At first, most people won't notice when they slip into early periodontitis. The symptoms of gingivitis typically get worse. The gums may be slightly more tender. They may bleed more easily. Periodontal pockets will measure in the range of 3 to 5 millimeters. (One millimeter is about the same thickness as a dime.)

What can be done: Once periodontitis has set in, brushing and flossing should remain top priority. However, specific treatments will be needed. Mild periodontitis can still be brought under control without surgery.

The first step is scaling and root planing, a deep cleaning technique. Scaling removes plaque and calculus (tartar) from under the gum line. Root planing smoothes any bumps or rough areas on the tooth roots. Plaque tends to build up on rough surfaces.

In some cases, antibiotics are used along with scaling and root planing. Antibiotics can be swallowed as a pill or applied in gel, powder or chip form to the affected area of the mouth.

Sometimes these treatments are not successful. Periodontal surgery may be needed.

Important: Unlike in gingivitis, the effects of periodontitis can't always be reversed. Even if the disease is brought under control, it is a chronic (long-term) condition. It can always resurface if oral hygiene becomes lax. People with periodontis should diligently follow their periodontists' advice.