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Types of Periodontal Disease

Periodontal disease (also known as periodontitis and gum disease) is a progressive disease which affects the supporting and surrounding tissue of the gums, and also the underlying jawbone. If left untreated, periodontal disease can result in loose, unstable teeth, and even tooth loss. Periodontal disease is in fact the leading cause of tooth loss in adults in the developed world and should not be taken lightly.

Periodontal disease begins when the toxins found in plaque start to attack the soft or gingival tissue surrounding the teeth. This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear to recede. The resulting pockets between the teeth deepen and, if no treatment is sought, the tissue which makes up the jawbone also recedes causing unstable teeth and tooth loss.

Types of Periodontal Disease

There are many different varieties of periodontal disease, and many ways in which these variations manifest themselves. All require immediate treatment by a periodontist to halt the progression and save the gum tissue and bone.

Here are some of the most common types of periodontal disease along with the treatments typically performed to correct them:

Gingivitis

Gingivitis is the mildest and most common form of periodontitis. It is caused by the toxins in plaque and leads to periodontal disease. People at increased risk of developing gingivitis include pregnant women, women taking birth control pills, people with uncontrolled diabetes, steroid users and people who control seizures and blood pressure using medication.

Treatment: Gingivitis is easily reversible using a solid combination of home care and professional cleaning. The dentist may perform root planing and deep scaling procedures to cleanse the pockets of debris. A combination of antibiotics and medicated mouthwashes may be used to kill any remaining bacteria and promote the good healing of the pockets.

Chronic Periodontal Disease

Chronic periodontal disease is the most common form of the disease, and occurs much more frequently in people over 45. Chronic periodontal disease is characterized by inflammation below the gum line and the progressive destruction of the gingival and bone tissue. It may appear that the teeth are gradually growing in length, but in actuality the gums are gradually recessing.

Treatment: Unfortunately unlike gingivitis, chronic periodontal disease cannot be completely cured because the supportive tissue cannot be rebuilt. However, the dentist can halt the progression of the disease using scaling and root planing procedures in combination with antimicrobial treatments. If necessary, the periodontist can perform surgical treatments such as pocket reduction surgery and also tissue grafts to strengthen the bone and improve the aesthetic appearance of the oral cavity.

Aggressive Periodontal Disease

Aggressive periodontal disease is characterized by the rapid loss of gum attachment, the rapid loss of bone tissue and familial aggregation. The disease itself is essentially the same as chronic periodontitis but the progression is much faster. Smokers and those with a family history of this disease are at an increased risk of developing aggressive periodontitis.

Treatment: The treatments for aggressive periodontal disease are the same as those for chronic periodontal disease, but aggressive periodontal disease sufferers are far more likely to require a surgical intervention. This form of the disease is harder to halt and treat, but the dentist will perform scaling, root planing, antimicrobial, and in some cases laser procedures in an attempt to save valuable tissue and bone.

Periodontal Disease Relating to Systemic Conditions

Periodontal disease can be a symptom of a disease or condition affecting the rest of the body. Depending on the underlying condition, the disease can behave like aggressive periodontal disease, working quickly to destroy tissue. Heart disease, diabetes and respiratory disease are the most common cofactors, though there are many others. Even in cases where little plaque coats the teeth, many medical conditions intensify and accelerate the progression of periodontal disease.

Treatment: Initially, the medical condition which caused the onset of periodontal disease must be controlled. The dentist will halt the progression of the disease using the same treatments used for controlling aggressive and chronic periodontal disease.

Necrotizing Periodontal Disease

This form of the disease rapidly worsens and is more prevalent among people who suffer from HIV, immunosuppression, malnutrition, chronic stress or choose to smoke. Tissue death (necrosis) frequently affects the periodontal ligament, gingival tissues and alveolar bone.

Treatment: Necrotizing periodontal disease is extremely rare. Because it may be associated with HIV or another serious medical condition, it is likely the dentist will consult with a physician before commencing treatment. Scaling, root planing, antibiotic pills, medicated mouth wash and fungicidal medicines are generally used to treat this form of the disease.

If you have any question or concerns about the different types of periodontal disease and treatments, please ask your dentist.

