what is the difference between gingivitis and periodontitis

Gingivitis and periodontitis are two stages of the same process. Both start with plaque bacteria at the gumline. The difference is how deep the damage has gone, and that difference decides whether the problem can be fully reversed or only controlled.

Gingivitis: the gums are inflamed, the foundation is intact

In gingivitis, the gum reacts to plaque by becoming red, puffy and prone to bleeding. The fibres that attach the gum to the tooth and the bone underneath are still healthy. Once plaque and tartar are removed and daily cleaning improves, the gum returns to normal, usually within a couple of weeks. Nothing is permanently lost.

Typical signs: bleeding on brushing, slightly swollen gum edges, perhaps bad breath. Often no pain at all.

Periodontitis: the support around the tooth is breaking down

In some people, long-standing gingivitis moves deeper. The body's own inflammatory response, together with the bacteria, starts to break down the periodontal ligament (the fibres that hold the root in its socket) and the jawbone around the root. The gum detaches from the tooth and a pocket forms. That pocket fills with more bacteria and tartar that a toothbrush cannot reach, so the process feeds itself.

Typical signs of periodontitis:

• Gums that have pulled back, making teeth look longer.
• Persistent bad breath or a bad taste.
• Pus when you press on the gum.
• New gaps between front teeth, or teeth that have drifted.
• Teeth that feel loose or a bite that feels different.

Many people with periodontitis have no pain until it is advanced, which is why it is often found late.

How a dentist tells them apart

You cannot reliably tell which one you have by looking in a mirror. Your dentist uses a periodontal probe, a thin measuring instrument with millimetre markings, to measure how deep the gap between gum and tooth is at several points around each tooth. Healthy gum has a shallow gap. Deeper pockets, especially with bleeding, suggest periodontitis. X-rays then show how much bone has been lost and in what pattern. A digital RVG X-ray of specific teeth is usually enough, and a full-mouth OPG scan may be advised in some cases; if so, we will tell you where it is done and what it costs.

Why the difference matters to you

• Treatment. Gingivitis usually needs a scaling and better home care. Periodontitis needs deeper cleaning below the gumline, a re-check after healing, and sometimes gum surgery.
• Outcome. Gingivitis is cured. Periodontitis is controlled: bone that has been lost does not grow back by itself, although the disease can be stopped.
• Follow-up. After periodontitis you need regular maintenance cleanings for life, often every three to six months, because it can return.

One more thing people often miss

Not everyone with gingivitis goes on to develop periodontitis. Smoking, chewing tobacco, uncontrolled diabetes and family history all raise the risk. If one of these applies to you, take bleeding gums more seriously and get them checked rather than waiting. Our gum treatment page explains the options, and the MDS periodontics department handles advanced cases.