deeper than a toothbrush can. This prevents plaque and bacteria from building up and attacking your gums.

Unhealthy Eating

In our modern life, we’re eating so much processed junk food and that’s one of the biggest reasons why gingivitis and periodontal disease are so common.

When you eat processed foods and it gets stuck between your teeth, it causes cavities. If you do this for months or even years, then bacteria starts to build up under your gums leading to periodontal disease.

Another reason processed foods cause damage, is because your body thinks of them as a threat. When your body encounters a threat, it triggers inflammation as a line of defense.

Inflammation is a good thing since it protects us against toxins and threats, but if you’re constantly inflamed, it’ll affect your gum health.

To avoid this, stop eating inflammation-causing processed foods. These include:

  • Sugar
  • Trans-fat
  • Vegetable oils
  • Refined carbs
  • Processed meats.

Instead, eat foods that come from animals and plants and avoid everything else. Some healthy foods to eat in your fight against periodontal disease include:

  • Grass-fed meats
  • Eggs
  • Organic vegetables
  • Fruits
  • Fish.

These foods are all high in nutrients so they help your body fight periodontal disease and inflammation.

Can You Reverse Periodontal Disease?

Periodontal disease treatment depends on how much symptoms have progressed. Treating periodontal disease quickly will allow you to reverse the symptoms.

If you catch gum disease while it’s still gingivitis, then reversing it is a simple process. You’ll need to go in for a few cleanings while emphasizing oral hygiene. Your dentist will also tell you what to do based on your personal needs. If you stick to this, your gum disease will be a thing of the past in a few months. You’ll be on your way to healthy teeth and gums once again.

But if you allow your gums to progress to slight periodontal disease, then you can’t reverse it. However, you can manage the damage caused by the infection and keep most, if not all your teeth. Managing slight periodontal disease may involve going for a few deep cleanings while taking care of your oral hygiene.

If you’ve caught the gum disease late, then it might have progressed into moderate and advanced periodontal disease. Still, it’s not too late to do damage control and save your teeth. Depending on the severity of your gum issues, you’ll have to go for gum surgery like gingivectomy and gingivoplasty.

Also, your dentist will give you penicillin, antibiotics, and a special toothpaste and mouthwash to help kill bacteria.


Periodontal disease is a serious condition that millions of people suffer from. This commonly leads to tooth loss, bone loss, bad breath, and jaw damage. It can also increase your chance of getting a heart attack, stroke, and diabetes. But the good news is, if you catch it early enough, it’s easily reversible, and you can have healthy gums once again!

It goes without saying that good oral hygiene is essential for healthy gums and a healthy smile. This includes regular dental visits and dental cleaning (professional cleaning).


The American Dental Association Releases Guideline on Gum Disease Treatment. American Dental Association. Retrieved 7/31/2021 from https://www.ada.org/en/press-room/news-releases/2015-archive/july/the-american-dental-association-releases-guideline-on-gum-disease-treatment

What is Gum Disease? American Dental Association. Retrieved 7/31/2021 from https://www.ada.org/~/media/ADA/Publications/Files/for_the_dental_patient_jan_2011.pdf

Friedman, Michael DDS. 10/9/2019. Gingivitis and Periodontal Disease (Gum Disease). WebMD. Retrieved 7/31/2021 from https://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease

Periodontitis. The Mayo Clinic. Retrieved 7/31/2021 from https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473

Schroeder, Katrina M., D.M.D. The Patient’s Guide to Periodontal Disease: What it is, how to treat it, and why it is important, March 2019

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