Periodontitis: symptoms, causes and treatment

Periodontitis is gum disease that damages the tissues supporting the teeth, including the bone around their roots. It may develop with surprisingly little pain, so waiting for toothache can mean missing earlier signs.

Bleeding gums deserve attention, but bleeding alone does not tell you whether you have periodontitis. An examination is needed to distinguish it from gingivitis and other causes, and to plan the right care.

What causes periodontitis?

Dental plaque and the body’s inflammatory response play a central role. Smoking, diabetes and individual susceptibility can affect the risk and the response to treatment. A family history may matter, but it does not make tooth loss inevitable. This is not a condition limited to a particular age group or a simple judgement about how well someone brushes.

Gingivitis affects the gums without the loss of tooth support that defines periodontitis. When periodontitis develops, pockets can form around the teeth and supporting tissues can be lost. Treatment aims to control the disease and preserve teeth; it does not automatically rebuild all the support already lost.

Which symptoms should you notice?

Arrange a dental assessment for bleeding, persistent bad breath, gum recession or a change in how your teeth meet. Teeth may look longer or gaps may become more noticeable. These changes can have other explanations, which is why self-diagnosis is unreliable.

A newly loose adult tooth, very sore swollen gums or a painful swelling needs urgent dental advice. Call NHS 111 if you cannot reach a dentist. Rapidly spreading swelling or difficulty breathing or swallowing requires emergency help. The NHS gum disease guide gives further advice.

What does treatment involve?

The assessment may include measurements around the teeth and X-rays to check the supporting bone. Your dental team will discuss cleaning techniques and relevant health factors, including smoking and diabetes management.

Treatment commonly involves removing deposits above and below the gum line, then reviewing the response. Local anaesthetic can help when needed. A routine polish alone is not a substitute for treating deeper disease, and fluoride varnish does not remove deposits beneath the gums.

Vector is one ultrasonic system used in periodontal care. Its instrument makes a controlled linear movement; describing it as working without vibration would be misleading. The choice of equipment does not remove the need for a diagnosis, effective cleaning or follow-up, and no device can guarantee a painless result for everyone.

Some cases need further treatment or referral to a periodontist. A gum graft may be considered for selected areas of recession, but it is a different procedure from controlling active periodontal disease. It is not an alternative cure for periodontitis or a guarantee of complete root coverage. Cambridge University Hospitals explains gum grafting.

Keeping the disease under control

Home cleaning and regular maintenance are part of long-term care. The team will tailor the interval to your condition and response rather than assuming one visit a year is enough. Tell them if bleeding, swelling or tooth movement changes between appointments.

Gum health matters alongside general health, but associations with other diseases should not be presented as proof that periodontitis causes a heart attack or that dental treatment prevents one. Keep up your medical care as well as dental care.

Ask for a written treatment plan, including the likely maintenance needs and costs. If you are considering instalments, use our current finance information and discuss eligibility and terms before applying. Urgent symptoms should be assessed promptly, without waiting for a finance decision.