Santé des gencives

Periodontitis: stop gum recession (dentist’s guide)

Periodontitis destroys the bone that supports your teeth. Symptoms, causes, and treatment process (scaling, root planing, surgery) to stop it in time.

Publié le 25/06/2021 Mis à jour le 28/08/2026 10 min de lecture Relu par l'équipe Y-Brush

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Periodontitis is an infectious and inflammatory disease that gradually destroys the periodontium, meaning all the tissues that support the tooth: the gums, bone and ligaments. Managed through periodontics, the dental specialty dedicated to gum health, it is easier to treat when detected early. Treatment follows a clear process: clean below the gumline, control the infection, then stabilize the condition over time. Here is how it works, step by step, and when to seek care.

key takeaways

Periodontics is the specialty that treats the periodontium (gums, bone and ligaments); periodontitis is the disease that progressively destroys it.
The first warning sign is bleeding gums during brushing, often accompanied by bad breath or the early stages of gum recession.
The main cause is the buildup of dental plaque and tartar below the gumline, worsened by smoking and diabetes.
Treatment begins with scaling followed by root planing (cleaning the roots below the gumline); advanced cases may require surgery or laser treatment.
If left untreated, periodontitis can lead to tooth loss: only a dentist or periodontist can diagnose it and oversee treatment.
Prevention relies on thorough brushing, daily interdental cleaning and regular checkups.

Periodontics or periodontitis: what are we talking about?

Periodontics (or periodontology) is the branch of dentistry that deals with the periodontium, the tissues that support the tooth. Periodontitis, meanwhile, is the disease: a bacterial infection that inflames the gums and then affects the bone and ligaments. It is an advanced stage of gum disease, much more serious than simple gingivitis.

It generally starts with gingivitis: the gums become red and bleed, but nothing has been destroyed yet. If plaque and tartar build up below the gumline, the inflammation spreads to the deeper tissues and becomes periodontitis. At this stage, bone loss is irreversible: the disease can be stopped, but what has been destroyed cannot spontaneously grow back. This is why receding gums should be addressed promptly.

Definition. The periodontium consists of four elements: the gums, the alveolar bone, the periodontal ligament (or desmodontium), and the cementum covering the root. Periodontitis attacks them in this order, from the surface inward.

What are the symptoms of periodontitis?

Periodontitis is silent and painless for a long time, making it all the more insidious. However, certain signs should prompt you to consult a dentist without delay.

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Red and swollen gums

Healthy gums are pale pink and firm. Red, smooth, and swollen gums indicate active inflammation.

Bleeding

Blood when brushing or biting into a firm food is never normal: it is the earliest and most common sign.

Persistent bad breath

Persistent bad breath and a bad taste in the mouth often accompany infection in the gum pockets.

Gum recession

The gums recede, making the teeth appear longer, while the exposed necks become sensitive to hot and cold.

Periodontal pockets

The gum pulls away from the tooth, forming a deep space where bacteria proliferate, measured by the dentist during probing.

Loose teeth

In advanced stages, bone loss causes the teeth to become loose; they may shift, separate, or even fall out.

Please note. Gums that bleed regularly are not inevitable, but they are always a symptom. It is best to consult a dentist at the first sign of bleeding, while the disease is still reversible.

What are the causes and risk factors?

The direct cause of periodontitis is bacterial: dental plaque, the sticky film that constantly builds up on the teeth, mineralizes into tartar, and infiltrates beneath the gums. Inadequate brushing is therefore the primary contributing factor. However, several factors accelerate the disease and worsen its severity.

Smoking: the leading preventable risk factor, it reduces blood flow to the gums, masks bleeding, and decreases treatment effectiveness.
Diabetes: poorly controlled diabetes promotes inflammation; the relationship is reciprocal, as periodontitis itself disrupts blood sugar levels.
Genetic predisposition: with the same level of oral hygiene, some people develop more aggressive forms.
Hormonal changes: pregnancy, puberty, and menopause make the gums more vulnerable.
Stress, certain medications, and an unbalanced diet: they weaken local defenses and promote inflammation.

