Periodontal Disease – What it Looks Like and How to Avoid It

Tips and best practices on how to recognize and avoid periodontal disease

Keeping our teeth strong and healthy is an important part of not only our oral health, but our overall well being. Making sure our teeth and gums are brushed, flossed, and rinsed daily ensures that we’re doing all the right things to keep away cavities and conditions such as periodontal disease. 

But what is periodontal disease and how do you know what it looks like if you have it? What are the best practices to avoid getting periodontal disease? In this article, we’re going to delve a little deeper into:

  • What periodontal disease is (and what causes it)
  • Who can get periodontal disease
  • What periodontal disease looks like
  • Best ways to avoid periodontal disease
  • How to treat periodontal disease

What is periodontal disease?

Periodontal disease: what it is and what causes it

Periodontal disease is a serious condition that manifests an infection in your mouth. If not treated properly, it can spread to other areas of your body as well. 

Periodontal disease is also referred to as gum disease, and it occurs when your gums become infected and inflamed. This infection of your gums is not something to be taken lightly, as if it is left untreated, can potentially spread to other parts of your body. In addition, periodontal disease can not only be painful, but it can cause your teeth to loosen and possibly fall out. 

But what causes gum disease? Usually this type of infection is caused by a buildup of plaque, which is the sticky film that is always present on our teeth. If the plaque is not properly removed (along with other food debris) after we eat and drink on a daily basis, it keeps feeding the bacteria. This cycle keeps repeating itself until the plaque hardens into tartar, and the bacteria infection continues to worsen. 

As unfortunate as all this sounds, it’s reassuring to know that periodontal disease is preventable. If you have a good oral hygiene routine that involves brushing twice a day, flossing, rinsing with mouthwash, and visiting your dentist for checkups, you’re doing a lot to keep gum disease away. There are a few stages of gum disease (more on that below), which is why it’s helpful to learn how to recognize the signs of it. When caught early, it can be treated and you can avoid the swollen gums, loose teeth, and even potential tooth loss. 

When dentists speak about periodontal disease, they typically divide it into two groups based on the severity of the condition:

  • Gingivitis. This is an infection of the gums that can be treated. Bleeding is the greatest indicator of gum infection. At this stage you will notice inflamed and swollen gums.
  • Periodontitis. As the disease progresses if it is left untreated in the gingivitis stage, it will eventually develop into periodontitis. It causes irreversible damage to the supporting structures of teeth. This can result in loosened teeth, bone loss, and tooth loss. 
labeled diagram of a tooth and swollen gums

Who can get periodontal disease?

Are some people more at risk than others to get periodontal disease?

father, mother, and daughter sitting on the grass smiling at each other
Gum disease can affect anyone if the plaque and bacteria on their teeth isn’t removed on a daily basis. However, some people might be at a greater risk of developing periodontal disease based on underlying factors. 

Periodontal disease is something nobody wants, and if you aren’t practicing a good oral hygiene regimen, you are increasing your chances of developing it. However, there are other risk factors that can increase your chance of developing gum disease.


There is a connection between an increased chance of developing gum disease and having either diabetes type 1 or 2. Likewise, doctors have found that having a condition such as periodontal disease can increase your chances of developing other chronic conditions such as diabetes. While the connection between gum disease and diabetes is not completely understood, we do see a correlation between the two.

Because people with diabetes must constantly work to ensure their glucose levels are where they’re supposed to be, they are at a higher risk of developing additional infections. In addition, an infection such as periodontal disease may also have an impact on blood sugar, which makes someone with diabetes that much more likely to experience complications when it comes to controlling their glucose levels. 

Heart conditions

Another type of condition that has a correlation with an increased risk of periodontal disease is heart disease. While this link is still being studied, people who are affected by one are oftentimes also sharing common risk factors with the other. If you’re a smoker who has diabetes, your chance of developing both heart disease and gum disease are much higher than if you did not already have a chronic condition and engaged in tobacco use. 

These shared risk factors often produce an inflammatory response in the body (such as gum disease or heart disease) and doctors and periodontists are working together to better monitor patients that have one of these conditions. This is done in hopes of reducing their chances of developing the other condition. 


Obesity is another factor that can not only increase your chances of developing diabetes or heart disease, but it can also have an impact on the likelihood you develop gum disease. A good diet that includes fruits and vegetables, and limits sugars and starches, is a good way to ensure you’re treating both your body and your teeth and gums right. 


