A LOOK BELOW THE GUMLINE

Periodontitis:
When gingivitis, inflammation of the gingiva, is left untreated, it can lead to an infection of the
tissue and structures that hold your teeth in place (periodontitis).

A tool in determining a diagnosis for periodontitis is the presence of alveolar bone loss (bone
loss around the teeth). This can be seen and determined through the combination of clinical and
radiographic assessment. Without a radiographic assessment, the dental professional is unable to
physically see below the gumline to determine a proper diagnosis.

WHAT DOES THIS LOOK LIKE?

Stage I Periodontitis
Slight Bone Loss
o Radiographic bone loss in the coronal third of the root (<15%)
o This is indicative of the beginning stage of periodontitis.
Gingivitis has progressed to cause permanent damage to the bone.

Stage II Periodontitis
Moderate Bone Loss
o Radiographic bone loss in the coronal third of the root (15-33%)
o The bone loss present is no longer considered slight, it has
advanced to a more moderate stage.

Stage III and IV Periodontitis

Severe Bone Loss
o Radiographic bone loss extends to the middle third of the root
and beyond.
o At this stage vertical bone loss and tooth mobility will often be
present.

Prevention:
To prevent gingivitis from advancing to periodontitis, or to prevent the progression of
periodontitis:
o Brush twice daily and floss daily
o Visit the dentist routinely
o Avoid smoking and tobacco use
o Reduce stress levels
o Consume a healthy diet

2017 classification of periodontal and peri-implant diseases and conditions. American Academy of Periodontology. (2022, August 31). Retrieved
April 16, 2023, from https://www.perio.org/research-science/2017-classification-of-periodontal-and-peri-implant-diseases-and-conditions/

Iannucci, J. M., & Howerton, L. J. (2022). Dental radiography: Principles and Techniques (6th ed.). Elsevier.