You’ve noticed it for weeks now. Maybe months. That pink tinge in the sink when you brush. The way your gums look darker, puffier than they used to. That metallic taste that lingers even after mouthwash. And you keep asking yourself the same question: Is this serious?

I’m Dr. Gregg Hendrickson, and in my 20+ years treating patients throughout Henderson and Las Vegas, I’ve sat across from thousands of people asking this exact question. They’re worried. Confused. Hoping they caught it early enough. And here’s what I tell them – the difference between gingivitis and periodontitis isn’t just medical terminology. It’s the difference between a condition you can reverse at home and one that requires professional intervention to save your teeth.

Let me walk you through exactly what’s happening in your mouth right now, how to tell which condition you’re dealing with, and most importantly, what you can do about it before it’s too late.

What’s Actually Happening to Your Gums Right Now

Think of your gums as the foundation of a house. When everything’s working properly, they fit snugly around each tooth, forming a tight seal that keeps bacteria out. But when plaque builds up along your gum line, something changes. Your immune system recognizes this bacterial film as a threat and responds with inflammation.

That’s gingivitis. Your gums are fighting back. They swell. They bleed. They turn a darker shade of red. But here’s the critical part – at this stage, the damage hasn’t reached the bone and connective tissue that anchor your teeth in place. Everything that supports your teeth is still intact. That’s why gingivitis is reversible.

Periodontitis is different. When inflammation persists for weeks or months without treatment, bacteria don’t just sit on the surface anymore. They migrate deeper, settling into the space between your gum tissue and tooth root. Your immune system responds aggressively, and in the process of fighting infection, it starts breaking down the very structures meant to hold your teeth in place. Bone deteriorates. Connective fibers detach. Pockets form where bacteria thrive in an oxygen-poor environment.

Once you cross that line from gingivitis to periodontitis, you can’t reverse the bone loss. You can stop it from progressing. You can stabilize the condition. But the structural damage is permanent.

The Warning Signs You’re Seeing (And What They Really Mean)

Let’s talk about what you’re experiencing. Because understanding these symptoms helps you determine whether you’re dealing with early-stage gingivitis or something that’s already progressed to periodontitis.

Bleeding when you brush or floss – This is your body’s earliest alarm system. Healthy gums don’t bleed from normal brushing. If you see pink in the sink occasionally, especially when you’ve been lax with flossing, that’s typically gingivitis. But if you’re seeing blood every single time you brush, or if your gums bleed spontaneously, that suggests deeper inflammation.

Swollen, puffy gums – Run your tongue along your gum line. Do your gums feel thick and spongy instead of firm? With gingivitis, you’ll notice swelling primarily along the gum line where plaque accumulates. With periodontitis, the tissue often looks rolled or bulbous, and you might notice the swelling extends higher up toward where your gum meets your tooth.

Bad breath that won’t go away – Everyone gets morning breath. But persistent halitosis, that metallic or sour smell that returns an hour after brushing, signals bacterial activity below the gum line. When you have periodontitis, bacteria colonize those deep pockets, producing volatile sulfur compounds that no amount of mouthwash can mask.

Gums pulling away from teeth – Look in the mirror. Do your teeth look longer than they used to? Can you see more of the tooth surface, or even a hint of the root? That’s recession, and it’s a defining characteristic of periodontitis. Your gums aren’t actually pulling away voluntarily. The supporting bone is shrinking, and the gum tissue follows.

Teeth feeling loose or shifting – This one’s unambiguous. If you can wiggle a tooth with your tongue, or if you’ve noticed gaps opening between teeth that used to touch, you’re dealing with advanced periodontitis. The bone loss has progressed to the point where teeth are losing their anchoring.

Pain or sensitivity – Gingivitis rarely hurts. It’s inflammation without deep tissue involvement. But periodontitis? That can create sensitivity to temperature, pressure when chewing, or even a dull ache that comes and goes. The exposed root surfaces and inflammatory chemicals in those deep pockets make teeth hypersensitive.

Gingivitis vs Periodontitis: The Clinical Differences That Matter

When you come to my office in Henderson or Las Vegas with gum concerns, here’s exactly how I determine what you’re dealing with. These are the same assessment criteria you can use to understand your own situation before scheduling an appointment.

Gingivitis Characteristics

Inflammation stays superficial – Your gums are red and swollen, but a periodontal probe (that small measuring tool we use) shows pocket depths of 3mm or less. That’s normal, healthy attachment.
No bone loss on X-rays – When I take digital X-rays, the bone level around your teeth looks normal. The triangular peaks of bone between teeth are intact.
Gums bleed easily – When I gently probe around your gum line, you see bleeding. That’s your inflamed tissue responding to even light pressure.
Reversible with good home care – This is the defining feature. Commit to proper brushing and flossing for two weeks, and you’ll see dramatic improvement. The inflammation resolves. The bleeding stops. Your gums return to a healthy pink color.