How is periodontitis treated?

The treatment aims to free the teeth and gums from inflammation and prevent further deterioration. It progresses from least invasive to most invasive: treatment begins with deep cleaning, followed by a reassessment, and surgery is used only if the pockets persist. Here is the usual process.

Assessment and diagnosis. The practitioner measures pocket depth (periodontal probing), assesses bleeding and mobility, and takes X-rays to evaluate bone loss.
Scaling and decontamination. Visible plaque and tartar are removed from above the gumline, and the patient is taught appropriate oral hygiene techniques.
Root planing. The core of so-called “closed” treatment: under local anesthesia, the dentist cleans and smooths the roots beneath the gumline using curettes, ultrasonic instruments or a laser, to prevent bacteria from attaching again.
Antibiotics if necessary. In severe or aggressive forms, an oral antibiotic or one applied locally in the pocket may complement the cleaning.
Periodontal surgery. If deep pockets remain, a procedure can clean inaccessible areas and, when necessary, regenerate the bone with a graft.
Periodontal maintenance. Regular follow-up, often every three months at first, stabilizes the results over the long term.

Non-surgical treatment: scaling and root planing

Subgingival cleaning is the key to the initial phase. It involves removing bacterial plaque and tartar below the gumline, around the necks of the teeth and on exposed roots. This is known as “closed” periodontal treatment because the gum is not opened: the dentist cleans the pockets under local anesthesia, using fine instruments (curettes and scalers), an ultrasonic device or a laser, then smooths the root surfaces. A professional dental cleaning often completes this stage, with polishing and fluoride treatment.

Basic treatment is often enough to stop the inflammation. In severe cases, antibiotic therapy may be added, either in tablet form or applied locally (gel or ointment) directly into the pocket. A bacteriological test can sometimes help identify the most suitable antibiotic.

Surgical treatment

It becomes necessary when the pockets remain deep despite root planing, or when the disease has already caused extensive damage. It combines deep cleaning and, if necessary, tissue regeneration.

The practitioner opens the pocket with a small incision under local anesthesia to access the infected areas.
It cleans the exposed roots and removes diseased tissue, then sutures the area so that the gum can reattach to the tooth.
When the bone is severely damaged, a bone graft, taken from the patient or sourced from a tissue bank, can improve the existing structure; however, complete regeneration remains impossible.

Good to know. Lasers are increasingly used alongside root planing to disinfect the pockets. They do not replace mechanical cleaning, but may improve comfort and results. Only your practitioner can determine whether it is appropriate.

Follow-up: why periodontal maintenance is essential

Periodontitis is a chronic disease: once stabilized, it requires long-term monitoring. When the gums have receded, the necks and roots of the teeth, lacking protective enamel, become more susceptible to cavities. Structured follow-up, known as periodontal maintenance, prevents relapses.

This follow-up combines impeccable daily hygiene, check-ups, and regular professional cleaning, sometimes several times a year. Appointments, often every three months at first, make it possible to check the condition of the pockets and monitor risk factors such as smoking and diabetes.

Y-Brush advice. Add your maintenance appointments to your calendar: consistent follow-up is what most clearly distinguishes stabilized periodontitis from recurring periodontitis.

How can you prevent periodontitis every day?

The best defense against periodontitis remains rigorous oral hygiene, which prevents plaque from building up under the gumline. Three steps form the foundation of prevention.

Thorough brushing, twice a day. The goal is to clean every surface of the teeth, including along the gumline, without irritating it. Learning to brush your teeth properly makes all the difference.
Daily interdental cleaning. Interdental brushes, dental floss, or a water flosser remove plaque where a toothbrush cannot reach, between the teeth and under the gumline.
Regular check-ups. Scaling and an examination can detect the disease before it progresses.

