Learn All The Stages of Gum Disease in 2023

Want to know what to expect from all the gum disease stages? Keep reading because we’re going to cover it all in this guide

Ensuring that you’re brushing your teeth, flossing, and regularly seeing your dentist are all important to maintaining your oral health. However sometimes circumstances arise and your teeth do not get the care that they need. Unfortunately, a lapse in care can lead to gingivitis and possibly gum disease. This is why, as your dentist will confirm, it’s important to stick to a routine when it comes to the care of your teeth and gums. You may be curious to know more about gum disease—how you can get it and what the stages of it are. If so, keep reading because in this guide, we’re going to cover:

  • What is gum disease?
  • The causes of gum disease
  • Whether or not you can prevent gum disease
  • Gum disease stages
  • How to treat gum disease
  • What to do after you treat the different stages of gum disease

What is gum disease?

Let’s talk about how you define gum disease

female dentist speaking with male patient at the dentist office
Gum disease occurs when bacteria and plaque buildup go untreated on your teeth and gums. Although the first stage is treatable, later stages can cause serious issues for your teeth and gums.

Before we start the discussion regarding the stages of gum disease, it’s helpful to start at the beginning and learn exactly what gum disease is. Dentists and periodontists define gum disease (also known as periodontitis) as what happens when bacterial growth in the mouth causes gingivitis (inflammation of the gums) and goes untreated. The difference between gingivitis and periodontitis is that gingivitis is the early stage of unchecked bacterial growth and plaque build up. At this point, it can still be treated effectively, which would allow your mouth to go back to a healthy normal. 

When not treated, gingivitis can continue to worsen, eventually progressing into gum disease. You may have gingivitis if you’re experiencing:

  • Red and inflamed gums
  • Painful gums
  • Blood on your toothbrush after brushing

As we mentioned, gingivitis occurs when bacteria and plaque are allowed to build up in your gums and between your teeth. It will continue to multiply if it is not dealt with and will eventually turn into a harder substance known as tartar. This substance is very difficult to remove at home and should be dealt with by a dentist.

As the tartar continues to accumulate along the gum line, your gums will continue to become inflamed, and will begin to gradually pull away from the teeth. This can eventually end up causing tooth loss.

Periodontitis is a serious condition, not only because it can cause painful gums and tooth loss, but the bacteria causing this disease could possibly enter your bloodstream. You may then be more susceptible to additional serious bacterial infections. 

Source: http://www.kennettperio.com/Periodontal-Disease

What causes gum disease?

Although gingivitis is the primary cause of gum disease, there may be other factors that can influence whether or not you will develop gingivitis and eventually gum disease. These include:

  • Illnesses. If you have a condition such as cancer or diabetes, your body may have a harder time fighting off infections such as gum disease.
  • Medications. Likewise medications used to treat certain illnesses or conditions could decrease your body’s immune system response, making it more difficult to fight off infections. 
  • Lifestyle habits. If you are a smoker, this can make it more difficult for your gums to heal themselves and to keep infections away. 
  • Poor oral hygiene. Good oral hygiene is essential in preventing gingivitis as well as gum disease. 
  • Family history of gum disease. If gum disease runs in your family, you may be more likely to experience gingivitis and periodontitis. 

What are the symptoms of gum disease?

How do you know if you are developing the symptoms of gum disease?

male dentist shaking hands with patient in the chair
Pay attention to the symptoms of gum disease so you are able to treat it as quickly as possible.

Periodontitis is a preventable disease, but you should still be aware of the symptoms so you know when to check in with your dentist. As soon as you notice any one of these symptoms, it’s time to do something about it. If you let the disease run its course, eventually your gums will pull away from your teeth and cause pockets to develop, where bacteria can continue to grow and the condition will worsen. 

As these pockets continue to deepen, you will not only experience painful gums and tooth loss, but this ongoing infection can start to put a strain on your immune system. That’s why it’s important to know the symptoms, so you can put a stop to the infection before it has time to worsen.

Symptoms of gum disease include:

  • Swollen gums
  • Tender gums
  • Gums that bleed easily during brushing
  • Bad breath
  • Pus at the gumline
  • Painful chewing
  • Receding gumline 
  • Larger looking teeth due to a receding gumline

These are all symptoms that something isn’t right with your gums and teeth. When gingivitis is caught in the early stages, it can be treated successfully. This is why it’s important to speak to your dentist if you’re noticing any out of the ordinary symptoms or pain in your gums. You don’t want to let gum disease progress, and it will not go away on its own. 

Can you prevent gum disease?

What are the best strategies for preventing gum disease?

close up shot of a woman smiling and looking to the right while standing outside
You can successfully prevent gum disease by sticking to a good oral hygiene routine and visiting your dentist. 

