Gum disease begins with bacterial growth in the mouth and can lead to tooth loss by destroying the tissue surrounding your teeth if not properly treated.

What is the difference between gingivitis and periodontitis?

Periodontitis is usually preceded by gingivitis. However, it is important to know that not all gingivitis turns into periodontitis.

In the early stages of gingivitis, bacteria build up in plaque, causing gums to become inflamed and bleed easily when brushing. Although the gums may be irritated, the teeth are still firmly implanted in their sockets and no irreversible damage to the bone or other tissues has occurred at this stage.

If gingivitis is left untreated, it can progress to periodontitis. In a person with periodontitis, the inner layer of gum and bone moves away from the teeth and forms pockets. Debris collects in these small spaces between the teeth and gums and can become infected. The body’s immune system fights the bacteria as plaque spreads and grows under the gum line.

Toxins produced by the bacteria in the plaque, as well as the body’s “good” enzymes involved in fighting the infection, begin to break down the bone and connective tissue that hold the teeth in place. As the disease progresses, the sinuses deepen and more and more gum tissue and bone are damaged. When this happens, the teeth are no longer in place, become loose, and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults.

What causes gum disease?


Plaque is the main cause of gum disease. However, other factors can also contribute to gum disease. These include:

Hormonal changes: such as during pregnancy, puberty, menopause and menstruation, which make the gums more sensitive, making it easier to develop gingivitis.

Diseases can affect the condition of the gums: These include diseases such as cancer or HIV, which affect the immune system. Because diabetes affects the body’s ability to utilize blood sugar, patients with this disease are at higher risk for infections, including gum disease and tooth decay.

Medications can affect oral health: This is because some of them reduce saliva flow, which has a protective effect on the teeth and gums. Certain medications, such as the anticonvulsant Dilantin, the anti-angina drug Procardia, and Adalat, can cause abnormal growth of gum tissue.

Bad habits like smoking make it difficult for gum tissue to repair itself.

Poor oral hygiene habits, such as not brushing and flossing daily, make it easier for gingivitis to develop.

A family history of dental disease can contribute to the development of gingivitis.

What are the symptoms of gum disease?

Gum disease can progress without pain, resulting in some visible signs, even in the late stages of the disease. Although the symptoms of gum disease are often subtle, the condition is not completely without warning signs. Some symptoms may indicate some form of the disease. Symptoms of gum disease include:

  • Bleeding of the gums during and after brushing your teeth.
  • Red, swollen or sensitive gums
  • Persistent bad breath or a bad taste in the mouth
  • Receding gums
  • Formation of deep pockets between teeth and gums
  • Loose or shifting teeth
  • Changes in the way teeth fit together when you nibble or insert partial dentures.

Even if you don’t notice any symptoms, you may have gum disease. For some people, gum disease may only affect certain teeth, such as the molars. Only a dentist or periodontist can detect and determine the development of gum disease.

How does my dentist diagnose gum disease?

During a dental exam, your dentist will usually check for these things:

Bleeding gums, swelling, firmness, and the depth of the pocket (the space between the gums and the teeth; the larger and deeper the pocket, the more severe the disease).

Tooth movement, sensitivity, and proper alignment of the teeth

Jaw bone, to detect deterioration of the bone surrounding your teeth

How is gum disease treated?

The goal of treating gum disease is to promote the reattachment of healthy gums to the teeth, reduce the swelling, depth of the sinus cavity, and risk of infection; and stop the progression of the disease. Treatment options depend on the stage of the disease, response to previous treatments, and your overall health. Options range from nonsurgical treatments that control bacterial growth to surgical procedures to restore supporting tissue. For a full description of the different treatment options for gum disease.

How can gum disease be prevented?

Gingivitis can be reversed and progression of gum disease stopped in almost all cases if proper plaque control is performed. Proper plaque control consists of professional cleanings at least twice a year and daily brushing and flossing. Brushing removes plaque from accessible tooth surfaces; flossing removes food particles and plaque from between teeth and below the gum line. An antibacterial mouthwash can reduce the bacteria that cause plaque and gum disease, according to American Dental Association. Other health and lifestyle changes that reduce the risk, severity and speed of developing gum disease include

Quitting smoking: Tobacco use is a major risk factor for periodontal disease. Smokers are seven times more likely to develop gum disease than non-smokers, and smoking can reduce the chances of success for some treatments.

Reduce stress: stress can make it harder for the body’s immune system to fight infection.

Make sure you eat a balanced diet: proper nutrition helps the immune system fight infection. Eating foods that contain antioxidant properties – for example, those that contain vitamin E (vegetable oils, nuts, and green leafy vegetables) and vitamin C (citrus fruits, broccoli, and potatoes) – can help your body repair damaged tissue.

Avoid grinding and gritting your teeth: these actions put extra pressure on the supporting tissues of the teeth and can increase the rate of destruction of these tissues.

Despite good oral hygiene and other healthy lifestyle habits, up to 30% of Americans are genetically susceptible to developing gum disease, according to the American Academy of Periodontology. And those who have a genetic predisposition are up to six times more likely to develop some form of gum disease. If someone in your family suffers from gum disease, this could mean that you are at a higher risk as well. If you are at a higher risk of developing gum disease, your dentist or periodontist may recommend more frequent checkups, cleanings, and treatments to better control the condition.

Is gum disease associated with other health problems?

According to the Centers for Disease Control and Prevention (CDC), researchers have uncovered possible links between gum disease and other serious health problems. In people with healthy immune systems, the bacteria in the mouth that enter the bloodstream are usually harmless. But in certain circumstances, these microorganisms have been linked to health problems such as stroke and heart disease. Diabetes is not only a risk factor for developing gum disease, but gum disease can make diabetes worse.