Periodontitis: Causes, Symptoms, and Treatment

Periodontitis is a long-term disease of the gums that causes gradual damage to the soft tissues and the bone that hold teeth in place. It is the most severe stage of gum disease, developing after gingivitis, and is one of the main causes of tooth loss in adults worldwide. The disease is mainly caused by bacteria that build up in dental plaque—a sticky film that forms on teeth. The body’s immune response to these bacteria leads to inflammation, which can destroy the supporting tissues and bone. Factors such as genetics, smoking, diabetes, stress, and certain health conditions can make people more likely to develop periodontitis or worsen its effects.

Without treatment, periodontitis can cause gums to pull away from the teeth (gingival recession), loose teeth, difficulty chewing, and eventually tooth loss. The disease often progresses slowly and may not cause noticeable pain at first, which can delay diagnosis. Signs that may appear over time include red, swollen, or bleeding gums, bad breath, gum tenderness, and teeth that shift or develop spaces as bone loss increases.

Treatment usually begins with professional cleaning procedures, such as scaling and root planing, which remove plaque and hardened deposits (tartar) from below the gumline. In some cases, antimicrobial rinses or antibiotics are used to control infection. Severe cases may require surgery, including gum flap procedures, bone grafts, or gum grafts, to rebuild lost support.

Prevention relies on good daily oral hygiene. This includes brushing teeth at least twice a day, cleaning between teeth with floss or other interdental tools, and using antiseptic mouth rinses. Regular dental check-ups and professional cleanings are also important for detecting and treating the disease early.

Difference Between Gingivitis and Periodontitis

Gingivitis is the earliest stage of gum disease and is generally reversible with proper oral hygiene and professional care. It is characterized by inflammation confined to the gum tissue (gingiva) without affecting the underlying bone or connective tissues that support the teeth. Common signs include redness, swelling, tenderness, and bleeding during brushing or probing. At this stage, there is no permanent damage to the supporting structures, and treatment such as improved oral hygiene and routine dental cleanings can usually restore gum health.

Periodontitis occurs when gingivitis is left untreated and the disease progresses. In this stage, the inflammation extends deeper, causing destruction of the periodontal ligament and alveolar bone, which anchor the teeth in place. This results in the detachment of gums from the teeth and the formation of periodontal pockets—spaces between the teeth and gums where bacteria accumulate. Unlike gingivitis, periodontitis causes permanent damage to the supporting structures and cannot be fully reversed. It may lead to gum recession, tooth mobility, and eventual tooth loss. Treatment requires more intensive interventions, ranging from deep cleaning (scaling and root planing) to surgical procedures such as flap surgery or bone grafting, depending on the severity..

Types of Periodontitis

Periodontitis is classified into several types based on clinical presentation and progression:

Chronic Periodontitis: Chronic periodontitis is the most prevalent form of the disease and typically affects adults, although it may occur in younger individuals as well. It is characterized by slow to moderate progression of inflammation and tissue destruction. The disease is strongly associated with dental plaque accumulation, which leads to the gradual loss of attachment and alveolar bone. Clinical signs include gingival inflammation, periodontal pocket formation, gum recession, and tooth mobility in advanced cases.
Aggressive Periodontitis: Aggressive periodontitis is less common but more severe, with rapid loss of periodontal attachment and bone. It often affects younger patients, sometimes during adolescence or early adulthood, and may progress despite relatively low levels of plaque accumulation. The disease has a strong genetic component, with familial aggregation frequently observed. Clinically, it may present as localized (typically affecting the first molars and incisors) or generalized (involving multiple teeth).
Necrotizing Periodontitis: Necrotizing periodontitis (also known as necrotizing ulcerative periodontitis) is a severe form characterized by necrosis (tissue death) of the gingiva, periodontal ligament, and alveolar bone. It is associated with acute pain, spontaneous bleeding, halitosis, and the presence of crater-like lesions in the gums. This type is most frequently seen in individuals with compromised immune systems, including those with HIV/AIDS, malnutrition, or systemic illnesses, and may also be linked to psychological stress and poor oral hygiene.
Periodontitis as a Manifestation of Systemic Diseases: In some cases, periodontitis develops as a direct result of underlying systemic conditions. These include metabolic disorders such as diabetes mellitus, genetic syndromes (e.g., Papillon–Lefèvre syndrome, Down syndrome), hematological disorders such as leukemia, and conditions affecting immune function. The severity and presentation vary depending on the primary systemic disease.

