What’s the difference between Gingivitis & Periodontal Disease?

This is a simple question, but patients are often confused by the difference. This is often because dental offices don’t do a good job explaining the difference.  Sadly, periodontal disease is still one of the most under-diagnosed and under-treated diseases in the United States.  Part of the reason for the lack of treatment does come from the lack of proper diagnosis.  The other part is, many patients believe that treatment for periodontal disease is too uncomfortable or that it doesn’t work very well.  Fortunately, we now have a genuine treatment that both works and is comfortable: Laser Periodontal TherapyTM.  Still, it is important to understand the difference between gingivitis and periodontal disease.


In the simplest terms, gingivitis is inflammation of the gums, caused by a build-up of plaque around the teeth.  It happens quickly, if you don’t regularly brush and floss. Think of it like a paper cut on your skin: it gets red, irritated, sore, and may bleed a bit, but if you take good care of it by putting ointment on and a bandaid (the equivalent of good brushing and flossing), it will go away quickly.
What do you need to do to cure gingivitis?

  1. Brushing at least twice/day
  2. Flossing at least once, preferably twice/day, with good technique, and possibly
  3. Using a non-alcohol-based, fluoride mouthrinse.

If left untreated, gingivitis can progress to become periodontal disease if there are other contributing factors, but it does not automatically do so, and it can be reversed with improved care of your teeth and gums.

Periodontitis (Gum Disease)

Periodontal Disease is not just inflammation, but genuine infection, which means that the bacteria that have built up in the plaque, in the tartar, and in the gum tissue have reached a level at which the body’s immune system can no longer contain or reverse the infection.  There are several ways to determine how advanced the infection is:

  1. Measuring how well the gums are attached to the teeth by using a little ruler, called a periodontal probe, that tells how deep the pockets around the teeth are.  In general, as long as the pockets are 3mm or less, that is considered to be healthy.  If the pockets are 3mm or less with bleeding, this usually indicates gingivitis. Once the pockets are 4mm deep or greater with bleeding and even pus, then periodontitis is the correct diagnosis.  There are reasons why 4mm or even deeper pockets do not necessarily mean there is active gum disease, but pocket depth is one of the most reliable diagnostic methods.
  2. Assessing the amount of calculus, also known as tartar, that is visible on x-rays and can be felt with instruments.  Given how much tartar must be present for it to show up on x-rays, if large pieces can be seen on x-rays, that is an indication that gum disease is present.
  3. Bone loss.  When gum disease starts getting moderately advanced, the bacterial by-products and your body’s immune system get locked into a serious battle, with the resulting chemicals and enzymes causing bone to be destroyed.  We evaluate bone loss on x-rays.  Once bone has been destroyed, it is very difficult to regenerate, and only 1 treatment has been shown to consistently stimulate bone growth: LANAP, or Laser-Assisted New Attachment Protocol.

Here’s the thing to remember about Periodontal Disease: because your mouth is connected to the rest of your body, the bacteria that cause chronic gum disease do get into your blood stream and spread throughout your body.  These bacteria and the inflammatory products they create have been associated with an increase in the risk of heart attack, stroke, diabetes, and more.  Bear in mind – that does NOT mean that gum disease causes those conditions, and we’re not even sure if it’s purely coincidental.  However, it is a chronic infection in your mouth, and that’s obviously bad.  It’s not just your teeth at risk – it’s your total health.  If you’re concerned you have gum disease, see if you have any of these signs/symptoms:

  • Bleeding gums when brushing or flossing
  • Mouth sores
  • Bright red, red-purple or shiny gums
  • Gums that are tender to the touch
  • Constant bad breath that does not go away

To make an appointment for a Complimentary Consultation:

Request an Appointment Online or call us at 704-364-7069.

We’ll look forward to meeting you soon!

Back to blog home