It causes more tooth loss in adults than decay does, yet it progresses so quietly that most people only notice once a tooth has started to move.
- Periodontitis can be controlled, but lost bone does not grow back. Treatment aims to halt the disease and preserve remaining teeth.
- The decisive difference from gingivitis is bone loss: gingivitis is reversible, periodontitis is not fully so.
- The disease is usually painless until a late stage, so it tends to be found once teeth are already loose.
- Scaling and periodontal treatment are covered by health insurance when prescribed as treatment for a condition.
Patients often open with the same sentence: "This tooth has gone loose and there is no decay in it." A tooth that is loose without decay usually points to periodontal disease, which is a disease of the tissue holding the tooth rather than of the tooth itself.
The short answer
Periodontitis can be controlled, but bone that has already been lost does not grow back. That is the single most important difference from gingivitis. The aim of treatment is to halt progression and preserve the remaining teeth, not to restore the original state. Which is why when treatment begins matters so much.
Gingivitis and periodontitis are not the same
The two terms are often used interchangeably, but they differ on one decisive point: whether bone has been lost.
Gingivitis is the early stage. Inflammation is confined to the gum around the tooth. The gum is red, swollen and bleeds easily on brushing. The alveolar bone and the ligament holding the tooth are still intact. This stage is reversible: remove the tartar, maintain good hygiene, and the gum recovers.
Periodontitis is when inflammation extends deeper and destroys the periodontal ligament and the alveolar bone that keep the root firm in the jaw. Deep pockets form between gum and root, sheltering bacteria that continue the destruction. Lost bone does not regenerate on its own.
A simple way to picture it: gingivitis is a dirty fence, periodontitis is a rotting post.
Signs of periodontitis
- Persistent bleeding from the gums, sometimes spontaneously.
- Bad breath that does not resolve despite consistent oral hygiene.
- Receding gums making teeth look longer, exposing roots and causing sensitivity.
- Gaps opening up between teeth, with more food packing than before.
- Loose teeth, or a bite that feels different when chewing.
- Swollen gums, with discharge when pressed.
One feature invites complacency: periodontal disease is usually painless until a late stage. No pain means no appointment, and the disease gets years to progress quietly. That is a large part of why it is found late.
Who is more at risk?
Beyond the primary factor of accumulated plaque and tartar, some groups carry higher risk: smokers, people with poorly controlled diabetes, people with conditions that reduce immune defence, and older adults simply through longer accumulation.
The link with diabetes runs both ways: high blood glucose makes gum tissue heal poorly and become more prone to infection, while ongoing periodontal inflammation makes blood glucose harder to control. If you have diabetes, attend dental check-ups regularly and tell the dentist about your condition.
What treatment involves
The dentist first establishes the stage: assessing the gum tissue, measuring pocket depth around each tooth, checking mobility, and taking x-rays to see the extent of bone loss. This step matters because gingivitis and periodontitis are managed differently.
Treatment usually follows a sequence: removing tartar above and below the gum line, deep cleaning of the root surfaces within the pockets, re-teaching brushing and interdental cleaning, then review to assess the response. For a loose tooth that can be retained, splinting may be considered. Where a tooth has lost too much support to be kept, the dentist will discuss extraction and the options for replacing it.
On health insurance: scaling and periodontal treatment fall within the covered group when prescribed as treatment for a condition. Bring your health insurance card, or the VssID or VNeID app, plus photo identification. The dentist will set out clearly which items are covered and which are self-paid before treatment.
Why review appointments matter
Periodontal disease is chronic. After a course of treatment the pockets are cleaner and the gums less inflamed, but bacteria return if plaque accumulates again. Periodontal treatment therefore does not end at the final cleaning appointment; it moves into a maintenance phase of scheduled reviews and professional cleaning.
What you do at home counts as much as what is done at the clinic: brushing twice daily with a soft brush, cleaning between the teeth every day, and stopping smoking if you smoke.
If you have a loose tooth, receding gums or persistent bleeding, arrange an examination to find out which stage you are at. Ky Hoa Dental sees patients at 266A - 268, Duong 3 Thang 2, Hoa Hung Ward, Ho Chi Minh City.
Frequently asked questions
Does periodontitis lead to losing teeth?
It can, if it is left untreated and unmonitored. The disease gradually destroys the ligament and bone supporting the root until the tooth has too little support left. Conversely, when the disease is controlled early and the patient maintains good hygiene with regular reviews, many teeth are kept long term.
Can a loose tooth still be saved?
It depends on how much bone has been lost around the root. A slightly mobile tooth with adequate remaining support can often be kept after periodontal treatment, sometimes with splinting. A tooth that is very mobile through extensive bone loss may not be worth retaining. Only an examination with x-rays can answer this tooth by tooth.
Is periodontal treatment painful?
Deep cleaning below the gum is done under local anaesthetic, so you should not feel pain during the procedure. Afterwards the gums can feel tender and sensitive for a few days, easing gradually. The dentist will give aftercare instructions and arrange a review.