The course of a periodontal disease
Deposits build up and a mild gum inflammation arises from plaque and calculus.
The gum becomes inflamed; it bleeds. Deposits build up on the tooth at the gum margin, and plaque and calculus give rise to a mild inflammation of the gum – gingivitis.
The gum margin detaches from the tooth, bacteria spread, plaque hardens into calculus and the surrounding bone breaks down. The result is a severe inflammation of the gum and the periodontium – periodontitis.
The gum recedes, jawbone and retaining fibres break down further, and a bony defect forms. The tooth becomes loose and falls out.
Recession
If periodontitis goes untreated, the inflammation works its way deeper along the root. Bony defects arise – the bone is broken down and the gum follows. Where this exposes the neck of the tooth, it is called a recession defect.
Possible without inflammation too
Gum and bone can also recede without any preceding inflammation. The reasons vary: brushing too hard with a stiff brush, an unfavourable tooth position, a tight lip frenulum pulling at the gum, or naturally thin tissue.
The distinction matters, because treatment differs: with inflammation that has to heal first; with a mechanical cause the cause is addressed first.
The key points at a glance
- It begins with deposit at the gum margin, which turns into gum inflammation.
- If that persists, the gum margin detaches from the tooth and pockets form.
- In the pockets the deposit hardens into calculus and the bone breaks down.
- In the end the tooth becomes loose. Until then, none of it hurts.
Answered briefly
Frequently asked questions
There is no general answer. In some people it remains gingivitis for years; in others the inflammation reaches the bone within months. Smoking, diabetes and a hereditary predisposition speed up the course.
By exposed tooth necks, teeth that look longer, persistent bad breath and later by teeth that move. The only reliable sign is the measurement of pocket depths at the practice.
Yes. In most people it can be brought to a standstill. What cannot be reversed is the bone loss that has already occurred – which is why every month of earlier treatment counts.