Frequently Asked Questions
Types of Periodontal Disease, TX

Periodontal disease, also called gum disease or periodontitis, is a progressive bacterial infection that affects the gums, supporting tissues, and the underlying jawbone. It begins when bacteria in plaque attack the gum tissue around the teeth. If left untreated, it can cause gum recession, deepening pockets between teeth and gums, bone loss, and eventually tooth loss. In fact, periodontal disease is the leading cause of tooth loss in adults in the developed world.
There are five primary types: gingivitis (the mildest and most common, also the early stage), chronic periodontal disease (the most common adult form), aggressive periodontal disease (rapid progression with possible genetic link), periodontal disease linked to systemic conditions (such as diabetes or heart disease), and necrotizing periodontal disease (a rare, severe form usually associated with serious underlying medical conditions).
Gingivitis is the earliest and mildest form of gum disease, caused by plaque buildup along the gumline. Common signs include red, swollen, or tender gums that bleed when brushing or flossing. The good news is that gingivitis is fully reversible with consistent home care and professional cleanings. People at higher risk include pregnant women, individuals on birth control or certain medications, people with uncontrolled diabetes, and those using steroids.
Chronic periodontal disease is the most common advanced form of gum disease and occurs most often in adults over 45. It causes ongoing inflammation below the gumline and gradual destruction of gum tissue and bone. Teeth may appear longer over time, but this is actually due to gum recession. Unlike gingivitis, chronic periodontal disease cannot be fully cured — but its progression can be halted with scaling, root planing, antimicrobial therapy, and sometimes gum surgery.
Aggressive periodontal disease is similar to chronic periodontitis but progresses much more rapidly, causing fast destruction of gum attachment and bone. It often runs in families and is more common in smokers. Because of its rapid pace, this form usually requires earlier and more intensive treatment, including scaling and root planing, antimicrobial therapy, and in many cases periodontal surgery or laser treatment.
Some forms of periodontal disease are linked to or worsened by underlying medical conditions such as diabetes, heart disease, or respiratory disease. Even when little plaque is present, these systemic conditions can intensify and accelerate gum disease. Treatment focuses on managing both the medical condition and the gum infection together, often in coordination with your physician.
Necrotizing periodontal disease is a rare and severe form characterized by the death (necrosis) of gum tissue, the periodontal ligament, and even the alveolar bone. It typically affects people with weakened immune systems — such as those with HIV, severe malnutrition, chronic stress, or who smoke. Treatment usually involves coordination with a physician, plus scaling, root planing, antibiotics, medicated mouth rinses, and antifungal medications when needed.
Only a dentist or periodontist can accurately diagnose your specific type and stage of gum disease. During a periodontal evaluation, we measure pocket depths around your teeth, check for inflammation and bleeding, examine X-rays for bone loss, and review your medical history. Based on these findings, we can identify the type, assess severity, and recommend the right treatment plan.
Common warning signs include red, swollen, or tender gums; bleeding when brushing or flossing; persistent bad breath; gums that appear to be receding; loose or shifting teeth; pus along the gumline; and a change in your bite. Many people, however, have gum disease without obvious symptoms — which is why regular dental checkups are so important.
It depends on the type. Gingivitis is fully reversible with proper care. However, once the disease has progressed to chronic, aggressive, or more advanced forms, the lost gum and bone tissue cannot be fully regenerated. The progression can be stopped and managed with consistent treatment and maintenance, allowing you to keep your teeth and protect your oral health long-term.
Treatment depends on the type and severity. Mild cases (gingivitis) usually respond to improved home care and professional cleanings. Moderate to advanced cases typically require scaling and root planing — a deep cleaning that removes tartar from beneath the gumline — along with antimicrobial therapy. Advanced cases may require periodontal surgery, laser treatment, gum grafting, or bone grafting to restore lost tissue support.
Risk factors include poor oral hygiene, smoking and tobacco use, diabetes, hormonal changes (pregnancy, menopause), certain medications (steroids, blood pressure drugs, seizure medications), genetics, stress, weakened immune system, and certain systemic diseases such as heart disease and HIV. People with multiple risk factors should be especially vigilant about preventive dental care.
Yes, periodontal disease can return if proper care isn’t maintained. Once you’ve been treated for gum disease, you’ll need ongoing periodontal maintenance — typically professional cleanings every 3 to 4 months instead of every 6 — along with diligent home care. With this commitment, most patients keep the disease under control and protect their teeth for life.
Prevention is straightforward and effective. Brush twice a day with fluoride toothpaste, floss daily, avoid tobacco, manage chronic conditions like diabetes, eat a balanced diet, and visit your dentist every six months for cleanings and exams. Early detection during routine checkups is one of the most powerful tools for preventing gum disease from advancing.