Now that you’re aware of what gum disease is, what causes it, and the symptoms to be aware of, now it’s time to talk about how you can work at preventing it. As we mentioned, gum disease is a preventable disease. That being said, there are a few ways that you can work to prevent gingivitis and gum disease. 

Make sure to brush

This goes without saying, but it is very important you try to brush your teeth at least twice a day. Ensuring that you’re properly brushing can go a long way in preventing gum disease and its painful symptoms. Make sure you’re using a good toothbrush that fits in your mouth properly, either a manual or an electric brush is fine. 

Use a toothpaste that contains fluoride and make sure to brush your teeth (including your gums and tongue) for at least two minutes. This is the amount of time it takes to ensure all of your teeth are cleaned, including the spaces in between. 

Always floss

While many people do in fact brush twice a day, many more don’t floss. Dentists are always asking their patients if they’ve been flossing, and there’s a reason for this. Flossing between your teeth at least once a day is the best way to remove food particles and any lingering plaque. 

You don’t want to forget this step because when plaque is allowed to remain between your teeth (in the spaces that your brush can’t reach) it can eventually turn into tartar. Tartar is a harder substance than plaque, and it’s more difficult to remove. Avoiding tartar buildup is essential to preventing gingivitis and gum disease. 

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Use mouthwash

After brushing and flossing, it’s also a good idea to use mouthwash. Simply swishing it around in your mouth for about a minute can help remove any additional food particles that were left behind. It is also a great breath freshener. You may want to consider using a mouthwash that is alcohol-free, since alcohol can not only cause an uncomfortable burning sensation, it can also lead to dry mouth. You don’t want to inhibit the production of saliva in your mouth, which can be caused by a mouthwash with alcohol.

Visit your dentist

You should be visiting your dentist at least two times per year for regular checkups and cleanings. Having your teeth professionally cleaned can help fight plaque buildup, and will reduce the likelihood that it will continue to grow unchecked. If you happen to have any tartar, a professional cleaning may also be able to remove this as well. This should put a stop to any symptoms of gingivitis you may be having.

Visiting the dentist is also a chance for them to examine your overall oral health, and discuss any concerns they have with your teeth and gums. If you have any questions regarding your likelihood of developing gum disease, you can also discuss this with them. 

Stop or reduce smoking/tobacco use

If you are a smoker or tobacco user, a good way to help prevent gum disease is to reduce your amount. Smoking makes it harder for your gums to heal, and can also have an effect on your immune system. This means that should you start to develop symptoms of gingivitis or gum disease, your body will have a more difficult time fighting the infection off. 

What are the stages of gum disease?

Here we’ll examine the gum disease stages and determine what stage you may be at

woman helping patient while he is sitting in operation chair
Know what stage of gum disease you're in so you can get the proper treatment.

If you find yourself dealing with some of the symptoms of gum disease we outlined above, you may be wondering what stage of gum disease you are in. Dentists break down the progression of this periodontitis into four categories. 


The first stage of gum disease is gingivitis, which refers to the inflammation of your gums. This is the stage where you would first start to notice that your gums are feeling a little more sensitive than usual. You may also see blood or pink stains on your toothbrush. These may just seem annoying at the time, and might not even be painful. It is important to remember however that gingivitis is the first stage in a very serious bacterial infection, so you should not be so dismissive of these early signs and symptoms. 

Gingivitis is also the only stage that offers you the chance to reverse the damage being done to your gums and teeth. If you find yourself dealing with these types of symptoms, it is important to stick to a good oral hygiene plan and visit your dentist for checkups. There you can ask them about any additional concerns you may have.  

Stage I

If you progress past the gingivitis stage, you will then be in the second stage of gum disease, which is slight periodontal disease. This stage is manageable, but you may find that your dentist is not able to completely reverse the damage already done by the disease. At this stage the infection that started out as gingivitis has turned more aggressive as the bacteria have continued to multiply. 

You will no longer be able to fight this stage of gum disease with brushing, flossing, and mouthwash alone. Visiting your dentist and getting a professional cleaning is where you should start if you’re experiencing:

  • Increased swelling of your gums
  • Bad breath
  • Bleeding with brushing or flossing

Stage II

If gum disease has reached this stage, the pockets created as your gums recede from your teeth are not reversible, and they are likely increasing in size. This gives even more room for bacteria to multiple and do damage. You will need to see your dentist immediately, and not just for a professional cleaning. 

At the moderate periodontal disease phase, your dentist will likely employ a deep cleaning technique known as scaling and planing, which will go underneath the gumline in an attempt to clean out the bacteria from the pockets that have formed. 

You may start to notice loosened teeth at this stage, which can cause pain while chewing and your bite to be different. Both your teeth and your gums will be very sensitive, and you may notice more bleeding.

