Periodontal disease, commonly known as gum disease, is one of the most prevalent chronic inflammatory conditions affecting adults today. According to the Centers for Disease Control and Prevention (CDC), nearly half of all American adults aged 30 and over — a staggering 47.2% — have some form of periodontal disease.

As periodontal disease ranges from mild gingivitis to severe periodontitis, it’s essential to understand how it develops, what the associated risks are, and how to prevent tooth loss.

Read on to learn more about how long you can expect to keep your teeth when faced with a diagnosis of periodontal disease.

Periodontal disease begins with gingivitis, which arises when plaque, a sticky film of bacteria, accumulates around the teeth and gums.

When plaque hardens into tartar, it causes inflammation and irritation in the gums. Signs of gingivitis include red, swollen, and bleeding gums.

At this early stage, gingivitis is completely reversible through improved oral hygiene and professional cleanings to remove plaque and tartar. However, if left untreated, gingivitis can progress to periodontitis over time.

Periodontitis affects not only the gums but also the bone and ligaments that surround and support the teeth. As the disease advances, it leads to tissue and bone loss, causing the gums to recede and form pockets around the teeth.

Bacterial toxins and the body’s inflammatory response start destroying the supporting structures. Eventually, this loss of stability and anchorage causes teeth to loosen and even fall out.

It’s crucial to note that periodontal disease does not inevitably lead to tooth loss in all cases. The extent of damage and chances of retaining your teeth depend on several key factors:

  • Early Detection and Intervention: Periodontal disease is often asymptomatic at first, which is why regular dental exams are vital for early diagnosis and treatment. Catching it at an early stage greatly improves the prognosis.
  • Progression of Disease: The more advanced the disease, the higher the likelihood of significant bone loss and tooth damage. Keeping it under control is key.
  • Oral Hygiene: Stringent oral hygiene, including brushing twice a day, flossing, and using antiseptic mouthwash can reduce plaque buildup and limit disease progression.
  • Smoking and Overall Health: Smoking is a major risk factor for periodontal disease. Other health conditions like diabetes also worsen outcomes. Making healthy lifestyle choices helps.
  • Compliance with Treatment: Following prescribed treatment protocols, including any required surgery and periodontal maintenance, is imperative.

With early intervention and diligent ongoing care, many patients regain periodontal health and are able to keep their natural teeth for life. However, negligence can lead to tooth loss.

The duration for which people can expect to retain their teeth after being diagnosed with periodontal disease depends on several variables, including disease severity, treatment efficacy, and oral hygiene compliance.

Mild to moderate cases often respond well to non-surgical treatments like professional cleanings and scaling and root planing.

Along with adequate oral hygiene, these procedures can effectively control infection and inflammation in the majority of periodontitis cases.

As long as patients maintain periodontal health through regular maintenance and care, they may keep their natural teeth for many years, or even lifetime.

However, some patients suffer from aggressive or advanced periodontal disease that progresses despite standard treatments.

Such cases may require advanced procedures, such as flap surgery, tissue grafts, and bone grafts to try to regenerate lost structures.

Though effective, these treatments cannot fully restore the periodontium to its original state. Patients become more prone to tooth loss if they do not comply with strict maintenance protocols.

# Can Periodontitis Stop Progressing?

Yes, in many cases, the progression of periodontitis can be halted with adequate treatment and care. The key is to control the bacterial infection causing the inflammation.

Professional cleanings combined with good oral hygiene practices help eliminate plaque and tartar, thus reducing the microbial load.

Deep cleanings through scaling and root planing are especially effective, as they remove tartar and smooth out contaminated root surfaces.

This deprives bacteria of an adhesion site and food source. Antibiotics or antimicrobial rinses may also be prescribed to manage infection.

For more advanced periodontal disease, surgical procedures become necessary to reduce periodontal pockets and restore lost bone and gums.

Through techniques like guided tissue regeneration, bone grafts, and the use of growth factors, destruction can be stopped, and healing initiated.

Successfully treated patients must adhere to regular dental cleanings and meticulous home care thereafter.

