Gum Disease: Gingivitis and Periodontitis – Treatment of Gum Disease at the Dentist, Protecting Your Gums, and Prevention

A gum disease is an inflammatory condition of the gums or the periodontal tissues. Medically speaking, it is an inflammation of the gums that initially begins on the surface and, as it progresses, can spread to deeper structures. Depending on the severity, a distinction is made between gingivitis and periodontitis.

The primary cause of gum disease is the buildup of dental plaque on the teeth. This plaque consists of food debris and microorganisms—particularly certain types of bacteria—that can trigger inflammation. If this plaque is not removed regularly, it leads to irritation of the gums.

Other contributing factors include poor oral hygiene, inadequate brushing, failure to clean between the teeth, smoking, hormonal changes, and certain systemic diseases.

Gingivitis is a common inflammation of the gums that is limited to the gum line. 

Healthy gums are light pink, firm, and do not bleed.

In contrast, when inflamed, the gums are dark red in color and bleed easily; swollen gums may occur, or bleeding may happen, for example, while brushing.

This bleeding prevents the teeth from being cleaned thoroughly enough. As a result, plaque can continue to build up, which in turn promotes the progression of the disease.

With consistent dental care, improved oral hygiene, and, if necessary, professional teeth cleaning at the dentist’s office, gingivitis can usually be completely cured.

Hormonal changes (estrogen levels) during pregnancy can lead to a specific form of gingivitis known as pregnancy gingivitis. After pregnancy ends, it usually resolves within two to three weeks.

In cases of gum disease, the gums are usually inflamed and appear dark red © Марина Демешко | AdobeStock

If gingivitis remains untreated, the gum inflammation can progress deeper into the tissues. Periodontitis (also known as periodontal disease) develops. This affects not only the gums but also the entire periodontal ligament. There is a risk of tooth loss.

The inflamed gums pull away from the surface of the tooth neck. Gum pockets form, which are quickly colonized by bacteria because a toothbrush cannot reach them. The plaque that forms calcifies beneath the gums into tartar.

As a result, the bone and supporting structures of the tooth are broken down. This leads to loosening of the teeth and ultimately to tooth loss. Often, additional symptoms include receding gums, bad breath, and exposed tooth necks.

The tooth begins to loosen more and more and eventually falls out.

Despite the bone loss, the gums may remain at their normal level. However, they may also shrink: in this case, the teeth appear longer.

Periodontitis usually progresses relatively slowly in adults.

Juvenile periodontitis occurs between the ages of 12 and 20 and progresses very rapidly. It often takes only a few months before teeth are lost.

Fortunately, this condition is very rare (about 0.1 percent).

A similar inflammation with comparable symptoms can also occur around dental implants. This condition, known as peri-implantitis, affects the tissue surrounding a dental implant and requires targeted treatment to preserve the implants.

The goal of periodontal therapy is to protect the periodontium from further damage and thereby preserve the teeth and their function. In addition, the aim is to promote regeneration of the periodontal tissue. Treatment is individually tailored by a dentist.

Treatment is carried out in several stages. The patient can play a decisive role in its success through exemplary oral hygiene. At the start of treatment, patients receive detailed instructions on regular dental care at home.

First, the dentist assesses the exact extent of the gum disease. This is done using X-rays and periodontal probing. This method allows the depth of the gum pockets and the extent of inflammation to be measured using a special probe that is guided along the tooth.

A saliva test provides more detailed information about the types of bacteria present there.

Such a comprehensive diagnostic evaluation also includes an assessment of the overall condition of the dentition.

In the first phase of treatment, hard and soft dental plaque is thoroughly removed (professional teeth cleaning). Restorative treatment of the teeth may also be necessary. 

Following this, the actual treatment of the bacterial foci located below the gum line begins. Depending on the findings, an antibiotic may also be prescribed. In severe cases, surgical intervention is necessary to prevent further deterioration of the periodontal tissues. Consistent follow-up care is crucial.

The treatment is performed under local anesthesia. The dentist then cleans the areas inside the gum pockets of plaque. To do this, he uses

• special scrapers (curettes),
• ultrasonic or
• laser devices

. This method is called subgingival scaling or closed curettage.

Sometimes the pockets are very deep, or closed treatment has proven unsuccessful. In such cases, surgical treatment may be necessary. With this open form of treatment, the areas beneath the gums are exposed and cleaned again under direct visualization.

In addition, severely damaged areas can be treated with bone substitute materials or membranes. This supports the regeneration of the periodontal tissues.

The most effective method for preventing gum disease is consistent oral hygiene. The goal is to permanently reduce bacterial plaque and prevent inflammation.

This includes:

• thorough brushing twice a day
• Cleaning between teeth with dental floss or interdental brushes
• regular checkups at the dentist
• regular professional cleanings as part of preventive care

This is how you can maintain good oral health in the long term.

The most common gum diseases are gingivitis and periodontitis.

Yes, bleeding gums are an early sign of gum inflammation.

Consistent oral hygiene, regular checkups, and professional teeth cleanings can significantly reduce the risk.

Certain types of bacteria in dental plaque trigger inflammation and accelerate the progression of the disease.

Depending on your individual risk, it’s recommended to visit the dentist 1–2 times a year.