John L. Smith, DDS, MSPeriodontics & Dental Implants

What happens if gum disease is left untreated?

Untreated periodontitis can destroy support around the teeth and eventually lead to tooth loss. It may progress without pain. Not every case advances at the same rate, and early gum inflammation does not always become periodontitis.

Written and reviewed by John L. Smith, DDS, MS · Reviewed

Discuss your concern with Dr. Smith Before your first appointment

Does all gum disease cause bone loss?

Gingivitis is inflammation limited to the gums. It is usually reversible with good home care and a professional cleaning.

Periodontitis damages the tissues and bone that support the teeth. It needs treatment and ongoing maintenance.

Gingivitis does not always become periodontitis. Risk factors and past findings help guide follow-up, but they cannot predict exactly what will happen to an individual tooth.

What can happen over time?

Periodontitis can deepen the spaces between gums and teeth and damage the supporting tissues. A toothbrush cannot reach the bottom of a deep pocket to remove deposits there.

As support is lost, teeth may loosen or shift and chewing can become difficult. Bleeding or bad breath may occur, but the amount of pain does not tell you how much damage there is.

How is progression checked?

Dr. Smith measures the spaces around the teeth, checks for bleeding and gum recession, and assesses the supporting bone on X-rays.

Comparing these findings with earlier records or later visits helps show whether the condition is changing. A single examination cannot show exactly how quickly past damage occurred.

Why does time matter?

As support is lost, the options for keeping a tooth may narrow. It is worth having recurrent bleeding or other changes assessed even if your mouth does not hurt.

A plan to monitor follows an examination and includes follow-up. It is different from leaving suspected disease unchecked. Ask which findings would change the plan and when another assessment is needed.

What can treatment change?

Treatment can control inflammation and help protect the support that remains. Some procedures can rebuild support in suitable areas, and some loose teeth become more stable after treatment. The result depends on why the tooth is loose and how much damage has occurred. Periodontitis needs ongoing care, and some teeth cannot be saved.

The gum-disease guide explains cleaning, surgery, and maintenance. Before delaying care, discuss how much support remains, whether disease is active, and what delay could change.

Is gum disease linked to other health problems?

Periodontitis and diabetes affect each other. Diabetes raises the risk of gum disease, and gum inflammation can make blood sugar harder to control. In people with both conditions, gum treatment lowered HbA1c, a measure of average blood sugar, by about 0.4 percentage points three to four months later.

Gum disease is also linked with heart attack and stroke. The American Heart Association reports that the link has not been shown to be one of cause and effect, and there is no direct evidence yet that gum treatment prevents heart disease. Tell Dr. Smith about diabetes, heart conditions, and the medicines you take.

When should you contact a dentist?

Contact a dentist about bleeding that keeps returning or a change in your bite. You do not need to wait for pain.

Contact a dentist promptly for severe dental pain, swelling, or a tooth or implant that feels loose. If swelling makes it hard to breathe or swallow, seek emergency medical care now.

What does it cost?

Each office sets its own consultation fee, so ask when you book. Your treatment estimate depends on what the examination finds.

Ask for an estimate for the proposed treatment and any ongoing maintenance. If surgery is recommended, ask which procedure is proposed and what is included.

Questions to bring to a consultation

  • Do I have gingivitis or periodontitis?
  • How much support has been lost, and where?
  • What findings suggest that the disease is active?
  • What could change if I wait?
  • Which teeth could benefit from treatment?
  • When should I be reassessed, and by which office?

Discuss your concern with Dr. Smith

Call the office you would like to visit and describe what you have noticed. If you are worried about discomfort or cost, mention it when you call.

Offices and contact

Sources for this guide

Authorship and clinical review

Written and reviewed by John L. Smith, DDS, MS, periodontist. Last reviewed .