Staying on top of periodontal maintenance and keeping inflammation in check are the keys to stopping periodontitis progression.

With such concerted efforts, most patients can retain their natural teeth for decades.

III. What are the 4 Stages of Periodontitis Disease?

The four stages of periodontal disease are:

1. Gingivitis

Gingivitis signifies the early stage of gum disease, marked by inflammation of the gums. Symptoms include red, swollen gums that may bleed during brushing or flossing. This stage is reversible through professional cleaning and improving oral hygiene.

2. Early Periodontitis

If left untreated, gingivitis can progress to mild periodontitis, marked by the beginning of tissue and bone loss. There may be slight gum recession and pockets of 4-5 mm. Bleeding during oral hygiene procedures persists.

3. Moderate Periodontitis

With increasing severity, gum recession becomes more pronounced, and periodontal pockets deepen to 6-7 mm. Bone loss increases, and teeth may start to loosen. At this stage, extensive professional cleaning below the gumline is required.

4. Advanced Periodontitis

The most severe stage sees rapid progression of bone and attachment loss. Pockets exceed 7 mm and are abundant with pus and bacteria. Gums recede extensively, often exposing tooth roots. Teeth can become loose or fall out due to inadequate support.

# What is Stage 4 Periodontal Disease?

As outlined above, Stage 4 periodontitis, also known as advanced or severe periodontal disease, denotes the most destructive form of the condition. Some key characteristics include:

  • Pronounced gum recession, sometimes exposing the tooth roots
  • Periodontal pockets around teeth exceeding 7 mm in depth
  • Heavy accumulation of plaque, tartar and bacteria in the gum pockets
  • Pus discharge from the gums
  • Loose, drifting or migrating teeth due to severe bone loss
  • Tooth sensitivity and pain while eating due to inflammation
  • Halitosis (chronic bad breath)

At this late stage, periodontitis can no longer be controlled through basic measures. Corrective treatments like flap surgery, bone and tissue grafts, or guided regeneration are needed to try to salvage the teeth. However, extraction may still be inevitable in cases with excessive damage.

Though periodontal disease adversely affects oral health, it seldom becomes life-threatening or fatal. However, research shows links between serious gum disease and serious systemic health issues.

Some potential problems associated with severe periodontal disease include:

  • Cardiovascular disease: Periodontal bacteria entering the bloodstream can lead to inflammation within blood vessels and clot formation, exacerbating heart disease.
  • Respiratory infection: Bacteria inhaled from the mouth into the lungs can cause respiratory issues including pneumonia.
  • Diabetes complications: Uncontrolled diabetes worsens gum disease, and the inflammation also makes diabetes management more difficult.
  • Adverse pregnancy outcomes: Advanced maternal periodontal disease heightens risks for pre-term labor and low birth-weight infants.

In very rare instances, extreme periodontal infection may become fatal through:

  • Sepsis: Dissemination of damaging bacterial toxins in the bloodstream can lead to widespread inflammation, organ damage, and potentially death.
  • Severe secondary infections in susceptible individuals: Those with compromised immune function due to illnesses like leukemia and HIV/AIDS face heightened risks.

The key is prevention through meticulous daily oral hygiene, professional cleanings, and early intervention at the first signs of gum disease.

Managing systemic conditions like diabetes is also important, along with quitting smoking. With such diligent care, the chances of periodontal disease escalating to a life-threatening level are extremely low for otherwise healthy individuals.

However, severe infection left uncontrolled can indirectly impact mortality in those already medically compromised.

The rate at which periodontal disease progresses from gingivitis to advanced periodontitis varies substantially among individuals based on several factors:

  • Oral hygiene – Poor oral care accelerates plaque accumulation and bacterial proliferation, hastening periodontitis development.
  • Smoking – Tobacco use impairs healing and resistance to infection.
  • Medications – Drugs like anti-depressants increase susceptibility.
  • Diseases – Diabetes, HIV etc. compromise immunity and wound healing.
  • Genetics – Some are inherently more prone to aggressive disease.
  • Stress – It can dampen the immune response.
  • Age – Periodontitis increases in prevalence with age.
  • Lifestyle habits – Excess alcohol intake and malnutrition aggravate risk.

