Gum Disease Stages: Causes And Effect


Gum disease also known as periodontal disease, happens when there is infection to the gums and associated bone structure. Periodontics is the dental specialty that takes care of the supporting and surrounding tissues of teeth and dental implant.

Gum disease can occur at any age, and is the most prevalent in adults. Causation can be categorized into two groups – dental plaque related and non dental plaque related. The risk factors for gum disease development include:

  1. poor oral hygiene
  2. pregnancy (hormonal changes can affect blood flow to the gums
  3. uncontrolled diabetes
  4. use of certain medication such as phyentoin
  5. individuals with systemic conditions (HIV infection, malnutrition and immunosuppression etc)
  6. unclean tooth appliances (dentures, even that yucky toothbrush we have used for years!)
  7. misaligned tooth structures that causes gum irritation

 Below we will share with you the different gum disease stages.



Gingivitis is the weakest form of gum disease. We can tell if a person have gingivitis if his gums have become red and possibly sore and tender. Another sign could be when gums easily bleed during flossing and brushing. Gingivitis is the inflammation of the gum structure.The early stage of gingivitis is reversible as no gum or tooth structure is permanently injured.


The gingiva, when not properly cleaned, is very susceptible to bacterial accumulation, that facilitates the formation of plaque and tartar. The spaces between teeth are common places for gingivitis development because of the sheer difficulty in reaching those places. The bacteria in the plaque produces toxin that causes an inflammation response from the body. As gingivitis is usually not painful, people may not be aware when they develop it. Gingivitis precedes periodontitis, but not all gingivitis develops into periodontitis.





If left undetected, the gum infection will worsen into periodontal disease (periodontitis).


What happens is, in response to the prolonged attack by the toxins produced by the bacteria in plaque, the gums will start to pull away from the tooth structure, forming deepened spaces called pockets. The breath is usually foul due to the constant presence of bacteria overgrowth. Treatment at this time can stop further damage. However, if it is allowed to further progress, the periodontitis will become more advanced. These pockets become wells for the bacteria and toxin to accumulate, causing structural damage to the bone and gum structure. The tooth socket that holds the teeth may disintegrate so much that the affected tooth falls out. Structural losses are usually irreversible. When treatment cannot save the tooth, it may be removed and be substituted with dentures.


There are a few kinds of periodontitis-

 1. Aggressive periodontitis:


Often found in younger people, aggressive periodontitis progresses faster than chronic periodontitis, often leading to bone and tooth loss. It is linked to the presence of this specific strain of bacteria – aggregatibacter actinomycetemcomitans (Aa). It has been suggested that aggressive periodontitis is correlated with higher chances of heart disease and stroke.


 2. Chronic Periodontitis


The chronic inflammation of the gums and surrounding tissue. It is the most frequent form of periodontitis.

It usually occurs slowly, and is found most often in people between ages of 50s-60s. Chronic periodontitis is annoying due to the array of presenting symptoms such as bad breath, nagging dull gum pain, metallic taste in mouth etc.

A recent study has found that men in their thirties with chronic periodontitis are three times more likely to have erection problems. Perhaps the bad breath is also a big turn off?


3. Systemic disease related periodontitis

Often occurs in younger ages, research has shown that development of periodontitis can also be a symptom of body wide systemic disease such as cardiovascular disease, type 2 diabetes mellitus, stroke, pregnancy outcomes such as low birth weight infants, and osteoporosis.


4. Necrotizing periodontitis


Also known as trench mouth.

It is an infection distinguishable by death of gingival tissues, periodontal ligament and alveolar bone. It is often found in people whose immune systems are suppressed (lymphoma, HIV, etc), or malnourished individuals.


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