Dee Nishimine, D.D.S., Inc.
Sophia Y. Tseng, D.M.D.
Periodontics & Dental Implants
Call: (559)229-6557

Signs & Symptoms of Periodontal Disease (PD)

Periodontal Disease (PD) (also known as periodontitis and gum disease) is a progressive condition and the leading cause of tooth loss amongst adults in the United States of Amereica.  Periodontal Disease (PD) occurs when the toxins found in Bacterial Plaque begin to irritate or inflame the gingiva (gum tissue).  The resulting bacterial infection often known as gingivitis, can eventually lead to the destruction of the gum tissue and underlying bone.  If Periodontal Disease (PD) is not treated, it can also lead to loose teeth or tooth loss.

There are many common types of Periodontal Disease (PD) including aggressive, chronic, necrotizing periodontitis, and periodontitis associated with systemic diseases.  Each of these types of Periodontal Disease (PD) has its own distinct characteristics and symptoms, and all require prompt treatment by  Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng to halt subsequent bone, tissue, and tooth  loss.

Common Signs & Symptoms

It is extremely important to note that Periodontal Disease (PD) can progress without any signs or symptoms such as pain.  This is why routine periodontal examinations  are important. Described below are some of the most common signs and symptoms of periodontitis.

If you have any of these signs or symptoms, the advice of a general dentist or Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng  should be sought as soon as possible:  Contact us

  • Unexplained bleeding – Bleeding when brushing, flossing or eating food is one of the most common symptoms of a periodontal infection.  The toxins in Bacterial Plaque cause a bacterial infection which makes the tissues prone to bleeding.
  • Pain, redness or swelling – A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason.  It is essential to halt the progression of the infection before the gum tissue and jaw bone have been affected.  It is also critical to treat the infection before it is carried into the bloodstream to other areas of the body.  This can affect your entire body or systemically.
  • Longer-looking teeth – Periodontal Disease (PD) can lead to gum recession.  The toxins produced by Bacteria Plaque can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy.”
  • Bad breath/halitosis – Although breath odor can originate from back of the tongue, the lungs and stomach, from the food we consume, or from tobacco use.  Bad breath may be caused by old food particles which sit between the teeth and underneath the gumline.  The deeper gum pockets are able to house more debris and bacteria, causing a mal odor.

  • Loose teeth/change in bite pattern – A sign of rapidly progressing periodontitis is the loosening or shifting of the teeth in the affected area.  As the bone tissue gets destroyed, teeth that were once firmly attached to the jawbone become loose or may shift in position.
  • Pus – Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress.  The pus is a result of the body trying to fight the bacterial infection.  It is composed of dead dying tissue and the bacterial waste products.

Treatment of Periodontal Disease (PD)

It is of the utmost importance to halt the progression of Periodontal Disease (PD) before it causes further damage to the gum tissues and jawbone.  Your general dentist may initially assess the whole mouth in order to ascertain the progress of the disease. Ideally this should be treated by a specialist. Inturn you will be referred to Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng.  

In the case of moderate Periodontal Disease (PD), the pockets (under the gumline) of the teeth will be completely cleared of debris using a procedure called scaling and root planing (SRP's).  Antibiotics and prescription mouthwashes may be used as and adjunctive measure.


Severe periodontitis can be treated in several different ways, such as:

  • Tissue & bone grafting – Where a considerable amount of bone or gum tissue has been destroyed,  Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng may elect to graft bone to the area and use a membrane to stimulate tissue and bone growth.
  • Pocket reduction surgery –  Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng may choose to perform “flap surgery” to  reduce the pocket depths.  Ideally we would like the pocket depths to be less than 3 mm.

If you have any further questions about the signs and symptoms of periodontal disease, please ask your dentist or our Periodontal Team.  Contact us