Periodontitis, Periodontal Disease, and Symptoms: Which Treatments Are Effective and How Periodontitis Is Treated

The German Society of Periodontology (DG PARO) distinguishes between different forms of periodontitis. In addition to the chronic form, there is aggressive periodontitis, which progresses more rapidly and frequently affects younger people.

The stages of periodontitis range from early inflammatory changes to severe periodontitis with significant bone loss. 

In advanced periodontitis, large portions of the bone are already affected. The individual course of periodontitis depends heavily on general health factors and the timing of treatment initiation.

The development of periodontitis is multifactorial; the most important risk factors for periodontitis include:

• poor oral hygiene
• significant plaque and tartar buildup
• genetic predisposition
• a weakened immune system
• systemic diseases such as diabetes mellitus
• Smoking as a key risk factor

These factors can contribute to periodontitis and significantly increase the risk of developing it. People with periodontitis often exhibit several of these risk factors.

Typical signs of periodontitis include:

• red, swollen gums
• recurrent bleeding gums
• bad breath
• Receding gums
• Loose teeth

Early symptoms are often painless. This is precisely why the disease is often diagnosed late. Periodontitis is frequently diagnosed only after bone loss has already occurred.

Periodontitis is usually a slowly progressive disease, but in certain cases it can progress rapidly.

Diagnosis is the foundation of all dental treatment. The dentist first assesses the clinical condition of the teeth and gums.

X-ray Examinations for Periodontitis

X-rays for periodontitis allow for the assessment of bone loss in the jawbone. However, changes only become visible once the disease has already progressed. Therefore, X-rays are primarily used today to monitor the disease’s progression.

An X-ray of the jaw provides a good way to assess the condition of the teeth © Massimo Cattaneo | AdobeStock

Periodontal Screening Index (PSI)

This index was established by the German Society of Periodontology. Using a special WHO probe, the dentist measures the depth of the gum pockets.

The severity of the condition is determined using defined codes. The PSI enables early identification and is part of the statutory preventive care program.

aMMP-8 Rapid Test for Periodontitis

A modern method is the aMMP-8 rapid test, which can detect active inflammatory processes. The enzyme is released during tissue breakdown and allows for a detailed assessment of disease activity.

Periodontitis is treated in stages according to current guidelines for the systematic treatment of periodontitis. The goal is to reduce pathogenic bacteria and stabilize the periodontal tissues.

Initial Phase

The process begins with a thorough dental cleaning. This removes both hard and soft dental plaque. A professional dental cleaning is essential for eliminating superficial plaque.

In deeper areas, mechanical cleaning of the root surfaces is performed. These measures are part of active periodontitis treatment.

Good oral hygiene helps preserve teeth and prevent periodontitis © Prostock-studio | AdobeStock

Follow-up Therapy

In cases of more severe findings, more intensive treatment may be necessary. So-called systematic treatment involves subgingival scaling, supplemented by antibiotic therapy if necessary.

This structured therapy complies with current guidelines and is performed entirely by a dentist.

If periodontitis is treated, bone loss can often be halted. However, successful treatment requires consistent follow-up care.

After active treatment is completed, regular monitoring of the progression of periodontitis remains crucial. Without supportive measures, existing periodontitis can become active again.

Untreated periodontitis leads to progressive tissue destruction over the long term. Therefore, ongoing care by a dentist is essential.

The link between periodontitis and systemic diseases has been scientifically studied. The relationship between periodontitis and cardiovascular diseases is particularly relevant. Chronic inflammatory processes in the tissues can contribute to changes in the inner walls of blood vessels, which can lead, for example, to a stroke or heart attack. There is a close link between rheumatism and periodontitis, as both conditions are characterized by chronic inflammatory processes and similar immunological mechanisms contribute to tissue destruction.

In addition, periodontitis influences the risk of metabolic diseases such as diabetes; conversely, poorly controlled diabetes also hinders healing.

This makes it clear that periodontitis can also have an impact on overall health. 

Periodontitis During Pregnancy

It has been known since the 1990s that severe gum inflammation during pregnancy can endanger the unborn child. Hormonal changes promote periodontitis, as the gums receive increased blood flow and are more susceptible to bacterial colonization. If pathogens enter the uterus via the bloodstream, the risk of miscarriage and preterm birth increases significantly—and untreated periodontitis substantially raises this risk.

In addition to consistent oral hygiene, pregnant women should therefore visit both their OB-GYN and their dentist regularly to prevent and treat periodontitis early on.

Consistent oral hygiene is crucial for preventing periodontitis. Brushing your teeth twice a day, cleaning between your teeth, and regular checkups effectively reduce bacterial load over the long term.

Regular professional dental cleanings further support prevention. By following these measures, you can actively prevent periodontitis and lower your individual risk of developing the condition.

What is the difference between gingivitis and periodontitis?

Gingivitis is a superficial inflammation of the gums. Periodontitis also affects the periodontal tissues and can lead to bone loss.

Is periodontitis curable?

Complete regeneration of the destroyed bone is usually not possible. However, if the onset of periodontitis is detected and treated early, the progression of the disease can be halted and stabilized.

How does the treatment work?

First, the teeth are professionally cleaned and plaque is removed. This is followed by a structured periodontitis treatment plan in accordance with current guidelines.

What happens without treatment?

Untreated periodontitis causes progressive bone loss, loosening of the teeth, and ultimately tooth loss.