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What Are the Stages of Gum Disease?

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Dr Teresa Li
April 23, 2024

Gum disease is the inflammation of the soft pink gum tissues as a result of bacterial infection from the plaque on our teeth.  It’s not only the leading cause of tooth loss in adults but also places you at greater risk of heart attack and stroke among other serious health problems. 

With this in mind, you shouldn't ignore bleeding, swollen, puffy gums. 

There are 3 stages of gum disease that I’ll explain in this article:

  1. Gingivitis
  2. Periodontitis
  3. Advanced periodontitis

I’ll also cover the:

  1. Symptoms of gum disease 
  2. Treatment options at each stage 

Gum Disease - More Common Than You Might Think

Almost 36% of Australians aged 45-64 have some form of gum disease.  This increases to 53% for those aged 65 and up. Gum disease is fairly common and with age the chances of having some form of gum disease increase. 

But it’s not all doom and gloom.  Today we have many options for treating gum disease.  With swift action, there’s an excellent chance you can treat your gum disease.  

The Three Stages of Gum Disease

Gum disease doesn’t happen overnight.  It’s a progressive disease. 

Plaque (or calculus) builds on our teeth when food and saliva mix. Left on the teeth too long it starts the inflammatory process of gum disease.

Here’s the best way to understand it:

  1. Gingivitis - Plaque harbours bacteria and this bacteria leads to inflammation of the pink gums and the early stages of gum disease.

  2. Periodontitis - As more plaque and bacteria accumulate the inflammation worsens.  The gums swell and “pockets” (gaps) form between the gums and teeth. Some bone loss will happen around the teeth too.  [Image 3]

  3. Advanced Periodontitis - In the advanced stages of gum disease, the gums have significantly detached from the tooth roots and there is an advanced bone loss.  Teeth become loose or fall out completely.


Is the earliest stage of gum disease. 

If you have gingivitis, you may have swollen or puffy gums. They may also become red and tender.

Another early sign of gingivitis is bleeding gums when you brush or floss your teeth. Other problems could lead to bleeding gums too so it’s best to check with your dentist.

At this stage, the bacterial infection is mild and hasn't damaged the ligaments and bone that houses and protects our teeth.

Because there’s no damage to the bone or tooth ligaments, it’s most likely completely reversible.  Great news, right?

Treating Gingivitis

A visit to your dentist for a professional scale and clean will remove the bacteria and plaque build-up on your teeth. 

Your dentist may recommend specific home care instructions as plaque build-up is the cause of gingivitis, it's essential that you brush and floss twice daily. 

To stop plaque build up stick to regular professional cleans. Everyone gets some plaque build up, this applies no matter how well you brush and floss. 

It's also worth mentioning that depending on your genetics and other factors, you may get more than others.  If you have a family history of gum disease, let your dentist know. 


Periodontitis is a more advanced form of gingivitis. 

Prolonged inflammation of the gums due to untreated gingivitis and plaque build-up causes the gums to separate from the tooth and form a gap.  

This gap (called a “ periodontal pocket”) traps food, plaque and bacteria leading to further infection, bone loss and more gum detachment.

While the periodontitis can be managed the bone loss and tissue damage caused by the disease is often irreversible.

Treating Periodontitis

Periodontitis is a more involved treatment process compared to gingivitis but still has excellent success rates.  

To manage periodontitis your dentist will do special cleans (called “root planning”) to remove plaque beneath the gums.  It’s done with a combination of hand scaling instruments and gentle ultrasonic equipment.

These cleans take a little longer than a normal hygiene appointment and will likely be spaced 3 months apart until your condition is under control.

While this can all sound a bit scary, the truth is, today's dental instruments are more advanced and therefore more gentle than ever.  

At TL Dental even our numbing technology is so advanced it’s virtually pain-free.

With your permission, we’ll numb your gums with "the wand".  Our computer-assisted system that gently anaesthetises.  Most patients that experience the wand are surprised they don’t even notice.  This is super helpful for those that have a bit of dental anxiety (and if you do, don’t worry, you’ll be reassured every step of the way to give you the best, anxiety-free experience).

You’ll need to be extra vigilant about your oral hygiene and keep to regular check-ups with your dentist to avoid a recurrence of gum disease.

3. Advanced Periodontitis

During this stage, the bone and ligaments that support your teeth become quite damaged and stop functioning as they should. 

With advanced periodontitis, there is significant lost loss around your teeth and teeth will loosen, shift, and even fall out. This will affect your bite and make eating difficult and painful.

Treatment for Advanced Periodontitis

If you get advanced periodontitis, you will need advanced dental treatment that can involve surgically adding gum and bone around your teeth. 

This treatment is then followed by regular maintenance appointments with your dentist and a personalised home care regime to keep the bacteria levels in your mouth down.

Your dentist will likely work with a gum specialist in planning this type of treatment for your best outcomes.

If your dentist and/or gum specialist (Periodontist) believe this type of treatment won't work for you, they’ll recommend removing one or more teeth.  

After tooth removal there are some options to consider to replace your missing teeth including dental implants, implant supported dentures or dentures.

How to Know If You Have Gum Disease?

Adults are most likely to get gum disease. That said, some children may suffer from the condition, especially in cases of malnutrition. This can happen in conjunction with certain other medical conditions too.

The key to controlling and avoiding gum disease is to act early and swiftly. This will not only save your teeth but also money and time on additional treatments.

If you suffer from any of the symptoms below, book an appointment straight away:

  • Swollen, red, and tender gums

  • Bleeding during flossing or brushing

  • Receding gums

  • Pockets on your gums from where your teeth have pulled away
  • Noticeable changes in the alignment of your teeth when you bite or chew food
  • Pus or fluid seeping from your gums or around your teeth
  • Bad breath or a bad taste in your mouth

Some autoimmune diseases can lead to gum disease. Autoimmune diseases affect more than 1 million people in Australia and the rest of the Western World. 

Autoimmune diseases that affect the mouth, saliva, and swallowing include but aren't limited to:

  • Sjogren's syndrome

  • Crohn's disease
  • Systemic lupus erythematosus
  • Psoriasis
  • Hashimoto's disease
  • Scleroderma

Unfortunately, the number of people with autoimmune diseases is growing. As a result, so is the number of people with gum disease.

If you’re worried about your bleeding gums get a dental check-up at TL Dental

With early intervention, we can control or even reverse your gum disease reducing the chances of tooth loss or more extreme forms of treatment. 

If you have any of the signs of gum disease listed above, get on top of it early by scheduling a visit.

At TL Dental Port Macquarie dentist, we are preferred providers of HCF, Medibank, and NIB, among others. With this in mind, there's a good chance that your private health insurance will cover most, if not all of your treatment.

Call us today on 02 6583 4055 or book online now.

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