Periodontitis is an inflammatory infection that is completely or largely painless until the late stages, like when teeth become loose and start falling out. But that can take a long time to happen. In the meantime it doesn’t hurt.
A good way to explain it is it’s kind of like high blood pressure. Painless for sure, even if untreated, until one day you start experiencing fatigue, chest pains, or worse. In the case of high blood pressure this can take many years; same thing with periodontitis. Gum disease is usually painless, even if untreated. But one day your teeth start to loosen up and cavities starting to pop up. This is when the gum disease starts to become painful. BTW – cavities are also a type of biofilm infection and they are painless as well in the early stages.
The early stages of gum disease create a buildup of tartar or “biofilm plaque”. This plaque is made up of live and dead bacteria and other microbes, some of which can be very destructive to your enamel as well as the structures that support your gums and teeth as it progresses. At this early stage the symptoms are mainly bleeding gums and some inflammation. No doubt your dentist will mention “bleeding points” after you have your teeth cleaned. This condition of early stage periodontal disease is, as you noted, painless.
If you allow the plaque to continue to build up, it will eventually invade the area below your gum line and cause more worrisome problems. These include mid-stage gum disease, receding gums, cavities, and root cavities and pain will often start at this time.
If these conditions are allowed to progress further you will likely experience “pocketing” which is a symptom involving the detachment of the supporting tissues around the roots of your teeth. These “pockets” are measured in millimeters by your dentist or hygienist. You may have already been “charted” where this measuring was done. These pockets are considered a problem at more than 2 or 3mm deep.
They can be much deeper depending on the severity of your case. Certainly if there are more than a couple of deeper pockets your dental health professional will alert you to this condition and suggest ways to help. Teeth will usually start to loosen up when these pockets extend below 5mm all the way to 10mm or more. In extreme cases this condition is referred to as “refractory periodontitis” meaning late stage periodontal disease. Here is where you will undoubtedly be experiencing some pain; maybe a lot of pain.
The key here is to always keep up with your dental and oral health. See your dentist regularly. Brush, floss, and rinse with the best anti-bacterial/anti-microbial mouthwash you can get and watch out for those bleeding gums! To learn more about gum disease and the associated pain, check out the ADA’s publication What is Gum Disease.