For brushing that is both effective and gentle on fragile gums, our Y-Brush sonic toothbrush cleans both jaws simultaneously using filaments already angled correctly: ten seconds per jaw is enough, without pressing or scrubbing too hard. In addition, a water flosser helps rinse the spaces between the teeth and the gumline, which is particularly valuable when the gums have receded.

What to avoid. Brushing too aggressively or using a hard-bristled toothbrush does not remove plaque more effectively: it damages the gums and accelerates gum recession. Gentle, regular brushing is more important than force.

When should you see a dentist or periodontist?

You should see a dentist as soon as the first signs appear: gums that bleed, swell or recede, persistent bad breath, or teeth that become loose or appear longer. The earlier treatment begins, the simpler it is and the more likely the teeth are to be preserved. Dentists treat most cases of periodontitis; they refer patients to a periodontist, a gum specialist, for complex or advanced cases.

Please note. This article is for information purposes and does not replace professional advice. Only a dentist or periodontist can diagnose periodontitis and determine the treatment suited to your situation.

Frequently asked questions about periodontitis

What is the difference between gingivitis and periodontitis?

Gingivitis is a superficial and reversible inflammation of the gums, limited to the surface tissues. Periodontitis is its progression: the infection reaches the bone and ligaments, causing irreversible destruction. Untreated gingivitis can progress to periodontitis.

Is periodontitis reversible?

No. The disease can be stopped and the situation stabilised, but bone and tissue that have already been destroyed do not regenerate spontaneously. This is why early diagnosis is crucial. Only gingivitis, the preceding stage, is completely reversible.

What does root planing involve?

Under local anaesthesia, the dentist removes the plaque and tartar lodged beneath the gums, then smooths the root surfaces using curettes, ultrasound or a laser. This cleaning prevents bacteria from attaching again and allows the gums to reattach to the teeth.

Does periodontitis hurt?

It is often painless, especially at first, which explains why it can go unnoticed for a long time. When pain appears, it generally indicates an advanced stage. So do not wait until you are in pain to seek advice: bleeding is enough to raise the alarm.

How long does periodontitis treatment take?

The active phase (scaling, root planing, and reassessment) generally takes a few weeks to a few months. Periodontal maintenance then follows, involving long-term follow-up with check-ups often scheduled every three months at first, then spaced out according to the stability achieved.

Can periodontitis be treated naturally, without seeing a dentist?

No. No home remedy removes tartar beneath the gums or treats infection in deep pockets. Good oral hygiene and a balanced diet support treatment but do not replace it: professional root cleaning is essential.

Can periodontitis cause teeth to fall out?

Yes, it is the main complication. By destroying the bone that anchors the tooth, the disease causes increasing looseness, followed by tooth loss. This is precisely why treatment should begin early and follow-up should be regular.

Does smoking worsen periodontitis?

Significantly. Smoking is the leading preventable risk factor: it reduces blood flow to the gums, masks bleeding, and reduces treatment effectiveness. Quitting smoking significantly improves the prognosis and response to treatment.

Which toothbrush should you choose if you have sensitive gums?

Choose a soft-bristled toothbrush and brush without applying excessive pressure, cleaning along the gumline without irritating it. A sonic toothbrush like the Y-Brush, whose bristles are pre-angled correctly, helps clean effectively while limiting the force applied.

Is a water flosser useful for periodontitis?

It is a useful complement to brushing, not a substitute. By sending a stream of water between the teeth and along the gumline, it helps dislodge debris where a toothbrush cannot reach, which is especially valuable when the gums have receded.

Is periodontitis treatment covered?

Some treatments, such as scaling, are reimbursed by the French national health insurance system, but several specific periodontal treatments are reimbursed little or not at all and require a quote. Ask your practitioner for a detailed quote and check your supplementary health insurance coverage.

How often should you have periodontal follow-up appointments?

At the start of maintenance, check-ups are often scheduled every three months to assess the condition of the periodontal pockets and oral hygiene. The intervals are then extended depending on the stability of the disease and your practitioner's advice, without ever stopping completely because periodontitis is chronic.