Gingivitis Vs Periodontitis: Key Differences, Symptoms and Treatments

You may have heard your dentist warn you about the dangers of gingivitis or periodontitis during cleanings. While these terms are often used interchangeably in dental offices, they are distinct from one another. Each has unique symptoms, diagnostic criteria, treatments, and indicators of gum disease severity.

Understanding the difference between gingivitis vs periodontitis can help patients avoid irreversible damage and improve their oral health. In this article, we will break down the differences between gingivitis vs periodontitis, highlighting their key features, symptoms, and treatments.

What is Gingivitis? 

Gingivitis is an inflammatory (but reversible condition of the gums. It primarily results from suboptimal cleaning of teeth that leads to plaque and tartar deposition. Poor oral hygiene habits allow bacteria to proliferate and create a biofilm, which leads to the development of inflammation. 

Apart from inadequate hygiene, some medications and systemic diseases also contribute to the disease’s development. 

Common causes of gingivitis include:

• Poor oral hygiene 
• Genetic predisposition
• Smoking and tobacco chewing
• Hormonal changes, such as pregnancy or the onset of puberty
• Systemic diseases like diabetes, HIV, etc
• Reduced salivary flow or xerostomia
• Drug-induced inflammation: antiepileptic drugs, calcium channel blockers, immunosuppressants, etc.

What is Periodontitis?

Periodontitis is an irreversible, advanced form of gum disease. This form of inflammation extends from soft tissue to underlying bone, periodontal ligament, and cementum of the tooth. Periodontitis is characterized by pocket formation and loosening of teeth because of attachment loss. 

It is more common in individuals below 30 years of age, but a certain form with genetic predilection can affect younger individuals, called aggressive periodontitis. 

Additional factors apart from calculus deposition that increase the risk of periodontitis are:

• Restoration overhangs and crown margins
• Systemic syndromes: Ehlers-Danlos syndrome, Kindler syndrome, Cohen syndrome.
• Severe systemic diseases: diabetes mellitus, cardiovascular disorders, and lung disorders. 
• Stress 

Symptoms and Characteristic Features of Gingivitis vs Periodontitis

Although both diseases share some common clinical features and may manifest under similar circumstances, gingivitis vs periodontitis have distinct clinical presentations.

Gingivitis:

Gingivitis typically presents with the following symptoms:

• Red, swollen gingival tissue
• Bleeding from the gums if brushing or flossing
• Persistent bad breath in spite regular cleaning 
• Mild recession of gums

Periodontitis:

Periodontitis exhibits all the symptoms of gingivitis along with some additional unique clinical presentations. These are:

• Periodontal pocket formation with a depth of 4mm or more
• Loosening or shifting of teeth if the disease progresses for a longer time
• Pain while chewing food
• Suppuration and pus between teeth and gums
• Recession of gums exposing the root surface
• Bone loss around the tooth is evident on a radiograph

Gingivitis vs Periodontitis: Management and Treatment Modalities

The diagnosis of the disease is established using both clinical and radiographic tools. Clinical signs such as bleeding on probing, color changes in the gums, probing depth, and recession provide an overview of the gingivitis, while pocket measurement and mobility of teeth are primary requirements for confirmation of periodontitis.

Radiographic evaluation is needed to determine the extent of periodontal involvement and bone loss. Proper diagnosis helps in curating a treatment plan based on the severity of the disease.

Treatment of Gingivitis

Fortunately, gingivitis is reversible and can be remedied once the triggering agent is removed. 

1. Professional dental cleanings: Scaling and polishing of the tooth surface to remove plaque and tartar deposited on the tooth surface. 
2. Oral hygiene maintenance: Brush twice daily with good fluoridated toothpaste along with regular flossing to remove debris from interdental areas.
3. Use of antiseptic mouthwash, preferably chlorhexidine mouthwash. Avoid prolonged use to prevent staining and taste alterations.
4. Regular checkups: Visit the dental office regularly for follow-ups on gum health and healing.
5. Cessation of habits like smoking and tobacco chewing.

Treatment Of Periodontitis 

Periodontitis involves more extensive damage compared to gingivitis, and hence, the treatment approach applied may be surgical or non-surgical, depending on the prognosis.

Non-Surgical Therapy

For mild-to-moderate periodontitis 

• Scaling and root planing are generally the first line of treatment for mild-to-moderate cases. 
• Periodontitis originating from a carious tooth or defective restorations/crowns requires restoration of the decayed part, and repair of faulty restorations or crowns can prevent further damage.
• Topical application or oral antibiotics can help with the removal of bacteria and healing.

Surgical Approach: Severe Form of Periodontitis

If the non-surgical therapy is not fruitful and the periodontal disease is extensive, surgical intervention is required.

1. Periodontal Flap Surgery: Flap surgery involves positioning the gums at a new height to cover the defects and eliminate periodontal pockets.
2. Osseous Resection Surgery: Areas with underlying bone defects need to be repaired either by reduction or removal. 
3. Regenerative Therapy: Guided tissue regeneration therapy promotes new tissue growth. Using particulate bone graft materials and enamel matrix derivatives, bone cells and periodontal ligament cells can be stimulated to regenerate tissue.
4. Furcation Therapy or Root Resection: When the roots of the teeth are damaged, furcation therapy and root resection can address the associated discomfort. These procedures encourage regeneration or removing an infected portion of the root.

Laser Therapy 

Laser-assisted therapies are becoming popular because of their conservative approach and minimal trauma. 

Prevention Tips for Periodontal Disease vs Gingivitis:

Daily plaque control is the first step toward the prevention of gum disease:

• Use a soft-bristled toothbrush for plaque biofilm removal.
• Floss regularly to maintain interdental hygiene. You can also use interdental brushes. 
• Quit tobacco in whatever form you are consuming.
• Consume a balanced diet rich in nutrients, especially Vitamin C, for better gum health.
• Get professional cleanings every 6 months.
• Keep systemic diseases in check.
• Keep your orthodontic or prosthetic appliances clean.

Final Thoughts: Gingivitis vs Periodontitis

Understanding the difference between periodontitis and gingivitis can be key to preserving your teeth and maintaining long-term oral health. Don’t wait until it’s too late. Healthy gums are the basis of a great smile and overall well-being. If your gums are bleeding, swollen, or look abnormal, consult your periodontal doctor immediately. 

Looking for a Periodontal Doctor Near You? 

If you live in Northfield, Red Wing, Owatonna, Rochester, or Winona, Minnesota, and need a consultation from an expert periodontist, Periodontal Specialists is here to help. We integrate new-age technology with personalized care to effectively address gum disease and restore your oral health.Schedule your initial consultation at your nearest center for a comprehensive gum health assessment.