What is periodontitis?
Periodontitis is the advanced stage of gum disease. It starts as inflammation of the gums only; left untreated, it spreads to the bone and ligaments that hold the tooth, forming pockets between gum and tooth and gradually destroying bone. It's a leading cause of tooth loss in adults โ yet in most cases it can be stopped if treated in time. This guide was written under the supervision of Dr. Banan Alhawamdeh, periodontics and gum surgery specialist.
Gingivitis vs periodontitis
| Gingivitis | Periodontitis | |
|---|---|---|
| Where | Gums only | Gums, bone and ligaments |
| Signs | Redness, swelling, bleeding | Pockets, recession, bad breath, loose teeth |
| Permanent damage? | No โ fully reversible | Lost bone usually doesn't return, but disease can be stopped |
| Treatment | Cleaning and home care | Deep cleaning, sometimes surgery, lifelong maintenance |
Symptoms
- Gums that bleed repeatedly when brushing or flossing.
- Persistent bad breath or bad taste.
- Gum recession โ teeth look longer.
- Loose or shifting teeth, or new gaps.
- A change in how your teeth bite together.
- Pus or a gum abscess.
It's often painless in the early stages, which is why it's frequently found late.
Causes and risk factors
- Plaque and tartar at the gumline โ the main cause.
- Smoking โ raises the risk, hides bleeding and slows healing.
- Diabetes โ a two-way relationship.
- Genetics, stress, some medications and hormonal changes.
- Ill-fitting crowns or fillings that trap plaque at the gum.
Diagnosis
The dentist measures pocket depth around each tooth. Healthy gums usually measure 1โ3 mm; deeper pockets indicate more advanced disease. X-rays show bone levels, and tooth mobility is checked to stage the disease and plan treatment.
Can loose teeth become firm again?
It depends on how much bone remains. In many cases mobility reduces noticeably once inflammation is treated as the tissues heal and tighten. Splinting or bite adjustment may help. Teeth that have lost most of their bone may not be saveable; these are replaced once the disease is under control.
Treatment
- Scaling and root planing (deep cleaning) under local anaesthetic โ the core treatment. See regular vs deep cleaning.
- Correct daily home care โ success depends on it.
- Re-evaluation after several weeks.
- Gum surgery if needed for deep pockets that didn't respond; in selected cases some lost bone can be regenerated.
- Maintenance every 3โ4 months, as the disease can return if neglected.
Can I have implants if I have periodontitis?
Often yes โ but after the disease is under control, since the same bacteria can cause inflammation around implants. See immediate implants.
Frequently asked questions
Can periodontitis be cured?
It can be stopped and controlled in most cases, but lost bone usually doesn't grow back on its own, so the gums need ongoing maintenance.
Is deep cleaning painful?
It's done under local anaesthetic. Mild sensitivity for a few days afterwards is common.
Is mouthwash enough?
No. Mouthwash doesn't reach deep pockets or remove tartar; it can only help alongside professional treatment.
See a gum specialist
Bleeding, loose teeth or recession? Don't wait. Book a gum assessment with Dr. Banan Alhawamdeh in Sweifieh, Amman. See gum treatment and surgery or book an appointment.