One might be tempted to think that periodontal disease is painful.  In actuality, the process of developing a pocket and the loss of bone is relatively painless until it progresses into the latter stages.  A good way to envision the phenomenon of a pocket developing around the root of a tooth is to think of a turtleneck sweater being stretched out and becoming loose.

The first symptom that you will notice is that your gums begin to bleed when you brush or floss.  They will definitely bleed when you have them cleaned professionally.  The gum tissue will become red, puffy and swollen along the edge where the gums meet the tooth.  They may become soft and tender, but they also may not until the condition is really advanced.  

You may begin to notice a bad odor emanating from your mouth, which is called halitosis, that continues to exist over long periods of time, despite your attempts to eliminate it.  You may notice over time that your gums will pull away from the teeth, causing you to become “long in the tooth”.  This is known as recession, and could be an indication that you are experiencing bone loss.

Another symptom that is associated with this condition is what we call suppuration.  Suppuration is the formation of, conversion into, or process of discharging pus.  Once the tissues begin to suppurate, you have formed what is known as a periodontal abscess, and you are losing the support of the bone from around your tooth or teeth. 

Finally, you could experience loose teeth and you may notice that you are developing spaces between your teeth that were previously nonexistent.  This indicates that the bone loss is now severe, and unless action is taken, you will soon begin losing teeth.

You can have severe periodontitis and not exhibit any of the aforementioned symptoms.  Often times, patients will seek a second opinion with me because seemingly out of the blue, they were informed that they have periodontitis and they haven’t witnessed any evidence to support the diagnosis.

Ultimately the question arises, “Why do my gums bleed when you probe them, but they don’t bleed when I brush and floss?”.  The answer to that question is simple.  When you brush and floss, the bristles of your toothbrush and your floss only reach about 1 to possibly 2mm into the sulcus or periodontal pocket.  When I take measurements with my periodontal probe, I touch all the areas of the gum tissue that you can’t reach with your toothbrush and floss.  Your gums aren’t bleeding from the areas that you can reach with your toothbrush and floss.  They are bleeding from the areas that you can’t reach with your toothbrush and floss… the areas that my periodontal probe touches.