Last reviewed: March 2026 · Based on current clinical protocols at DenCos, Hoofddorp
Periodontitis is a chronic bacterial infection of the gums and bone that support your teeth. It is the leading cause of tooth loss in adults worldwide and affects more than 50% of people over the age of 30, according to the Global Burden of Disease study cited by the European Federation of Periodontology (EFP). At DenCos in Hoofddorp, periodontitis is diagnosed and treated by Dr. Gang Wu — a registered periodontist and implantologist (BIG 29918905102) who provides the full range of non-surgical and surgical periodontal care under one roof.
This article explains what periodontitis is, how it differs from gingivitis, what causes it, how it connects to your overall health, and what treatment options are available at DenCos.
What is the difference between gingivitis and periodontitis?
Gingivitis is the mildest form of gum disease — it causes red, swollen gums that bleed easily but does not damage the bone. With professional cleaning and consistent oral hygiene, gingivitis is fully reversible. Periodontitis begins when gingivitis is left untreated and the infection spreads below the gum line, destroying the bone and connective tissue that hold your teeth in place.
The Mayo Clinic describes the progression clearly: plaque hardens into tartar, bacteria travel beneath the gum line, and deep pockets form between the teeth and gums. These pockets fill with more bacteria and the cycle of bone destruction continues.
| Feature | Gingivitis | Periodontitis |
|---|---|---|
| Bone loss | No | Yes |
| Reversible | Yes, fully | Manageable, not reversible |
| Symptoms | Bleeding gums, redness | Loose teeth, receding gums, bad breath |
| Treatment | Professional cleaning | Scaling, root planing, possibly surgery |
At DenCos, Dr. Gang Wu uses digital X-rays and standardised periodontal probing to measure pocket depth and bone levels, distinguishing gingivitis from periodontitis with precision. Early detection is critical — the sooner treatment begins, the more bone and teeth can be preserved.
What causes periodontitis?
The primary cause of periodontitis is bacterial plaque — a sticky film that forms on teeth daily. When plaque is not removed through brushing and flossing, it hardens into tartar (calculus) that cannot be removed at home. Bacteria in tartar produce toxins that inflame the gums and gradually break down the bone.
According to Cleveland Clinic, several risk factors increase your likelihood of developing periodontitis:
- Smoking or vaping — the single strongest modifiable risk factor
- Diabetes — high blood sugar creates a favourable environment for harmful bacteria
- Genetics — family history of gum disease increases susceptibility
- Hormonal changes — pregnancy and menopause heighten gum sensitivity
- Poor oral hygiene — infrequent brushing, flossing, or dental visits
- Certain medications — drugs that cause dry mouth reduce the mouth's natural defences
At DenCos in Hoofddorp, Dr. Wu takes a detailed medical history to identify your personal risk profile. This includes medication use, systemic conditions, and smoking status — all of which influence how aggressively the disease is managed. The interdisciplinary model at DenCos means that if orthodontic treatment is also needed, Dr. Jing Guo and Dr. Wu coordinate care directly under one roof.
What are the symptoms of periodontitis?
Periodontitis is often painless in the early stages, which is why it frequently goes undiagnosed. The Mayo Clinic lists the following warning signs:
- Gums that bleed when brushing or flossing
- Swollen, red, or tender gums
- Persistent bad breath that does not improve with mouthwash
- Gums that pull away from the teeth (recession)
- Loose teeth or teeth that have shifted position
- Pain when chewing
- Pus between the teeth and gums
- New spaces between teeth (black triangles)
If you recognise any of these symptoms, schedule an appointment with a periodontist rather than waiting for your next routine check-up. At DenCos, Dr. Gang Wu can assess your periodontal status in a single visit using probing measurements and digital imaging, and start treatment immediately if needed.
How does periodontitis affect your overall health?
Periodontitis is not just a mouth problem — the bacteria and inflammation in your gums can affect your entire body. A 2019 review published in the International Journal of Molecular Sciences confirmed that periodontitis is an independent risk factor for both type 2 diabetes and cardiovascular disease.
The connection works in two directions:
- Diabetes ↔ periodontitis: high blood sugar promotes bacterial growth in the mouth, while gum inflammation makes it harder for the body to control blood sugar. Treating periodontitis can improve glycaemic control in diabetic patients.