Causes and Risk Factors

Periodontitis results from multiple interacting factors that influence the health of the gums and supporting tissues. These include microbial agents, inherited traits, daily habits, and wider health conditions affecting the immune response.

Bacterial Infection

The immediate cause of periodontitis is the accumulation of pathogenic microorganisms within dental plaque and subgingival biofilms. These biofilms are structured microbial communities that adhere to tooth surfaces below the gumline, making them difficult to remove through routine oral hygiene.

Among the most significant bacteria implicated are species collectively known as the “red complex,” including Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. These organisms release toxins and enzymes that directly damage gum tissues and disrupt host immune defenses. Their presence promotes chronic inflammation, which contributes to the breakdown of connective tissue and alveolar bone.

If dental plaque is not regularly disrupted by brushing, flossing, and professional cleanings, it calcifies into tartar (calculus). This hardened material provides an ideal environment for bacterial growth. As bacterial populations increase, the gums detach from the teeth, creating periodontal pockets where further bacterial invasion occurs. Over time, these pockets deepen, accelerating tissue and bone destruction

Genetic Predisposition

Genetic factors influence an individual’s susceptibility to periodontitis. Variations in genes related to immune regulation and inflammatory responses affect how the body reacts to bacterial infections.

Studies show that certain gene polymorphisms, such as those in interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-α), can lead to exaggerated inflammation. This increases tissue breakdown even when plaque levels are low.

Family history is also an important risk factor. Individuals with close relatives affected by chronic or aggressive periodontitis are at a higher likelihood of developing the disease themselves, suggesting a hereditary component in host immune regulation.

Lifestyle and Environmental Factors

Certain behaviors and exposures significantly increase the risk of periodontitis:

Smoking: Tobacco use is one of the strongest modifiable risk factors. Smokers are up to twice as likely to develop periodontitis compared with non-smokers. Smoking reduces blood flow to the gums, impairs immune cell activity, alters the bacterial composition of plaque, and slows the healing of periodontal tissues after treatment.
Oral hygiene: Poor or inconsistent brushing and flossing habits contribute directly to plaque accumulation and progression of disease. Infrequent professional dental cleanings further increase risk.
Stress: Chronic stress is associated with impaired immune function and may exacerbate inflammatory responses in the gums.
Nutrition: Diets lacking in essential nutrients such as vitamin C, vitamin D, and antioxidants reduce the body’s ability to repair tissues and control inflammation. Conversely, balanced nutrition supports periodontal health.
Medications and toxins: Certain drugs, including anticonvulsants (e.g., phenytoin), immunosuppressants (e.g., cyclosporine), and calcium channel blockers, can cause gingival overgrowth, making plaque control more difficult. Exposure to harmful chemicals or environmental toxins may also negatively affect gum health.

Systemic Health Connections

Periodontitis does not occur in isolation but interacts with broader systemic health. Several medical conditions have been shown to increase susceptibility or severity:

Diabetes mellitus: High blood sugar levels enhance inflammatory responses and impair wound healing, making individuals with uncontrolled diabetes particularly prone to severe periodontitis. Conversely, periodontitis can make glycemic control more difficult, creating a two-way relationship between the conditions.
Immunodeficiency: Diseases that weaken the immune system, such as HIV/AIDS, increase vulnerability to periodontal infections and accelerate disease progression.
Osteoporosis: Loss of bone density associated with osteoporosis may exacerbate alveolar bone loss, worsening periodontal outcomes.
Cardiovascular disease: Epidemiological studies have identified associations between periodontitis and heart disease, stroke, and atherosclerosis. Chronic inflammation from periodontal infection may contribute to systemic inflammatory burden, though causal relationships remain under investigation.
Pregnancy and adverse outcomes: Hormonal changes during pregnancy can increase gum inflammation, and severe periodontitis has been linked to preterm birth and low birth weight in some studies.

Symptoms and Clinical Presentation

Periodontitis presents with specific signs that indicate the onset and progression of gum infection and tissue damage. These signs vary from mild inflammation to severe tissue and bone destruction affecting tooth stability.

Early Warning Signs

Initial symptoms of periodontitis often resemble gingivitis but include more persistent inflammation. Common signs include redness and swelling of the gums, bleeding during brushing or flossing, and tenderness when touched.

