Periodontitis is usually preceded by gingivitis, except in smokers as an example, where preceding gingivitis may not be evident.
Dr. Lee to Martin: "This brochure is for you to keep, and it illustrates what is happening to your teeth and gums. In a healthy mouth, the supporting bone level is high and the gum pockets are not very deep. There is very little plaque or tartar. Poor oral hygiene habits cause plaque and calculus to accumulate, and the periodontal disease process begins. Bacterial infection causes the gum pockets to become inflamed, as they were on your last visit. Over time, the tissue begins to atrophy, gums recede, gingival pockets deepen, and the levels of supporting bone decrease. This is why your tooth is loose. If untreated, this tooth and others may fall out."
Do you have any questions before we talk about treatment?