There are certain prescription medications that may also increase the risk that you could develop periodontal disease should you take them. Medications that have the side effect of dry mouth, such as some oral contraceptives, antidepressants, and heart medicines, could increase the chances of gum disease.

This is due to the fact that saliva plays a very important role in moving bacteria and other debris out of the mouth. When your mouth is not producing as much saliva, bacteria have a chance to multiply unchecked. 

Other medications that have side effects on the gums themselves may also contribute to your risk of periodontal disease.

Tobacco use

As you’re probably already aware, tobacco use (cigarettes, cigars, vapes, and chew) can also increase the risk of developing gingivitis and gum disease. The longer you use tobacco, as well as the frequency with which you use it, can all greatly increase your chance of developing a gum infection. Limiting or quitting tobacco use can decrease your chances of not only gum disease, but of developing other conditions such as oral cancer or lung disease. 

This is one of the biggest preventable risk factors— by quitting tobacco you can lower your chances of having a number of medical conditions.


Sometimes gum disease appears to run in families, and your risk factor could increase if one of your family members has had it previously, especially if there are no other additional risk factors. Typically if one person in the family has been diagnosed with periodontal disease, it’s usually a good idea to have everyone else in the family tested as well.

What does periodontal disease look like?

How do you know if you have periodontal disease?

diagram of the stages of periodontal disease

Whether or not you have certain risk factors that could increase your chances of developing gum disease, everyone should know what periodontal disease looks like. When you’re aware of the signs that it could be starting, you can reach out to your dentist and get the help you need to treat it.

Stages of periodontal disease

Stage one: 

When your gums are healthy, they are pink and firm, and you can see how snugly they fit around your teeth. They do not look swollen, nor are they painful to the touch.

If you’re in this stage of periodontal disease, you may notice that your gums are a little tender, and they may look a little redder than usual. 

If you do notice swelling or bleeding while you’re brushing your teeth, this is something you should pay attention to. If it is accompanied by persistent bad breath, it may be time to speak to your dentist. The good news is, when gum disease is caught in the early stage, it is reversible. A therapeutic dental hygiene treatment and check up at your dentist should take away the plaque and bacteria that are causing your gums to be inflamed. 

Stage two: 

If the disease is allowed to go unchecked, it will progress into stage two. At this point, you will notice that your gums are turning a darker color, and they may even be painful to the touch. When you brush or floss, you may also notice pain and even bleeding gums. 

Unfortunately, if periodontal disease reaches this stage, it is already irreversible, and it is crucial that you contact your dentist immediately, as they will need to do more than just clean your teeth and gums to get rid of the bacteria. At this point, the bacteria has multiplied and has invaded even more areas between your gums and teeth, and potentially it has already moved into your bone. 

Stage three:

As periodontal disease progresses, it becomes more aggressive. At this point your gums are swollen and red, and you may start to notice them receding from your teeth. This opens up even more space for bacteria to grow in, and could lead to the development of pockets where pus can develop. 

At this stage, your dentist will need to do a deeper cleaning in order to remove all the infected parts of the gum. WIth stage three periodontitis, the bacteria is starting to attack not only the tooth and gum, but also the jaw, which could lead to bone loss. This could cause your teeth to begin to shift or to loosen, increasing the chances that they’ll fall out or require extraction.

Stage four: 

Advanced periodontal disease is an infection that will eventually spread from your mouth and get into your bloodstream. This can have serious consequences on your immune system. At this stage, you will continue to experience painful gums, have difficulty chewing, see your gums recede, and develop severe halitosis. 

At this point the disease has done a lot of damage, and the results could be gaps in your teeth and lost teeth, which means you may need dental appliances such as dentures, bridges or implants. You are also likely to have bone loss in your jaw, and be at a higher risk of developing an infection elsewhere in your body.

It’s important to know the early warning signs of what periodontal disease looks like:

  • Plaque
  • Swollen gums
  • Redness in the gums

To summarize, gingivitis is a reversible gum infection. When left untreated, it can progress to periodontal disease. Failure to treat periodontal disease can lead to tooth loss.

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How can you avoid periodontal disease?

Gingivitis and periodontal disease are not something that you want to deal with. Although some people are at a greater risk of developing gum disease, there are things you can do to ensure you reduce your chances. If you have any specific questions about how to ensure you keep your chances of developing gum disease low, make sure you speak with your dental professional.

