Can X-rays show periodontitis?

Oct 16, 2025 Source: Cainiu Health

Dr. Liu Chao

Introduction

For patients with moderate to severe periodontitis, prolonged inflammation leads to significant alveolar bone resorption. Periapical radiographs or panoramic radiographs can clearly show reduced alveolar bone height, decreased bone density, and even root exposure. These imaging studies also help determine the extent and severity of bone loss, providing essential information for developing a treatment plan. In such cases, radiographic imaging is highly valuable for diagnosis.

　　X-rays can reveal bone loss in moderate to severe periodontitis, but early-stage periodontitis is difficult to detect due to minimal and inconspicuous bone resorption, requiring clinical examination for accurate diagnosis. If symptoms such as gum bleeding or bad breath occur, prompt medical attention is recommended to prevent disease progression to moderate or severe stages, which increases treatment difficulty.

　　In patients with moderate to severe periodontitis, prolonged inflammation leads to significant alveolar bone loss. Periapical or panoramic radiographs can clearly show reduced alveolar bone height, decreased bone density, and even root exposure. These images also help determine the extent and severity of bone loss, providing essential information for developing an effective treatment plan. In such cases, radiographic imaging plays a crucial role in diagnosis.

　　Early periodontitis primarily presents as redness, swelling, and bleeding of the gums, with minimal alveolar bone loss that falls below the resolution limit of X-rays, making abnormalities hard to identify through imaging alone. At this stage, dentists must rely on clinical examinations—such as assessing gum color and measuring periodontal pocket depth—along with patient symptoms to make an accurate diagnosis. Relying solely on X-rays may lead to missed diagnoses.

　　It is recommended to brush teeth daily using a soft-bristled toothbrush and the Bass brushing technique, and to clean between teeth with dental floss after meals. Additionally, regular dental check-ups every six months to one year, along with imaging when necessary, can help detect and prevent periodontal problems early.

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Can wisdom teeth cause periodontitis?

In general, whether wisdom teeth cause periodontitis depends on their growth condition. When wisdom teeth are properly positioned and can be cleaned effectively, they usually do not lead to periodontitis. However, if the wisdom teeth are impacted or difficult to clean, they may trigger periodontitis. To prevent periodontal problems related to wisdom teeth, it is recommended to maintain daily oral hygiene by brushing teeth morning and night, using dental floss or water flossers to clean interdental spaces, and undergoing regular dental check-ups.

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Will gum recession continue to progress?

If gingival recession is caused by factors such as periodontitis, long-term improper brushing techniques, or malaligned teeth and remains untreated, the inflammation will continuously destroy the gums and alveolar bone, leading to further gum recession and increased exposure of tooth roots. This may also be accompanied by problems such as tooth mobility and sensitivity, creating a vicious cycle that progressively worsens the recession.

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Can severe oral ulcers lead to periodontitis?

In general, whether severe oral ulcers lead to periodontitis depends on the relationship between the two conditions. Severe oral ulcers alone typically do not directly cause periodontitis; however, if severe ulcers are accompanied by poor oral hygiene and excessive bacterial growth, the risk of developing periodontitis may increase. To prevent mutual influence between oral ulcers and periodontitis, proper daily oral care is essential.

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Can teeth be extracted if there is periapical periodontitis?

In general, whether a tooth can be extracted in cases of apical periodontitis depends on the specific condition of the inflammation and the actual status of the tooth. Before extraction, patients should honestly inform the dentist about their history and treatment of apical periodontitis, and cooperate with oral and imaging examinations. After the extraction, follow medical instructions to firmly bite down on the gauze for hemostasis, and avoid rinsing, brushing, or touching the wound with the tongue immediately.