Patients may notice persistent bad breath or a bad taste in the mouth. Gums may begin to recede, creating pockets between teeth and gums that collect plaque and bacteria. Early detection is crucial to prevent further damage.

Progression of Disease

The progression of periodontitis occurs gradually but can lead to severe and irreversible damage if not managed appropriately. In the early stages, gingival inflammation leads to the formation of shallow periodontal pockets as the gum tissue begins to detach from the teeth. As the disease advances, these pockets deepen, providing an environment for further bacterial colonization and plaque accumulation. Progressive destruction of periodontal ligament fibers and alveolar bone results in gum recession, exposing root surfaces and making the teeth appear longer. Patients may begin to notice increased tooth mobility, shifting of teeth, and changes in bite alignment due to the compromised support structures.

Pain is not always an early feature of periodontitis, which contributes to its ability to progress unnoticed for extended periods. However, as the condition worsens, discomfort can occur during chewing, and hypersensitivity may develop when roots are exposed. In advanced cases, localized infections may lead to the formation of periodontal abscesses characterized by swelling, tenderness, and pus discharge. The presence of purulent exudate indicates an active bacterial infection and necessitates urgent treatment to prevent further tissue breakdown.

Complications of Periodontitis

Complications of untreated periodontitis are significant both within the oral cavity and in relation to systemic health. Locally, the disease can lead to irreversible tooth loss as the supporting bone and connective tissues are destroyed, making restorative options such as implants or prosthetics necessary. Permanent gum recession reduces protection of tooth roots, which increases susceptibility to caries and hypersensitivity, while scarred or fibrotic gingival tissue may impair effective oral hygiene practices. Chronic infection also predisposes patients to recurrent flare-ups and persistent inflammation, further accelerating tissue breakdown.

Beyond the oral cavity, periodontitis has been linked to several systemic conditions, largely due to its role in sustaining chronic inflammation and allowing pathogenic bacteria or inflammatory mediators to enter the bloodstream. Numerous studies have identified associations between severe periodontal disease and cardiovascular conditions, including atherosclerosis, coronary heart disease, and stroke. In diabetes mellitus, periodontitis is considered both a complication and a contributing factor, as poorly controlled blood glucose exacerbates gum disease, while active periodontal inflammation worsens glycemic control. Associations have also been observed with respiratory diseases, adverse pregnancy outcomes such as preterm birth and low birth weight, and certain autoimmune conditions.

In advanced stages, complications can extend to the development of severe infections such as necrotizing periodontal diseases, which are characterized by rapid tissue destruction and systemic symptoms like fever and malaise. Left untreated, these conditions can spread beyond the oral cavity, especially in immunocompromised individuals. The chronic burden of pain, aesthetic changes from gum recession, and functional difficulties with chewing can also negatively impact quality of life, nutrition, and psychological well-being.

Diagnosis and Assessment

Accurate diagnosis of periodontitis requires detailed evaluation of clinical signs, supported by specific diagnostic tools, followed by classification to guide treatment. Key indicators include tissue inflammation, pocket depth, and bone loss.

Clinical Examination

The clinical examination evaluates gum condition, probing depths, attachment loss, bleeding on probing, and tooth mobility. Probing depths greater than 3 millimeters often indicate the presence of periodontal pockets, with deeper measurements reflecting more advanced disease. Bleeding on probing is a sensitive indicator of active inflammation and is frequently used to monitor disease activity over time. Clinical attachment loss, measured from the cementoenamel junction to the base of the periodontal pocket, quantifies the extent of periodontal support lost. Tooth mobility is evaluated manually and graded on a scale, with higher grades reflecting compromised bone and ligament support.

Visual inspection complements probing by identifying visible signs such as erythema, swelling, gingival recession, and the presence of plaque or calculus. Furcation involvement, where periodontal destruction affects the area between the roots of multi-rooted teeth, is also evaluated as it significantly influences treatment decisions and prognosis. Standardized periodontal charts are used to document these findings in a systematic way, ensuring consistency and enabling longitudinal comparison.

