What is periodontitis? Signs and symptoms

Periodontitis (irreversible gum disease) is a chronic, complex inflammatory disease linked to a dysbiotic (unbalanced) plaque biofilm.

It is marked by the progressive breakdown of the structures supporting teeth. Clinically, this is measured by observing the amount of clinical attachment loss (CAL) that has occurred around the teeth. CAL is the total sum of recession (shrinkage of the gum) and probing pocket depth (the space between the top and bottom of the gum pocket). Radiographically (via x-rays), this can be assessed by measuring the bone loss which has occurred around the tooth.

Many patients are surprised by a diagnosis of periodontitis, as they often assume the absence of pain means their gums are healthy. Periodontitis is often a ‘silent’ disease. If it does cause pain, it is more likely to be in its advanced stages.

Signs and symptoms of periodontitis

• Gingival (gum) bleeding during a dental assessment, brushing, flossing or sometimes spontaneously
• Inflamed gums (swollen or red gums may be apparent due to the inflammation in the gum tissues)
• Periodontal pocketing (increased spaces of the gum pockets around teeth)
• Gingival recession (shrinkages of the gums which exposes the tooth root and can lead to teeth looking longer and/ or tooth sensitivity)
• Alveolar bone loss is the visible loss of supporting bone around the teeth which is usually identified on radiographs (x-rays).
• Tooth mobility (loose teeth due to reduced bone support and attachment loss)
• Tooth migration (drifting of or spacing between teeth which can occur in advanced cases of periodontitis)
• Tooth sensitivity to cold, hot, sweet or tactile (pressure) stimuli due to exposed dentinal tubules occurring after gum recession (dentinal tubules are micro-channels which run from the outer surface to the inner tooth where the nerves are)
• Suppuration (pus discharging from the gum pockets)
• Halitosis (bad breath)
• Impaired ability to chew normally due to tooth loss, tooth mobility, bite collapse and migration of the teeth (this can occur in very severe cases)

Please visit a dental professional for an assessment if you experience any of the above.