Periodontitis is a chronic infectious disease of the gums that affects a large majority of the population. Severe forms are relatively more rare but still affect about 10% of the population. Periodontal disease always starts with gum inflammation due to plaque accumulation (gingivitis). Left untreated gingivitis can progress and disrupts the attachment of the gum to the root so that a pocket forms. If the disease is left to progress the infection will spread deeper and will be also associated with resorption of the bone supporting the roots. As a consequence, over time, teeth will become loose, they will drift, gum will recede and finally the teeth might be lost.

Periodontal disease is a serious condition that might affect health, function and esthetics of patients’ smile

Smoking is co-factor that increases the risk of developing more severe periodontal disease.


The image below shows sequential x-rays from a smoker patient who is affected by chronic periodontitis. For showing purpose, the teeth have been overlayed in white, the roots in yellow and the bone appears in gray. It is evident how at 15 years of age the bone had a normal anatomy as it was surrounding the whole root length. At 25 years of age the bone support to the roots was still unchanged. However, passed 35 years of age, the patient started to suffer of pocketing and progressive loss of supporting bone around the roots due to periodontitis. The loss of bone shown by the increasing distance between the level of the bone (in grey) and the dotted white line landmark is well evident.

As a result of this progressing periodontitis the teeth in question became wobbly and other teeth in this patient’s mouth were lost.

periodontitis bone loss.003.003

If you want to know how healthy your gums are please check the self-assessment table.