Diagnostic Tools

Radiographs, especially bitewing and periapical X-rays are commonly used to detect horizontal and vertical bone loss, calculus deposits, and furcation involvement. These radiographs also help in identifying secondary factors such as overhanging restorations that contribute to plaque retention. In complex cases, cone-beam computed tomography (CBCT) may be employed to provide three-dimensional visualization of periodontal structures, particularly in surgical planning or for evaluating extensive bone defects, though its use is limited by cost and radiation exposure.

Adjunctive diagnostic methods include microbial testing, which can identify specific periodontal pathogens such as Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans. While not routinely performed in general practice, these tests can guide tailored antimicrobial therapy in refractory or aggressive cases. Emerging diagnostic approaches involve the analysis of biomarkers in saliva, gingival crevicular fluid, and blood, including inflammatory mediators like interleukin-1 (IL-1) and C-reactive protein (CRP). These biomarkers hold promise for early detection and monitoring of disease activity, though they are not yet standard clinical tools.

Staging and Grading of Periodontitis

The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions introduced a staging and grading system that provides a structured framework for diagnosis. Staging reflects the severity and extent of disease, ranging from Stage I (mild, initial bone loss and attachment loss ≤2 mm) to Stage IV (severe, with extensive bone loss, tooth loss, and functional compromise). Factors considered include probing depth, radiographic bone loss, number of teeth lost due to periodontitis, and the complexity of management.

Grading evaluates the rate of disease progression and its potential systemic impact. It is categorized as Grade A (slow progression), Grade B (moderate progression), and Grade C (rapid progression). Grading incorporates clinical evidence of progression, indirect evidence such as percentage of bone loss relative to age, and risk factors including smoking and glycemic control in diabetic patients. Together, staging and grading allow clinicians to formulate a personalized treatment plan and provide a more accurate prognosis

Treatment and Management Options

Treatment of periodontitis focuses on controlling infection and preventing further damage to the supporting structures of teeth. It requires careful removal of plaque and calculus, sometimes combined with medications or surgeries to restore periodontal health.

Non-Surgical Approaches

Non-surgical treatment is considered the first-line approach for most cases of periodontitis. These interventions are designed to reduce bacterial load, eliminate inflamed tissue, and establish conditions that promote healing and reattachment of the gums to the teeth. The cornerstone of non-surgical periodontal therapy is scaling and root planing (SRP), also referred to as deep cleaning. Scaling removes plaque and hardened deposits of tartar (calculus) from the surfaces of teeth both above and below the gumline, while root planing smooths the root surfaces to discourage bacterial reattachment and facilitate gum reattachment.

Following the initial SRP, patients typically require ongoing professional care in the form of regular periodontal maintenance cleanings, usually every three to four months. These appointments enable clinicians to monitor periodontal pocket depth, assess levels of inflammation, and evaluate the stability of supporting bone structures. Regular maintenance is essential in preventing disease recurrence and progression.

In addition to professional treatment, improved oral hygiene practices at home play a central role in long-term management. Patients are educated on effective toothbrushing techniques, such as the modified Bass method, and are encouraged to use daily interdental cleaning tools like floss, interdental brushes, or water flossers. Consistent self-care is critical in maintaining treatment outcomes and reducing the likelihood of relapse.

Adjunctive therapies may also be employed to enhance non-surgical treatment. Laser therapy has been used to reduce bacterial load and remove diseased tissue, though its effectiveness compared with conventional methods remains under study. Antimicrobial rinses, such as those containing chlorhexidine or essential oils, can be prescribed to complement mechanical cleaning by reducing bacterial counts and inflammation.

Because periodontitis is a chronic condition, supportive periodontal therapy is a lifelong necessity for many patients. Individuals are placed on recall schedules tailored to their risk profile, which may be influenced by factors such as smoking status, systemic diseases, or genetic predisposition.

Surgical Interventions

When non-surgical methods fail to adequately control the disease—such as when deep periodontal pockets persist—surgical treatments may be indicated. These procedures aim to eliminate pockets, reshape tissues, and regenerate lost structures.

