Gum disease is one of the most common oral health issues, with gingivitis and periodontitis being the most prevalent forms. Despite only a one-letter difference, there are fundamental distinctions between gingivitis and periodontitis.

Gingivitis

Gingivitis is an early manifestation of oral inflammation, usually caused by oral bacteria such as plaque and calculus buildup.

It is typically characterized by gum bleeding, with the gum color transitioning from pink to darker red.

Healthy gums should not bleed even with vigorous brushing or light probing.

However, during the early stages of gingivitis, bleeding may occur with gentle probing.

It appears earlier than changes in gum color and is more objective.

Thus, bleeding upon probing serves as an important diagnostic tool for determining the presence of gum inflammation.

Treatment often involves professional cleaning (commonly known as scaling), to thoroughly remove calculus and control plaque.

In cases of gum overgrowth, surgical removal may be necessary to restore the gums' natural shape.

After resolving gum inflammation and restoring gum morphology, maintaining oral hygiene through daily thorough brushing to remove plaque is essential to preserve and consolidate treatment outcomes.

Note: If left untreated, gingivitis may progress to invade deeper periodontal tissues, developing into periodontitis.

 

Periodontitis

Periodontitis is a chronic inflammation of the periodontal supporting tissues caused by local factors.

Its early symptoms resemble those of gingivitis, primarily manifested as swollen, bleeding gums. 

Bleeding may occur not only during brushing but also while speaking or biting hard objects, with the gums appearing dark red and shiny due to swelling.

Additionally, periodontal pockets form.

Normally, the attachment of the gums to the tooth in the gingival sulcus is only 0-2mm deep; any depth beyond 2mm constitutes a periodontal pocket.

The formation of periodontal pockets indicates that inflammation has progressed from the gums to the periodontal supporting tissues, infecting deeper periodontal tissues.

In severe cases, periodontal pockets may discharge pus due to infection.

In the early stages of periodontitis, teeth do not loosen.

Tooth mobility occurs only when chronic destructive inflammation progresses to a certain degree, significantly weakening the supporting tissues.

Gum recession is also a symptom of periodontitis, though patients often fail to notice it.

In cases of locally induced periodontitis, the appearance of horizontal recession along the gum margin is attributed to prolonged pressure from substantial calculus, stimulating gum recession.

 

Treatment of Periodontitis

Periodontal Treatment + Dental Cleaning

The treatment of periodontal disease is referred to as periodontal basic therapy, which includes oral hygiene instructions, supragingival cleaning, subgingival cleaning, and root surface smoothing.

Oral hygiene instructions teach patients effective brushing techniques and reinforce brushing habits and effectiveness during follow-up visits.

In severe cases of periodontitis, systemic periodontal treatment is necessary, comprising periodontal basic therapy, periodontal surgical treatment, periodontal disease restoration treatment, and periodontal maintenance treatment.

Periodontal disease cannot be cured, but its progression and deterioration can be controlled through treatment and maintenance.

In summary, the treatment of periodontal disease includes diligent daily maintenance, combined with regular periodontal maintenance treatment; both are indispensable.

 

Conclusion

Gingivitis is the early stage of periodontal disease, with the disease limited only to the gums, typically characterized by gum bleeding and redness, with no involvement of alveolar bone absorption.

Gingivitis is reversible after treatment, and the gums can return to a healthy state.

In contrast, periodontitis involves not only gum inflammation but also the absorption of alveolar bone below the gums, resulting in gum recession, exposing tooth roots, and other symptoms.

These changes are irreversible; once alveolar bone is absorbed, it will not grow back to envelop the teeth, ultimately leading to tooth loosening and loss.