This ligament may become weakened and alveolar bone is irreversibly lost. The tooth becomes loose and there is a danger of further bacterial attack with the development of abscesses, and eventual tooth loss. The initial sign that the patient recognises is usually bleeding gums. This occurs fairly early in the disease. Bad breath and receding gums follow.
Tooth sensitivity is usually a later stage and eventually abscesses form with concomitant pain.
Current medication is not usually significant but phenytoin, nifedipine and cyclosporin may produce gingival hyperplasia. The combined oral contraceptive is also thought to increase the incidence of gingivitis. Gums bleed at the slightest provocation as they are poorly attached to the cementum and periodontal ligament. As the condition progresses the gum margin regresses and cementum, which is normally covered by the gum is seen. Malodorous breath may be noted.