Stages

Below you will see five illustrations of a cross section of a tooth, the outer gingival or gum tissue, the inner connective tissue that supports the tooth and a depiction of a graduated probe being inserted into the crevice or periodontal ‘pocket.’  The probe measures the pocket depth, giving the hygienist an idea of the severity of the decayed area.  The redder color of the gum tissue at the neck of the tooth indicates inflammation, which increases with the severity of the condition.  Notice how connective tissue is being destroyed during the progression.  Periodontal disease is a separate issue from caries or ‘tooth decay’ and caused by the infection of different pathogens, although lack of proper and thorough oral hygiene will promote the disease process in either case – and one can certainly exist without the other. For this reason, many may feel that, because they are not or no longer developing cavities, their oral health is not at risk.  However, studies show that between 75% and 95% of all adults are suffering some stage of periodontal disease.

The purpose of this page is to give you a general guide to compare with your personal condition.  Keep in mind that, naturally speaking; we have 32 teeth, so your own inspection and monitoring shouldn’t be some sort of passive activity if you are interested in the health of your mouth and body.  It is, however, well worth the effort and time on your part.

Periodontal_Images

Stages of periodontal disease or gum disease

1.  Healthy Teeth and Gums

In healthy gums, the gingival or gum tissue is a pink or coral color.  The tissue is firm and resilient and there will be minimal, if any, crevice or pocket depth.

2. Gingivitis

At the stage referred to as ‘gingivitis’ the gingival or gum tissue will be inflamed at the neck of the tooth, as opposed to the pinkish color indicated in #1.  There will be some pocket depth and gingival bleeding on probing (BOP).  There will not be any deterioration of supporting tooth structure.

3.  Early Periodontitis

Inflammation of periodontal ligaments and minor loss of attachment or pocket development. No tooth mobility at this stage. No connective tissue loss.

4.  Moderate Periodontitis

Moderate loss of attachment and/or moderate to deep pocket formation. 30%-50% loss of bone support and slight tooth mobility.

5.  Advance Periodontitis

Advanced breakdown of supporting periodontal tissues. Severe pocket depth or significant gingival recession. Severe loss of attachment. Greater than 50% loss of bone support and considerable tooth mobility.