Certain groups of people are at increased risk:

When you have gingivitis, your gums are red and swollen and bleed easily with brushing. Gingivitis doesn't usually cause discomfort. However, gingivitis can get worse. It can lead to a more serious form of periodontal disease, called periodontitis.

Gingivitis can be reversed with a combination of professional and home care. You will need a thorough cleaning in your dentist's office, including removal of plaque below the gum line. Then you must practice good oral care at home.

Chronic periodontitis is the most common form of periodontitis. Between 10% and 15% of the population has some form of it. The older you are, the more likely you are to show signs of periodontitis.

If you have periodontitis, your gums become detached from your teeth. Spaces form between the teeth and gums. These spaces are called periodontal pockets. The dental plaque that builds up in the pockets eventually destroys the bone that supports the teeth. In more severe cases, teeth can become loose and even fall out.

Periodontitis usually is not painful. Some people notice that their gums are bleeding and receding. People also may have bad breath or a bad taste in the mouth. However, periodontitis sometimes does not cause any symptoms that you would notice. Your dentist can diagnose it during an examination, however. The condition usually gets worse quite slowly, over several years.

Unlike gingivitis, periodontitis can't be completely reversed. That is because the lost supporting tissues usually can't be rebuilt. However, treatment and good oral hygiene can improve your oral health and stop periodontitis from getting worse. This can help prevent tooth loss and other serious problems.

Treatment for periodontitis typically includes a thorough cleaning called scaling and root planing. In certain cases, you may need other steps, such as antimicrobial therapy and/or periodontal surgery.

Aggressive periodontitis used to be considered a "young person's disease," but it is no longer classified this way. However, it is more common in younger people than in older people. Both forms of the disease are caused by the bacteria found in the dental plaque.

The treatment generally is the same as treatment for chronic periodontitis, but antibiotics and periodontal surgery are more frequently required. Aggressive periodontitis can be difficult to treat. Some people do not get better with treatment.

Treatment involves controlling the medical problem first. This is followed by treatment similar to that for chronic or aggressive periodontitis.

Other medical conditions can intensify all forms of periodontitis. People with these conditions usually have a fair amount of dental plaque and/or calculus (tartar) on their teeth. Examples include diabetes and HIV infection. People with these diseases are more prone to developing severe periodontitis.

Patients with these forms of periodontal disease also may develop a fever and swollen glands.

The American Academy of Periodontology recognizes two forms of necrotizing periodontal diseases. They are ulcerative gingivitis (NUG) and necrotizing ulcerative periodontitis (NUP). NUG destroys only gum tissue, while NUP affects the gums and the supporting bones as well.

These conditions occur most often in people whose immune systems have been suppressed. They are much more likely in people who smoke or have poor nutrition, psychological stress or HIV infection.

The treatment for NUG typically involves:

NUP is a relatively rare form of periodontal disease. Because it may be associated with a medical condition such as HIV infection, your dentist will consult with your physician. The treatment is very similar to that for NUG. It also may include use of medicine for fungus infections.