- Heart disease: chronic gum inflammation contributes to arterial inflammation. Periodontal bacteria have been detected in atherosclerotic plaques. People with severe periodontitis face a higher risk of heart attack and stroke.
- Other links: periodontitis has also been associated with respiratory disease, rheumatoid arthritis, adverse pregnancy outcomes, and Alzheimer's disease.
At DenCos, Dr. Wu takes these systemic connections seriously. When a patient's periodontal condition may be affecting — or affected by — a medical condition, he coordinates with the patient's general practitioner or specialist. This whole-body approach is part of the interdisciplinary philosophy at DenCos in Hoofddorp, where patients from Haarlemmermeer, Haarlem, Amsterdam, and surrounding areas receive integrated care.
How is periodontitis diagnosed?
Diagnosis requires a professional periodontal examination — you cannot diagnose periodontitis at home. The American Dental Association staging system classifies periodontitis into four stages (I–IV) based on severity, and three grades (A–C) based on progression risk.
A periodontist measures:
- Pocket depth — healthy gums measure 1–3 mm; pockets of 4 mm or deeper indicate disease
- Clinical attachment loss — how much gum and bone support has been lost
- Bone levels — visible on digital X-rays
- Bleeding on probing — a sign of active inflammation
At DenCos, Dr. Gang Wu performs a comprehensive periodontal examination that includes full-mouth probing, digital panoramic and periapical X-rays, and a medical history review. This allows him to determine your exact stage and grade, and design a targeted treatment plan. Because DenCos offers extended hours on Tuesday through Thursday until 18:30, working patients in Hoofddorp and the wider Haarlemmermeer region can schedule appointments outside standard office hours.
What are the treatment options for periodontitis?
Treatment depends on the stage and severity of your periodontitis. The goal is always to stop the disease, remove infection, and preserve as much bone and tooth structure as possible.
Non-surgical treatment
- Scaling and root planing — a deep cleaning performed under local anaesthesia. Your periodontist removes tartar and bacteria from below the gum line and smooths the root surfaces to help the gums reattach.
- Antibiotics — topical or oral antibiotics may be prescribed to control bacterial infection.
- Improved home care — instruction on brushing technique, interdental cleaning, and the use of antiseptic rinses.
Surgical treatment
For advanced periodontitis (stages III–IV), surgery may be necessary:
- Flap surgery (osseous surgery) — the gums are lifted to allow deep cleaning of the roots and reshaping of the bone
- Bone grafting — lost bone is rebuilt using graft material to provide a stable foundation
- Guided tissue regeneration — a biocompatible membrane encourages bone regrowth
- Gum grafting — tissue is transplanted to cover exposed roots caused by recession
At DenCos, Dr. Gang Wu performs all of these procedures in-house. Having a periodontist and implantologist under one roof means that if a tooth cannot be saved despite treatment, the transition to a dental implant is seamless — no referral to another practice is needed. This integrated approach reduces treatment time and ensures continuity of care for patients in Hoofddorp, Amstelveen, Haarlem, and surrounding areas.
How can you prevent periodontitis?
Prevention is straightforward but requires consistency. The StatPearls medical reference on periodontal disease emphasises that the majority of cases are preventable with good oral hygiene and regular professional care.
Key prevention steps:
- Brush twice daily with a soft-bristled or electric toothbrush
- Clean between teeth daily using interdental brushes or floss
- Visit your dentist or periodontist regularly — every 6 months for healthy gums, every 3–4 months if you have a history of periodontitis
- Do not smoke — smoking is the strongest modifiable risk factor
- Manage systemic conditions — keep diabetes and other conditions well controlled
- Eat a balanced diet — vitamin C and D support gum health
At DenCos, Dr. Wu and the dental hygiene team create a personalised prevention plan for every patient. This includes tailored cleaning intervals, specific product recommendations, and risk factor management — because preventing periodontitis is always preferable to treating it.
Next step
Bleeding gums, loose teeth, or persistent bad breath? Do not wait — early treatment prevents bone loss and tooth loss.
Book a periodontal consultation at DenCos in Hoofddorp, or call us at 023-792 0463. Dr. Gang Wu and the periodontology team are available Tuesday through Thursday until 18:30 for your convenience.