Stage III

The last stage of gum disease is where you can start to have bone loss and tooth loss due to the increasing intensity of the bacterial infection. You are also at a greater risk of having the infection spread to other parts of your body. Your gums will continue to swell and you could notice pus. Your gums and teeth will be very sensitive at this point, making it difficult and painful to chew, and you could have severe bad breath. 

After you lose teeth to advanced periodontal disease, you will be left with gaps that can cause additional bone loss. In order to correct this, you will need to be fitted with dentures or dental implants. 

As you advance through the stages of gum disease, it becomes very destructive to your teeth and gums very quickly. This is why you need to pay attention to the symptoms of the first stage, gingivitis, that can be reversed. Although gum disease can be prevented, if it is left unchecked, it can cause all kinds of discomfort. 

How do you treat gum disease?

What options do you have to treat gum disease?

illustration of normal tooth and periodontitis
Source: https://dorothylanedental.com/periodontal-dentistry/

How you treat gum disease will depend on what stage of periodontitis you are currently in. If you are in the first stage of periodontal disease (gingivitis) you should take a look at your current oral hygiene routine. Are you brushing twice a day, flossing and using a mouthwash to ensure your teeth and gums are clean? You may also ask yourself when was the last time you visited the dentist for a checkup.

If you’re unsure of the answer to that and you’re having some of the symptoms of gingivitis (swollen gums, pink in your toothbrush), then it’s definitely time to schedule an appointment for a professional cleaning. There your dentist or dental hygienist will give your mouth a thorough cleaning and a check up. They can answer any questions you might have about how to better care for your teeth so you can eliminate the symptoms of gingivitis. 

Just to be sure you’re on the right track, your dentist may recommend you come in more than twice a year to ensure your gums and mouth are in good shape. 

If you are in the second or third stages of periodontal disease, your dentist will have to do more than just a professional cleaning. At these stages they will employ a deep cleaning technique known as scaling and planing. This method will remove the tartar and bacteria that have built up in the pockets forming between your gums and teeth. You will need to have a local anesthetic applied in order to have this procedure.

After scraping out the tartar from the pockets and below the gumline, your dentist will then smooth out the surface of the tooth. This will hopefully provide a clean, smooth surface for your gums to eventually attach back to your teeth. 

If you find yourself in stage four periodontal disease, your dentist will need to use a surgical procedure known as pocket reduction surgery. This procedure involves anesthesia as your gums will be pulled back so that your dentist can get in and remove tartar and bacteria from the deep pockets that have formed. 

After the areas have been cleaned and smoothed (to reduce the chance of additional bacteria growth) your gums will then be closely attached back to the tooth.

However, if the four stages of periodontal disease are not treated, the result is tooth loss and the possibility that the bacteria infection could spread to other parts of your body. 

What should you do after treating the stages of gum disease?

Is there a way to prevent gum disease from returning?

After you have undergone treatment for one of the stages of periodontal disease, it is important that you continue to follow the advice of your dentist to prevent additional damage to your teeth and gums. They may suggest that you:

Practice good oral hygiene

If you were at stage one of gingivitis, this is extremely important. In order to prevent a return of that you will need to ensure you’re brushing, flossing and using mouthwash to prevent plaque and bacteria buildup. This can lead to gum disease. 

Maintain a balanced diet

Many foods have high amounts of sugar and starches, which bacteria like to feed on. If you don’t practice good oral hygiene and you don’t have a balanced diet, chances are you may end up dealing with gingivitis or later stages of periodontal disease again. Try to stay away from processed foods that contain these kinds of sugars and starches and instead opt for a diet that includes:

  • Fruits and vegetables--especially those that have a good amount of vitamin C
  • Lean protein
  • Leafy greens

These will not only keep your teeth and gums in good shape, but will benefit your immune system as well. 

Try to limit smoking/tobacco use

As we’ve mentioned a few times, tobacco use should be limited, especially if you’ve already undergone treatment for periodontal disease. Help keep your body’s immune system in the best shape you can so that it can be prepared to fight infection when it needs to.

Be consistent with dental visits

Getting regular cleanings and checkups with your dentist is essential after you’ve had treatment for periodontal disease, or have had symptoms of gingivitis. Remember, by making a point to keep up with your oral health, you are also contributing to the overall health of your body and immune system. 

There are four stages of gum disease, but only one of them is reversible. If you’re noticing the symptoms of gingivitis it is crucial that you’re practicing good oral hygiene habits and you visit your dentist. The dentist can help resolve the symptoms of gingivitis, and get you on track to better oral hygiene.

If you have more advanced stages of gum disease, there is still treatment out there, but it’s imperative that you do not allow the disease to progress unchecked. Speak with your dentist and they can help create a customized solution that will help you deal with gum disease.

Remember to know the warning signs of gingivitis, because if you don’t do something about it, it could develop into a very serious bacterial infection. If you’re noticing symptoms, contact your local Aspen Dental dentist.

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