Periodontitis Characteristics

Deep pocket formation – Probe depths measure 4mm or greater. I’m finding spaces between your gum and tooth where bacteria have colonized below the gum line.
Bone loss visible on X-rays – Those triangular peaks? They’re flattened or missing entirely. The bone level has dropped, sometimes significantly.
Gum recession – The gum tissue has migrated down the tooth, exposing root surfaces. This isn’t inflammation. It’s actual tissue and bone loss.
Tooth mobility – With advanced periodontitis, I can feel teeth move when I apply pressure. The bone support has deteriorated to the point where anchoring is compromised.
Not reversible, but controllable – You can’t regrow lost bone. But with professional treatment and excellent home care, we can stop the disease progression and maintain the support you have left.

Why the Distinction Matters More Than You Think

I understand the temptation to downplay what’s happening. “It’s just my gums,” patients tell me. “My teeth are fine.” But here’s what the research shows, and what I’ve witnessed in my own practice over two decades.

Untreated periodontitis doesn’t stay contained in your mouth. The bacteria causing inflammation in your gum pockets can enter your bloodstream through those damaged tissues. Research shows associations between periodontal disease and increased risk of heart disease, stroke, diabetes complications, and respiratory infections. While the exact nature of these connections is still being studied, your mouth isn’t isolated from the rest of your body – it’s connected to your overall health.

But even focusing purely on your oral health, the progression from gingivitis to periodontitis represents a point of no return. Once you’ve lost supporting bone, you’re managing a chronic condition for life. You’ll need more frequent professional cleanings. You’ll require ongoing monitoring. And without that commitment to treatment, you’re looking at eventual tooth loss.

I’ve seen patients in their 40s and 50s who ignored bleeding gums for years, assuming it was normal or harmless. By the time they finally scheduled an appointment, they’d lost significant bone support. We’ve been able to save their teeth with intensive treatment, but it’s a lifetime of management they could have avoided if they’d addressed gingivitis when it first appeared.

What Causes the Progression from Gingivitis to Periodontitis

Not everyone with gingivitis develops periodontitis. Several key factors determine who progresses:

Inconsistent oral hygiene – You brush regularly but skip flossing, or you’re diligent for weeks then slip back into minimal care. That inconsistency gives bacteria the opportunity to establish deeper infections.

Smoking and tobacco use – Nicotine constricts blood vessels in your gum tissue, limiting oxygen and nutrients that support healing while impairing immune response. Smokers progress faster and have worse treatment outcomes.

Genetic susceptibility – Some people are more prone to aggressive periodontal disease. Family history of tooth loss from gum disease puts you at higher risk.

Diabetes and systemic conditions – Uncontrolled diabetes significantly increases periodontitis risk. High blood sugar impairs healing and increases infection susceptibility.

How to Reverse Gingivitis (Before It Becomes Permanent)

If you’re dealing with gingivitis, you have a window of opportunity. Here’s exactly what needs to happen to reverse the inflammation and restore healthy gums.

Master proper brushing technique – You need two minutes, twice daily, with a soft-bristled brush. Angle the bristles 45 degrees toward your gum line. Use gentle circular motions, not aggressive back-and-forth scrubbing. You’re trying to disrupt bacterial colonies along the gum line without traumatizing the tissue. Most people brush too hard and too fast. Slow down. Be thorough.

Floss every single day – No exceptions. Brushing cleans about 60% of your tooth surfaces. The other 40% is between teeth where your brush can’t reach. Use about 18 inches of floss, wrapping it around your middle fingers. Curve the floss into a C-shape against each tooth surface, sliding it gently beneath the gum line. You should hear a slight squeaking sound as you move the floss up and down against the tooth.

Consider an antimicrobial rinse – I often recommend chlorhexidine rinses for patients with gingivitis. It’s prescription-strength and more effective than over-the-counter mouthwashes at reducing bacterial load. Use it twice daily for two weeks, followed by a maintenance phase with regular antiseptic rinses.

Schedule a professional cleaning – Even with perfect home care, you need professional removal of hardened calculus. Once plaque mineralizes into tartar, brushing can’t remove it. You need ultrasonic scaling and hand instruments to clean below the gum line effectively.

Give it two weeks – That’s how long it takes to see significant improvement with gingivitis. Your gums should look pinker, feel firmer, and stop bleeding. If you’re not seeing improvement after 14 days of excellent home care, you’re likely dealing with early periodontitis, and you need professional assessment.