Practice good oral hygiene

This is one of the best ways to avoid gum disease, and is something that you can ensure you do daily. By removing the plaque each day that builds up, you’ll prevent the development of tartar, which if not removed, will eventually infect your gums and cause them to be inflamed. Dentists describe good oral hygiene as:

  • Brushing for two minutes each day, additionally after meals and snacks
  • Replacing your toothbrush every three months to ensure your brush is able to reach all your teeth and scrub effectively
  • Flossing daily
  • Using a mouth rinse
  • Consider using a dental pick or interdental cleaner to ensure you’re cleaning out all the spaces between your teeth

Increase your vitamin C intake

The bacteria in our mouth that form plaque thrive on sugar and starches. By eating a healthy diet that’s full of fruits and vegetables, you can help avoid periodontal disease. Your dentist may also recommend that you increase your vitamin C intake specifically. In addition to regular care of your teeth and gums, vitamin C can help promote healing and can boost your immune system.

Vitamin C is readily available in a variety of fruits such as oranges, strawberries, and in vegetables such as broccoli and brussel sprouts. You can also take a vitamin C supplement if your dentist advises you to. 

Stay hydrated

Staying hydrated is a good healthy habit to include in your everyday routine, but it may also help you reduce the chances of developing gum disease. This is because when you’re hydrated, you are able to produce the appropriate amount of saliva. Saliva can help clear your mouth after you eat or drink, and help eliminate food debris and bacteria in the meantime. 

Schedule regular dental visits

Ensuring you’re visiting your dentist at least twice a year is a great way to avoid periodontal disease. At your visits, your dental professionals will clean your teeth and remove any plaque or tartar build up. Your dentist will then inspect your teeth and gums to ensure there are no early warning signs of periodontal disease. 

If you have a history of periodontal disease in the past, your dentist may ask you to come in more than two times a year for checkups so they can be sure there are no signs of gum disease developing again. 

Don’t use/limit your use of tobacco

You can also avoid periodontal disease by stopping or limiting your use of tobacco products. Smoking and chewing tobacco greatly increase your chances of developing gum disease as well as other conditions. 

What are the best ways to treat periodontal disease?

female dentist with face mask on in the aspen dental office
Depending on what stage of periodontal disease you're at, your dentist has a few options. Remember, the earlier they catch the disease, the easier it will be to get rid of the infection. 

If you do happen to develop periodontal disease, depending on its severity, there are a few ways to treat it.

Early stages

If you start to notice redder gums and little sensitivity when you brush or floss, you may be experiencing the first symptoms of gingivitis. If this is the case, call your dentist and tell them about your symptoms. They will provide therapeutic gingivitis treatment, which includes scaling and medicaments to promote healing.

Remember, gingivitis is the only stage of periodontal disease that is reversible, but you’ll need to see your dentist. The sooner you get in to see your dentist, the higher your chances are of reversing the early stages of gum disease.

Middle stages

If you’re in stage I or II of periodontal disease, your dentist will need to have you come in so they can evaluate your situation. Then they’ll decide on the best course of action for you. This could involve:

  • Scaling. This procedure will ensure the plaque and tartar that have built up around the gum line are removed. Your dentist will typically use a laser or ultrasonic device for this. By getting below the gum line, your dentist can stop the growth of bacteria in these pockets and hopefully avoid additional infection. 
  • Root planing. In addition to scaling, root planing will smooth the surfaces of your tooth roots in order to limit the further growth of bacteria. This type of deep cleaning will also help the gum reattach itself to the tooth, and promote healing. 

In addition to scaling and planing, your dentist may also prescribe antibiotics to help your body fight the infection in your gums.

Later stages

If you are in stage III or IV periodontal disease, your dentist may need to employ additional methods to help rid you of the infection. 

  • Flap surgery. Flap surgery is done so that your dentist can lift back sections of your gums in order to clean them. This also exposes the roots and allows for a more thorough cleaning of these areas as well. 
  • Grafting. Because periodontal disease causes bone loss, your dentist may decide that you need to have grafting done. If your gums have receded due to the disease, they may decide to use a soft tissue graft to build up these weakened areas, reducing the chances of additional gum recession.

You may also need to have bone graft if the bone that surrounds your teeth has been lost. By ensuring the teeth have a solid base of bone, this will help prevent tooth loss in the future. 

Because permanent damage has occurred, you may need more frequent periodontal maintenance visits to keep your oral health in remission.

Smile by Design helps to keep you up-to-date on these visits and recommends treatments geared towards helping you maintain a healthy smile for a lifetime.

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