What Are the Stages of Gum Disease?

Gingivitis is inflammation limited to the gum. The gums look red or puffy and bleed when you brush or floss, and breath may be slightly off. There is no bone loss and the teeth are firm.

This is the only stage that can be fully reversed. Thorough brushing at the gum line, daily cleaning between the teeth and a professional scaling usually settle it within one to two weeks, as described in our page on curing gum disease without a dentist.

If gingivitis is left, inflammation spreads below the gum edge and the first bone is lost. Pockets form, usually 4 to 5 mm deep. Bleeding continues and there may be some bad breath, but teeth feel firm and there is little pain, so it is easy to miss.

This stage needs deep cleaning of the roots, explained in scaling and root planing. The bone already lost does not return, but treatment can hold the position where it is.

Moderate periodontitis means deeper pockets and more bone loss. Gums recede, teeth look longer, and some teeth begin to feel slightly mobile. Pus may appear at the gum edge and abscesses can form.

Advanced periodontitis means a large share of the bone around some teeth is gone. Teeth drift, loosen, and may hurt when chewing. This is the stage people usually call pyorrhea, and the pyorrhea page explains the term.

Treatment at these stages is longer and may include surgery or referral to a periodontist. Teeth with very little bone left may not be saveable, and the honest advice for those is extraction with replacement.

You cannot judge the stage by looking, because the early stages cause no pain and bleeding is not a reliable guide. The dentist measures pocket depth around every tooth with a probe, checks whether teeth move, and uses an X-ray to see bone height.

Dentists now also record how fast the disease seems to be progressing and risk factors such as smoking and diabetes, because two people with the same pocket depths can need different plans. The steps are set out on our gum treatment page.

Each step down the stages costs more and keeps less. Gingivitis needs a scaling, which costs ₹800 to ₹2,500 in Lucknow in 2026. Periodontitis needs root planing at ₹1,500 to ₹4,000 per quadrant or ₹6,000 to ₹15,000 for the full mouth, plus ongoing maintenance. See the teeth cleaning cost page for the full table.

The bigger cost is bone, because it cannot be rebuilt by cleaning. Bleeding that lasts more than two weeks despite good cleaning is the signal to get measured rather than wait.