Treating Periodontitis: What Professional Intervention Looks Like

Periodontitis requires a different approach. Home care alone won’t resolve deep infections. Here’s what treatment involves, based on disease severity.

Scaling and Root Planing (Deep Cleaning)

This is the foundation of periodontal therapy. We use ultrasonic instruments and hand scalers to remove bacterial deposits and calculus from root surfaces below the gum line. Then we smooth the root surfaces, making it harder for bacteria to recolonize. The procedure typically requires local anesthesia because we’re working in those deep pockets where tissue is inflamed and sensitive.

Most patients need this done in quadrants – we treat one section of your mouth per visit, allowing adequate time to thoroughly clean each area. After scaling and root planing, I monitor your healing over the next few months. Many cases stabilize with this treatment alone.

Antibiotic Therapy

For moderate to severe cases, I sometimes prescribe antibiotics to help control bacterial infection. These might be systemic antibiotics you take orally, or localized antimicrobials we place directly into periodontal pockets. The goal is to reduce bacterial load while your immune system and professional cleaning address the inflammation.

Surgical Intervention

When pocket depths remain deep after scaling and root planing, or when disease continues progressing, surgical treatment becomes necessary. Flap surgery allows us to fold back gum tissue, access root surfaces and bone directly, remove all bacterial deposits, and reshape irregular bone contours. We then suture the tissue back in place at a level where you can maintain it with proper home care.

In some cases, we can perform bone grafting or guided tissue regeneration to encourage new bone growth. These procedures work best in localized defects where the surrounding bone provides a scaffold for regeneration.

Maintenance Phase

Once we’ve controlled active periodontitis, you enter lifelong maintenance with professional cleanings every 3-4 months. Without vigilant ongoing care, bacteria will recolonize those pockets and disease will progress. Periodontitis treatment requires commitment, but the alternative is tooth loss and eventual need for implants or dentures.

When You Should See a Dentist in Henderson or Las Vegas

Don’t wait until teeth feel loose. Don’t assume bleeding gums are normal. Don’t postpone treatment because you’re afraid of cost or discomfort. Here’s when you need professional evaluation:

Persistent bleeding – If your gums bleed regularly when brushing or flossing, schedule an appointment within 2 weeks.
Swelling that doesn’t resolve – Inflamed gums that stay puffy despite improved home care need professional assessment.
Bad breath that won’t disappear – Chronic halitosis suggests bacterial activity below the gum line.
Any gum recession – This indicates you’ve already progressed beyond gingivitis.
Tooth sensitivity or pain – Don’t ignore discomfort in your gums or teeth.
It’s been more than 6 months – Even if you’re not experiencing symptoms, regular cleanings prevent gingivitis from developing in the first place.

At Comprehensive Dental Care, we offer same-day emergency appointments for patients experiencing significant gum pain or swelling. Our Henderson and Las Vegas locations are equipped with digital X-rays and advanced diagnostic imaging, allowing us to assess bone levels and pocket depths accurately during your first visit.

I’ll be direct with you about what I find. If you have gingivitis, I’ll outline exactly what you need to do at home to reverse it. If you’ve progressed to periodontitis, I’ll explain your treatment options, timeline, and expected outcomes. The worst thing you can do is nothing. Periodontal disease doesn’t improve on its own. It progresses. And every month you wait, you lose more of the irreplaceable bone supporting your teeth.

Your Gums Are Telling You Something

That bleeding when you brush? That’s not normal. Those puffy, dark gums? That’s your body fighting an infection. The bad breath that returns an hour after brushing? That’s bacteria thriving below your gum line.

Your body is sending clear signals. The question is whether you’re going to listen while you still have time to reverse the damage, or whether you’re going to ignore the warnings until the damage becomes permanent.

I’ve guided thousands of patients through this decision over the past two decades. The ones who act early, who commit to treatment and proper home care, maintain their natural teeth for life. The ones who postpone treatment end up losing teeth they could have saved.

You’re already concerned enough to research the difference between gingivitis and periodontitis. That awareness is the first step. Now take the second step and schedule a comprehensive periodontal evaluation. Let’s determine exactly what you’re dealing with and create a treatment plan that makes sense for your situation.

Schedule your appointment at our Henderson or Las Vegas location. We’ll perform a thorough examination, including digital X-rays and periodontal measurements, and give you clear answers about your gum health. Same-day emergency appointments are available for patients experiencing significant discomfort.

Your mouth is the gateway to your body’s overall health. Don’t wait until small problems become major ones. Let’s address your gum concerns while treatment is still straightforward and reversible.