What are Different Gum Disease Stages?

gum disease stages

Gum disease, also known as periodontal disease, is the infection of tissues that support and surround the tooth. In gum disease, the gums become red, swollen, and bleed easily. Various gum disease stages are gingivitis, periodontitis, and advanced periodontitis.

Periodontal disease is majorly caused due to the formation of a colorless, sticky film of bacteria over the surface of the tooth. This colorless less film of bacteria is known as plaque, which hardens over time and forms tartar. Plaque is formed on teeth due to poor oral hygiene, like poor brushing and flossing.

Removal of plaque is necessary or else it leads to inflammation of gums. Because of lack of pain in the initial stages of gum diseases, you may not realize that you have it, which in its advanced stages can cause severe damage to the tooth. (1)

Gum disease stages

The initial stage of gum disease begins with the formation of plaque, which infects gums. As the disease advances due to lack of proper treatment, it damages the supporting structures of the tooth which may lead to loss of the tooth.

Gum disease stages are categorized into three phases as gingivitis, periodontitis, and advanced periodontitis.


Gingivitis is the very initial stage of gum disease. If the plaque formed on the tooth is not removed correctly by brushing and flossing, it releases toxins Causing irritation, redness, and swelling of your gingiva near the gum line.

This stage is reversible because at this stage the infection is restricted only to gums and no damage is done to the alveolar bone and periodontal fibers.

You may also notice bleeding of gums during brushing or flossing. It is crucial to take gingivitis seriously because it might lead to severe diseases like periodontitis and tooth loss.

Gum diseases stages infographic


When the gingivitis is left untreated, it advances to periodontitis. In periodontitis, the infection reaches to periodontal fibers. The toxins produced by bacteria starts destroying the periodontal ligament and can also damage the alveolar bone.

In this stage Gums separate from the teeth, forming gum pockets (spaces between the teeth and gums) that become infected due to trapping of food and plaque in the gum pockets. This damage to gums and supporting structures of the teeth are irreversible.

Few types of periodontitis are mentioned below –

Aggressive periodontitis

The Aggressive periodontal disease occurs in localized and generalized forms. The rapid loss of gum attachment characterizes it, loss of the bone tissue, and familial aggregation is seen.

The aggressive periodontal disease affects people who, in most cases, otherwise appear healthy but a smoker and those with a family history of aggressive periodontitis are more prone to this disease.

Chronic periodontal disease

The chronic periodontal disease is a chronic inflammation of the periodontal tissues, characterized by inflammation below the gum line and the progressive destruction of the gingival and bone mass.

It may appear that the teeth are gradually growing in length, but in actuality, the gums are progressively receding apically.

Necrotizing periodontal disease

This disease is rear and is characterized by ulceration and necrosis (death of tissue).  People suffering from HIV, immunosuppression, malnutrition, chronic stress or choose to smoke more likely to get affected by this disease.

This form of gum disease progresses quickly and worsens rapidly. Necrosis frequently affects the periodontal ligament, gingival tissues, and alveolar bone. (2)

Advanced periodontitis

The final stage of gum disease is advanced periodontitis. In this stage, the periodontal ligament and the alveolar bone get destroyed making the tooth mobile.

Saving the tooth at this stage is very difficult, but Proper treatment might save the damaged tissues and if not then teeth may need to be extracted.

How do I know if I have gum disease?

Initially, in gum disease, there are not many symptoms, but as the illnesses advance various changes are seen in gums and tooth-like,

  • Gums bleed while brushing and flossing.
  • The gums become red, swollen and tender.
  • Gums are pulling away from the teeth forming gum pockets.
  • Gums recede increasing the size of the crown of the tooth.
  • Persistent bad breath is coming from your mouth.
  • Change in position of teeth due to losing support.
  • Change in the fitting of the dentures on each other and in the way your teeth fit together while chewing.

Treatment for different gum disease stages

Treatment of gum disease aim on the removal of plaque formed between the teeth and to decrease the existing oral infection. Different methods are there for removal of plaque mechanically and chemically.

Scaling and root planning

Scraping off the plaque, Tarter, and food particles from the surface of the crown and root of teeth by a professional dentist or dental hygienist, and then smoothing away any roughness on the sources, because bacteria can gather in the irregularities of the surface of the tooth.

Pocket Reduction Procedure

If the gum tissue is pulled away from the tooth and you are unable to keep the pocket area clean then, by folding back the gum tissue, your dentist or periodontist can remove infectious bacteria and the smooth regions of damaged bone. (3)


Treatment with antibiotics, such as metronidazole or amoxicillin, may be recommended if you have Advance periodontitis. You’ll usually have to take these antibiotics for at least three days to see useful results. (4)

Gum Grafts

The gum grafts are gum tissues that are made from palate or other sources, and they are used to cover the root of the tooth with receded gum. (5)

Periodontal maintenance or supportive periodontal therapy

Gum diseases can occur again, so proper care of periodontal ligament and be practicing good oral habits is necessary to minimize the risk of recurrence or progression of gum disease.

Final words on gum disease stages

Practicing good oral habits improves the damaged gums and prevents all gum disease stages. Brushing correctly your teeth twice a day and flossing at least once a day will reduce plaque formation on your teeth and will prevent it from infecting your gums.

Periodontitis can cause other dental problems, and it can also spread to other body parts.

You can treat gingivitis with proper dental care at home and by visiting your dentist regularly. A regular visit to your dentist or dental hygienist will help in early diagnosis and adequate treatment of any gum disease stage.