# Progress Timeline:

  • Gingivitis: Can develop in days to weeks if oral hygiene lapses.
  • Early periodontitis: May take 6 months to several years to develop after gingivitis onset.
  • Moderate periodontitis: Can take 1-5 years after early stage to progress.
  • Advanced periodontitis: May develop over 5-25 years without proper care.

However, some individuals with genetic susceptibility or environmental risk factors can suffer rapid progression through all stages within a few short years or even months in severe cases.

Catching gingivitis early and implementing preventive interventions is key to slowing downperiodontitis development.

Every patient should watch for bleeding gums as the critical first sign and promptly seek professional dental care.

With regular dental cleanings and ongoing vigilance, most cases of periodontitis can be contained over many years to prevent tooth loss.

Yes, patients who have lost teeth due to severe periodontal disease have several options for replacing the missing teeth with artificial substitutes known as prosthetics:

  • Removable partial or full dentures: Replaces missing teeth with an acrylic base holding replaced teeth. They can be removed by the patient for cleaning.
  • Fixed partial or full dental bridges: False teeth anchored to crowns cemented onto natural teeth adjacent to the gap. Only removable by the dentist.
  • Dental implants: Titanium screws surgically inserted into the jawbone that integrate over months to serve as artificial roots for a crown, bridge, or denture.

The choice of prosthetic depends on the number of teeth lost, the health of remaining teeth, and the strength and thickness of available jawbone.

Dental implants offer the most durable and natural-looking tooth replacement solution. They prevent bone loss associated with missing teeth.

But sufficient healthy bone is needed for successful placement.

Replacing teeth lost to periodontal disease restores function and aesthetics. But diligent ongoing oral hygiene and professional maintenance are still required to protect remaining natural teeth from further periodontitis progression.

The artificial teeth must be properly cared for as well to ensure longevity.

Preventing periodontal disease progression requires effort on both the patient’s part as well as the dental team’s:

# At-home oral hygiene:

  • Brush teeth thoroughly twice daily
  • Floss once daily
  • Use antimicrobial mouthwash
  • Avoid tobacco products

# Professional care:

  • Regular dental cleanings & exams
  • Scaling & root planing to remove tartar
  • Antimicrobial medication if needed
  • Laser treatments to reduce inflammation
  • Surgical intervention if warranted

# Lifestyle measures:

  • Manage stress levels
  • Maintain a balanced, nutritious diet
  • Control diabetes and hypertension
  • Exercise regularly
  • Limit alcohol consumption

The combination of impeccable daily oral hygiene, dental cleanings every 3-6 months (or more frequently if needed), and addressing risk factors provides the best defense against periodontal disease.

Once diagnosed, following the dentist’s prescribed treatment plan is imperative. With diligent, multifaceted efforts, patients can successfully manage periodontitis.

The reversibility of gum damage from periodontal disease depends on the stage and severity. Catching gingivitis early often allows full resolution and restoration of normal gum health.

But more advanced stages can lead to permanent anatomical changes:

  • Gingivitis: At this initial stage, the gum inflammation and bleeding can be resolved fully with improved plaque control and professional cleanings. The gums can return to a normal, healthy state.
  • Early periodontitis: Scaling and root planing can halt tissue degradation and stabilize the gums. However, some mild recession may remain, though the gums will be otherwise functional.
  • Moderate to advanced periodontitis: The gum fibers and bones destroyed by chronic inflammation cannot regenerate fully. Though treatments can arrest disease progression, normal gum anatomy is unlikely to be restored. Recession and shallower pockets persist.
  • Gum recession: Receded gums no longer can grow back down to their original position once bone is lost. Gum grafts can cover exposed roots but do not regenerate lost tissue.

The takeaway is that the earliest stages are reversible, but extensive damage from moderate to severe periodontitis leads to permanent gum changes.

Ongoing periodontal maintenance and oral hygiene is critical for preserving remaining gum health and preventing further recession or pocketing after stabilization.

