Merck Manual

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Quick Facts




The Manual's Editorial Staff

Last full review/revision Oct 2019| Content last modified Oct 2019
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What is periodontitis?

Periodontitis is severe gum disease that can make your teeth loose or fall out.

  • Infection weakens the tissue that holds your teeth in place

  • Symptoms include sore, swollen or bleeding gums, bad breath, and loose teeth

  • Dentists treat periodontitis with repeated cleanings, dental surgery, and/or antibiotics

  • Periodontitis is one of the main causes of tooth loss in adults

What causes periodontitis?

Periodontitis is a severe form of gingivitis. Gingivitis is caused by plaque. Plaque is a sticky film full of germs that builds up on your teeth. Plaque that stays on your teeth for more than a few days and hardens is called tartar.

The buildup of tartar on your teeth below the gums causes periodontitis. The tartar irritates your gums and allows germs to grow. First, this causes gingivitis. If you don't get treated, the germs eventually weaken the tissue and bone that hold your teeth. Then your teeth get loose and eventually fall out.

You usually get periodontitis from:

  • Not brushing and flossing enough

  • Not getting regular cleanings at the dentist

Periodontitis happens faster in some people than others, even when they have the same amount of tartar. You may be more likely to get periodontitis if you have:

What are the symptoms of periodontitis?

Early symptoms of periodontitis include:

  • Sore gums

  • Swollen gums

  • Bleeding and redness of your gums

Later symptoms include:

  • Loose teeth

  • Painful chewing

  • Front teeth tilting outward

If you don’t get treatment, periodontitis can cause tooth loss.

What will happen at my dental appointment?

Dentists will examine your teeth, then they will:

  • Do x-rays

  • Measure how far your gums have pulled away from your teeth

How do dentists treat periodontitis?

Dentists treat periodontitis with:

  • Repeated cleanings in the dentist's office

The dentist cleans deep around the roots of your teeth. You'll also need to clean your teeth well at home and use special mouth rinses. If this doesn't cure your periodontitis, the dentist may:

  • Do surgery on your gums

  • Give you antibiotic pills or place antibiotics under the infected gums

  • Rarely, pull the affected teeth

You'll need to come back to your dentist for follow-up appointments.

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Periodontal Diseases
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