Medical Encyclopaedia › Periodontitis (short definition)
In brief: Periodontitis is a chronic inflammation of the tooth-supporting tissues, triggered by bacterial plaque (biofilm). If untreated, it leads to loss of bone and connective tissue and can loosen teeth, up to tooth loss. It is one of the most common chronic diseases in adults.
How does it develop?
It usually starts with gum inflammation (gingivitis) caused by plaque at the gum line, which can still regress completely with good oral hygiene. If it persists, the inflammation can progress deeper: gum pockets form in which bacteria continue to multiply, and the body’s own inflammatory response breaks down bone. Smoking, diabetes, stress and genetic factors significantly increase the risk.
Signs
- bleeding gums when brushing
- red, swollen or receding gums
- persistent bad breath
- sensitive tooth necks, loose or shifting teeth
Pain is often absent for a long time, so periodontitis is often noticed late. In Germany, a screening examination (Periodontal Screening Index) is part of the dental check-up for adults.
Stages and grades
According to the 2018 international classification, periodontitis is divided into stages I to IV, which describe severity and treatment complexity, and grades A to C, which indicate the risk of progression. The basis is bone loss, pocket depths, tooth loss and risk factors such as smoking and diabetes.
Treatment
The basis is thorough oral hygiene with instruction and removal of plaque above and below the gum line. In the main phase, the root surfaces in the pockets are cleaned (subgingival instrumentation). After a few months, success is checked; deep residual pockets may require further or surgical measures. Antibiotics are only used as an adjunct in certain situations. Lifelong supportive follow-up care at fixed intervals is crucial. In German statutory health insurance, systematic periodontitis treatment including a two-year follow-up phase is a covered benefit.
Periodontitis and general health
Periodontitis and diabetes influence each other: poorly controlled blood sugar worsens periodontitis, and treated periodontitis can improve blood sugar levels somewhat. Associations with cardiovascular disease and pregnancy complications have been observed; whether periodontitis is a cause here has not yet been conclusively clarified.
Related terms in the encyclopaedia
Periodontitis, Gingivitis, Gum recession, Bad breath, Tartar, Peri-implantitis, Professional tooth cleaning, Interdental cleaning
Sources
- S3-Leitlinie „Die Behandlung von Parodontitis Stadium I bis III“ (Deutsche Gesellschaft für Parodontologie, DGZMK; Adaptation der Leitlinie der European Federation of Periodontology)
- Gemeinsamer Bundesausschuss (G-BA): Richtlinie zur systematischen Behandlung von Parodontitis und anderer Parodontalerkrankungen (PAR-Richtlinie)
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG): gesundheitsinformation.de – Parodontitis
- Papapanou PN et al.: Periodontitis – Consensus report of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor, dentist or pharmacist. Last updated: October 2026.