A gum graft can restore gum coverage over exposed tooth roots and may be worthwhile for:

  • Aesthetic improvement: Grafts restore a more pleasing pink gumline instead of showing receded gums and prominent roots.
  • Reduced sensitivity: Covering exposed root surfaces prevents sensitivity to hot and cold stimuli.
  • Protection: Grafts protect vulnerable root surfaces from decay or abrasion.
  • Halting bone loss: By protecting roots they help preserve underlying bone.
  • Enhanced dental work outlook: Restores adequate gums to support crowns or veneers.

Success depends on various factors:

  • The amount of gum recession – more minor cases respond best.
  • Oral hygiene compliance after surgery to prevent re-infection.
  • Avoiding smoking, which impedes healing.
  • The graft source – grafts from the patient’s palate typically take best but involve a second surgical site.

While moderately invasive, a gum graft procedure typically takes only 1-2 hours. Side effects like pain and swelling are temporary.

With proper precautions, grafts offer an effective solution for gum recession concerns. The dentist can advise if one may be suitable.

Treating periodontal disease ranges in cost depending on the treatment’s complexity:

  • Basic dental cleaning: $70-$200
  • Periodontal maintenance visit: $80-$300
  • Scaling and root planing: $500-$1000 per quadrant
  • Full mouth debridement: $1000-$1500
  • Medications: $10-$100
  • Gum graft surgery: $600-$2500 per site
  • Flap surgery: $1000-$3000 per quadrant
  • Bone graft: $500-$6000 per site
  • Dental implant: $1000-$4000 per implant

Basic periodontal treatments often are covered by dental insurance. But insurance coverage for gum surgery is variable – most plans impose an annual maximum benefit. Uncovered expenses must be paid out of pocket by the patient.

Those without dental insurance can incur significant costs treating advanced periodontal disease. It underscores the value of prevention and obtaining coverage.

But balanced against potential tooth loss, investing in periodontal treatment remains imperative for oral health and well-being.

Extracting teeth affected by periodontal disease does not fully resolve the condition. Though it eliminates the immediate source of infection and inflammation, the underlying gum disease still requires treatment and ongoing management.

This is because periodontitis arises from bacterial overgrowth that spreads throughout the mouth.

Even after extractions, bacteria remain present along the gums and can continue to proliferate if oral hygiene is neglected.

Furthermore, the changes inflicted by the disease process, such as gum recession and bone loss, still persist even without the teeth.

These anatomical changes cannot be reversed. The tissues remain vulnerable to irritation and further degeneration if not properly cared for.

Therefore, patients receiving extractions for severe periodontitis must continue with treatment:

  • Professional deep cleanings to reduce bacterial load
  • Antimicrobial mouth rinses
  • Meticulous daily oral hygiene
  • Regular dental maintenance visits for examination
  • Correction of any other risk factors like smoking or diabetes

With such concerted efforts, the remaining gums and tissues can be maintained in a stable, healthy state.

But periodontal disease requires lifelong diligence even after losing teeth to its destructive effects.

Removing affected teeth does not mean the gum disease is cured. Continued prevention and care remains critical.

Periodontal disease is not considered contagious. However, it is linked to specific bacterial strains like Porphyromonas gingivalis that can be transmitted through saliva.

Kissing someone with advanced active periodontitis does pose a low risk of spreading these bacteria. Newer research has associated deep kissing with increased risk of acquiring gum disease.

Therefore, it is advisable for someone with diagnosed periodontitis that is not yet well-managed to exercise some caution with deep, intimate kissing to reduce any potential transmission.

Once the disease is brought under control through professional treatment and good oral hygiene, transmission risk is minimized.

Some common sense precautions for those with periodontal disease include:

  • Informing partners about your periodontitis diagnosis
  • Avoiding kissing when gum inflammation is high
  • Opting for gentler kisses over passionate French kissing
  • Not sharing utensils, cups or toothbrushes
  • Promptly treating any oral infections

Useful Links:

Prevalence of periodontal disease, its association with systemic diseases and prevention

Burden of chronic diseases associated with periodontal diseases: a retrospective cohort study using UK primary care data

What is periodontal disease?