Three Stages of Periodontal Disease and Periodontitis Treatment

Periodontal disease is categorized into three stages – gingivitis, early periodontitis and advanced periodontitis. Below we explain the difference between these three and how periodontitis treatment is initiated.


This is the first stage of periodontal disease. Some indications that you may have gingivitis may involve tender and some bleeding of your gums when you brush or floss. Gingivitis is reversible when corrective measures are undertaken. Some of these measures involve routine professional cleanings and proper brushing and flossing on a daily basis. Usually when the above measures are taken, no bleeding or tenderness of the tissues results. Therefore the gingivitis has been reversed back to a degree of healthy gums. Untreated gingivitis can advance to the second stage of periodontal disease, periodontitis.

Early Periodontitis

This is considered the second stage of periodontal disease. At this stage, plaque and tartar forms under the gums which are not accessible with brushing and flossing alone. Professional therapeutic methods need to be incorporated. Plaque and tartar begin to cause infection, which may damage the bone and the attachment of the gums to the teeth. You may notice that your gums start to pull away (gum recession) and more tenderness and bleeding may result. Proper dental care may involve tissue and root therapy or deep cleanings with the incorporation of other therapies depending on the advancement of the gum disease. Professional intervention is very important to prevent further damage of periodontitis.

The first periodontitis treatment step involves a special deep cleaning or tissue and root therapy. This procedure helps diseased pockets to shrink and gum tissue to regenerate. A local anesthetic is often used to make you more comfortable. Usually, treatment occurs in one appointment. Sometimes antibiotics may be inserted under the gums to aid in healing of the gingival tissues. Also, a medication via pill may be recommended to control infection or to aid in healing. A month after therapy, an examination will determine if further periodontal disease treatment is required.

Advanced Periodontitis

In the most drastic stage of periodontal disease, the bone and the attachment of the gums to the teeth have been destroyed. This may cause your teeth to shift or loosen and can affect how your teeth come together. You may notice a bad taste or smell in your mouth. Proper dental care must be initiated to save the teeth or they may need to be removed. Professional intervention may involve pocket reduction therapy and bone grafting along with the incorporation of other therapies.

Pocket reduction therapy is required for this form of periodontal disease when the gingival tissues have not resolved after initial treatment or tissue and root therapy. This is usually necessary when gingival tissues have not shrunk enough or when the supporting bone around the teeth has been lost. Since the gum tissue has not shrunk, they provide a greater place for bacteria to live and attack the bone and tissue causing further damage to occur.

Pocket reduction is a periodontal disease therapy that turns or pulls back the gingival tissue, removes tartar and smoothes the roots so that the gingival tissue can reattach. Diseased tissue is also removed to allow the gingival tissue to heal. The gingival tissue is sutured back into place into a new position to make the gingival tissue snug around the tooth and aid in healing. Sometimes bone grafts may be necessary to correct for bony defects that occur around teeth and where roots divide to prevent loss of teeth.

Feel free to contact us at Stoner Periodontic Specialists in Columbus, Ohio if you are interested in professional periodontal therapies.