Periodontitis is a development of gingivitis. To determine the severity of periodontitis, an X-ray of the teeth is required to check for pathological bone resorption in the alveolar bone. If the symptoms are limited to the gingival tissue, such as simple gingival bleeding, brushing bleeding, gingival swelling, or pus discharge, it can be managed by dental cleaning or ultrasonic scaling, followed by medicated irrigation around the gums to improve the inflammation. If subgingival calculus is present, it might also be addressed with scaling or root planing to remove the calculus. If there is significant alveolar bone resorption due to severe periodontitis, the condition is serious and may require guided bone regeneration surgery. In severe cases, tooth extraction may be necessary.