Periodontal disease is a serious bacterial infection that affects the soft tissues and bone supporting your teeth. This condition can damage the structures holding teeth in place and, without appropriate treatment, may lead to tooth loss. It is a widespread issue, recognized as a primary cause of adult tooth loss globally. Periodontal disease is a progressive condition, gradually causing more significant damage to oral structures.
Stage I: Early Periodontitis
The initial stage of periodontitis develops when gingivitis, an inflammation of the gums, is left unaddressed. The infection begins to extend beyond the gum line, affecting the underlying bone and tissues. Signs include inflamed, reddish, and swollen gums, often accompanied by slight bleeding during routine brushing or flossing.
Initial bone loss occurs, affecting the coronal third of the root, less than 15% of the root length. Periodontal pockets, spaces between the teeth and gums, begin to form with probing depths ranging from 4 to 5 millimeters. These symptoms may not cause significant discomfort, making them easy to overlook, but early detection and intervention are important to prevent further progression.
Stage II: Moderate Periodontitis
As periodontal disease advances to Stage II, the damage becomes more pronounced. Bone loss progresses, affecting 15% to 33% of the root length. Periodontal pockets deepen, with probing depths reaching 5 to 6 millimeters. This deepening allows more bacteria to accumulate in areas difficult to clean with regular oral hygiene practices.
Individuals in this stage may experience more noticeable symptoms, such as increased gum recession, where the gums pull away from the teeth, exposing more of the tooth surface. Persistent bad breath, also known as halitosis, can become an issue due to bacterial activity. While teeth may begin to feel slightly loose, this mobility is not always visually apparent.
Stage III: Severe Periodontitis
Stage III periodontitis signifies a more severe level of destruction to the supporting structures of the teeth. Significant bone loss has occurred, extending beyond 33% of the root length or reaching the middle third of the root. Periodontal pockets become deeper, measuring 6 millimeters or more, making them challenging to manage.
Symptoms include obvious tooth mobility, where teeth may visibly shift or feel unstable. Gum recession is extensive, exposing a larger portion of the tooth root and potentially leading to increased sensitivity. The formation of dental abscesses, which are localized infections, may also occur, causing discomfort or pain when chewing. This stage involves the loss of one to four teeth due to the disease.
Stage IV: Advanced Periodontitis
Advanced periodontitis represents the most destructive stage of the disease, characterized by extensive damage to the supporting bone and tissues. Bone loss exceeds 60% of the root length, extending to the apical third. This severe destruction can lead to substantial tooth loss, including five or more teeth.
Individuals with advanced periodontitis face significant aesthetic and functional impairments. Severe tooth mobility, shifting of teeth, and difficulty chewing are common. The widespread damage necessitates complex rehabilitation, which may include complete tooth extraction and prosthetic replacements to restore oral function. This stage impacts an individual’s oral health and overall quality of life.