PeriodonticsBasic

Gingivitis vs. periodontitis

Gingivitis inflames only the gingiva. Periodontitis also destroys the ligament and the bone that support the tooth.

What you need to know

Gingivitis: it is almost always caused by plaque. The gingiva is red, swollen and bleeds easily; it almost never hurts.
Gingivitis can go away, stay superficial for years or progress to periodontitis.
Periodontitis: attachment is lost (the fibers that join the tooth to the gingiva and bone come loose), bone is lost and pockets form. Pockets of more than 4 mm indicate periodontitis.
Associated bacteria: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and other rod-shaped gram-negative bacteria.
Risk factors: plaque, smoking, diabetes, obesity, stress and lack of vitamin C.
It is classified by stages (I to IV, by severity) and grades (A to C, by how fast it progresses).
Treatment: scaling and root planing, plus good hygiene at home. It is re-evaluated at 3 weeks; sometimes antibiotics or surgery are added.

	Gingivitis	Periodontitis
What is affected	Only the gingiva	Gingiva, ligament, cementum and bone
Bone loss	No	Yes (seen on the radiograph)
Bleeding	Yes	Yes
Pain	Almost never	Almost never, except in an acute infection
Tooth mobility	No	May be present

Periodontal pocketA sulcus between the tooth and the gingiva that has become deeper because of the disease.

Attachment lossLoss of the fibers that attach the gingiva and the ligament to the tooth.

Scaling and root planingDeep cleaning that removes calculus and smooths the root surface.

What distinguishes periodontitis from gingivitis?

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Attachment loss and alveolar bone loss, with pockets. In gingivitis only the gingiva is inflamed.

Ubertalli JT. Gingivitis. MSD Manual, Professional Version (2024 revision). View source
Ubertalli JT. Periodontitis. MSD Manual, Professional Version (2024 revision). View source