Flap surgery (periodontal flap procedure): The gum tissue is lifted away from the tooth to allow direct access for deep cleaning of roots and removal of infected tissue. After cleaning, the gums are sutured back in place to reduce pocket depth and improve healing.
Bone grafting: When significant bone loss has occurred, bone grafts (using natural bone, synthetic materials, or donor tissue) may be placed to stimulate bone regeneration and stabilize teeth.
Guided tissue regeneration (GTR): A biocompatible membrane is inserted between the gum and bone to direct the growth of new bone and connective tissue, preventing soft tissue from occupying the space where bone should regenerate.
Soft tissue grafts: In cases of gum recession, grafting procedures using tissue from the palate or donor sources can cover exposed roots, improve gum thickness, and enhance appearance.
Crown lengthening or pocket reduction surgery: These procedures reshape the gum and bone around teeth to reduce periodontal pockets and facilitate easier cleaning.

Post-surgical care involves follow-up visits to monitor healing, remove sutures if necessary, and adjust maintenance strategies. Healing outcomes depend on patient compliance with oral hygiene and avoidance of risk factors such as smoking.

Medications Used in Therapy

Pharmacological treatments are often used alongside mechanical cleaning to reduce bacterial load and modulate the inflammatory response.

Systemic antibiotics: Drugs such as amoxicillin, metronidazole, or a combination of both may be prescribed in severe or aggressive cases. These help suppress pathogenic bacteria but are used with caution to prevent antibiotic resistance.
Locally delivered antimicrobials: Medications such as doxycycline gels, minocycline microspheres, or chlorhexidine chips are inserted directly into periodontal pockets, providing high local concentrations with minimal systemic side effects.
Antiseptic rinses: Chlorhexidine gluconate mouthwash is frequently prescribed to reduce plaque formation during the initial healing phase. Long-term use is limited due to side effects such as tooth staining and altered taste.
Host-modulating agents: Certain drugs, such as low-dose doxycycline, can be prescribed to inhibit matrix metalloproteinases (enzymes that break down connective tissue), reducing the rate of tissue destruction.

Prevention Strategies

Preventing periodontitis relies on a combination of daily oral care, routine professional dental services, and broader lifestyle choices that support gum and systemic health. Because periodontitis often develops silently and can cause irreversible damage, preventive measures are considered the most effective approach to reducing its incidence and severity.

Oral Hygiene Practices

Consistent and effective oral hygiene is the cornerstone of preventing plaque accumulation, the primary cause of gum disease.

Toothbrushing: Teeth should be brushed at least twice daily using fluoride toothpaste. A soft-bristled toothbrush is recommended to minimize trauma to the gums while effectively removing plaque. Electric toothbrushes have been shown in clinical studies to reduce plaque and gingivitis more effectively than manual brushes. Each brushing session should last for a minimum of two minutes, with attention to all tooth surfaces and the gumline.
Flossing and interdental cleaning: Daily flossing or the use of interdental brushes removes food debris and plaque from areas that a toothbrush cannot reach. This reduces bacterial load in interdental spaces, which are common sites of periodontal pocket formation.
Mouth rinses: Antimicrobial mouthwashes containing chlorhexidine, essential oils, or cetylpyridinium chloride can decrease bacterial growth and reduce gingival inflammation. Fluoride rinses provide additional protection against tooth decay, which often coexists with gum disease.
Toothbrush replacement: Worn toothbrushes are less effective in cleaning. Replacing a toothbrush or electric brush head every three months—or sooner if bristles are frayed—is recommended.
Tongue cleaning: The tongue harbors bacteria that contribute to oral malodor and may play a role in gum inflammation. Cleaning the tongue with a scraper or brush can reduce microbial load in the mouth.

Regular Dental Visits

Professional dental care complements daily home care and is essential for long-term prevention.

Dental check-ups: Most dental professionals recommend visits at least twice per year. However, individuals with higher risk factors, such as smoking, diabetes, or a family history of periodontitis, may benefit from more frequent examinations.
Professional cleanings: Dental hygienists use specialized tools to remove hardened plaque (calculus) and biofilm deposits that cannot be eliminated with brushing and flossing alone. This prevents bacterial buildup in areas that are otherwise inaccessible.
Periodontal monitoring: Routine examinations include measuring pocket depth, assessing gum attachment levels, and monitoring bone health through radiographs when necessary. Detecting early signs of gingivitis or mild periodontitis allows for timely interventions.
Personalized guidance: Dentists and hygienists can provide individualized recommendations for brushing techniques, floss alternatives (such as water flossers or interdental picks), and preventive products tailored to the patient’s needs.

Lifestyle Modifications

Lifestyle factors play a significant role in determining susceptibility to periodontitis. Addressing these elements can improve both oral and general health outcomes.

