Gum Disease: Detection and Treatment

Gingivitis versus periodontitis

Gingivitis is inflammation limited to the gum tissue itself, presenting as redness, puffiness and bleeding when brushing or flossing. It is caused by plaque accumulating along the gumline and is fully reversible with professional cleaning and improved daily hygiene, usually within one to two weeks.

Periodontitis is the more advanced stage, in which the supporting bone and ligament around the tooth begin to be destroyed by ongoing inflammation. It produces gum recession, persistent bad breath, spacing between teeth, increasing tooth mobility and, if untreated, eventual tooth loss. Bone lost to periodontitis does not regenerate on its own once destroyed.

The transition from gingivitis to periodontitis is not inevitable, but it becomes more likely the longer inflammation is left unaddressed, which is why early detection during routine check-ups is so valuable.

How gum disease is diagnosed

A periodontal examination measures the depth of the small groove, or pocket, between the tooth and gum at several points around each tooth using a calibrated probe. Pockets deeper than three millimetres, particularly if they bleed on probing, indicate active disease.

X-rays reveal the level of bone support around the roots, allowing the dental team to distinguish between early, moderate and advanced periodontitis, which in turn guides how intensive the treatment plan needs to be.

Treatment stages

The first stage is scaling and root planing, a thorough professional cleaning that removes hardened deposits and bacterial biofilm from below the gumline, often performed under local anaesthesia for comfort in deeper pockets. Re-evaluation follows at six to eight weeks to assess healing.

Persistent deep pockets that do not respond fully to non-surgical cleaning may need flap surgery to access and clean root surfaces directly, guided tissue regeneration, or bone grafting in areas of significant bone loss. These procedures aim to reduce pocket depth and make long-term maintenance achievable.

Once active treatment is complete, maintenance cleanings every three to six months, tailored to the severity of the original disease, continue indefinitely, since periodontitis is a manageable but not fully curable condition that requires ongoing control.

The systemic link

Periodontitis is associated with poorer blood sugar control in people with diabetes, an elevated risk profile for cardiovascular disease, and adverse pregnancy outcomes including preterm birth in some studies. The relationship appears to run in both directions, with each condition capable of worsening the other.

Treating gum inflammation is therefore best understood as part of general health management rather than a purely dental concern, and is one of the reasons physicians increasingly ask about gum health during broader medical assessments.