Tobacco cessation: Smoking is one of the strongest risk factors for periodontitis. It reduces blood circulation in the gums, impairs immune cell function, and delays tissue healing. Quitting smoking or reducing tobacco use significantly improves treatment response and lowers the risk of disease progression.
Balanced nutrition: Adequate intake of vitamins and minerals supports gum health. Vitamin C is vital for collagen synthesis and gum tissue repair, while vitamin D aids calcium absorption and supports bone health. Diets rich in antioxidants, fruits, vegetables, lean proteins, and whole grains reduce systemic inflammation and promote oral healing.
Reduced sugar and acid intake: Frequent consumption of sugary and acidic foods fosters plaque development and enamel erosion, indirectly contributing to gum disease progression.
Stress management: Chronic psychological stress elevates cortisol levels, suppresses immune function, and increases systemic inflammation. Practices such as mindfulness, regular exercise, and adequate rest can reduce susceptibility to gum infections.
General health maintenance: Conditions such as diabetes and cardiovascular disease are closely linked with periodontal health. Managing blood sugar levels, maintaining a healthy weight, and adhering to prescribed medical care reduces the impact of systemic conditions on gum health.

Impact on Overall Health

Periodontitis affects more than just oral health; it influences various systemic conditions through inflammatory and infectious pathways. The disease contributes to increased risk factors for cardiovascular disease, complicates diabetes management, and may exacerbate respiratory illnesses.

Links to Cardiovascular Disease

Periodontitis is associated with an elevated risk of cardiovascular problems, including heart attacks and strokes. The inflammation from gum disease promotes the release of pro-inflammatory cytokines such as C-reactive protein (CRP), which contribute to arterial plaque formation.

Bacteria from infected gums can enter the bloodstream, potentially causing endothelial dysfunction. This dysfunction weakens blood vessel walls and facilitates atherogenesis. Patients with periodontitis often show higher levels of systemic inflammation markers, which correlate with cardiovascular risk.

Studies indicate that treating periodontitis may reduce some cardiovascular risks, although it should complement, not replace, conventional heart disease treatments.

Implications for Diabetes

Chronic periodontitis and diabetes have a bidirectional relationship. Poorly controlled diabetes increases susceptibility to periodontal infections by impairing immune responses and reducing wound healing.

Conversely, periodontitis exacerbates blood sugar control by increasing systemic inflammation and insulin resistance. Persistent gum infection can raise glycated hemoglobin (HbA1c) levels, making diabetes management more difficult.

Effective periodontal treatment has been shown to improve glycemic control in diabetic patients, highlighting the importance of oral health care in managing diabetes.

Respiratory Health Effects

Periodontitis may contribute to respiratory diseases such as pneumonia and chronic obstructive pulmonary disease (COPD). Oral pathogens can be aspirated into the lower respiratory tract, especially in vulnerable populations like the elderly or hospitalized patients.

This bacterial invasion can lead to infection, inflammation, and worsening of pre-existing respiratory conditions. Additionally, systemic inflammation from periodontitis may aggravate lung tissue damage.

Maintaining good periodontal health is important for reducing the risk of respiratory complications, particularly in those with compromised immune systems or chronic lung diseases.

Prognosis and Long-Term Outlook

The long-term outcome of periodontitis depends heavily on the stage of disease at diagnosis and the effectiveness of treatment. Patient compliance with oral hygiene and regular dental visits also significantly influence future results.

Disease Progression Scenarios

Periodontitis progression varies from slow and controlled to rapid and destructive. Early-stage periodontitis, if treated promptly, can remain stable with minimal attachment loss. However, without intervention, the disease may advance, causing deeper pockets, bone resorption, and tooth mobility.

Patients with systemic conditions like diabetes or smokers face a higher risk of faster progression. Failure to control plaque and tartar buildup also escalates tissue damage. In advanced cases, tooth loss becomes a common outcome despite therapy.

Quality of Life Considerations

Periodontitis can impact daily life through pain, discomfort, and aesthetic concerns. Untreated disease may lead to difficulties in chewing and impaired speech due to tooth loss or gum recession.

Treatment can restore function and reduce symptoms, though ongoing maintenance is necessary. Psychological effects, such as embarrassment from gum appearance, also affect well-being. Effective management aims to improve both physical health and patient confidence.