What Is Gum Disease?
Gum disease, known clinically as periodontal disease, is a bacterial infection that affects the gums, bone, and other structures that hold your teeth in place. It is one of the most common chronic conditions in adults and a leading cause of tooth loss.
The condition begins when bacteria in dental plaque trigger an inflammatory response in the gum tissue. In its mildest form, gum disease causes redness and swelling that you might not even notice. In its most severe form, it destroys the bone that supports the teeth, causing them to loosen and eventually fall out or need extraction.
Gingivitis vs. Periodontitis: The Two Stages
Gum disease progresses through two main stages. Understanding the difference between them helps you recognize what you are dealing with and how urgently you need treatment.
Gingivitis: The Early Stage
Gingivitis is mild inflammation of the gums caused by plaque buildup. At this stage, the gums may appear red, swollen, and may bleed when you brush or floss. Gingivitis does not involve bone loss, and the teeth are still firmly in place.
The good news is that gingivitis is fully reversible. A professional dental cleaning to remove plaque and tartar, combined with consistent daily brushing and flossing, can restore your gums to a healthy state. Many people have gingivitis and do not realize it because it is often painless.
Periodontitis: The Advanced Stage
When gingivitis is not treated, it can progress to periodontitis. At this stage, the gums begin to pull away from the teeth, forming spaces called periodontal pockets. Bacteria collect in these pockets and cause further infection below the gum line.
As the body's immune system fights the bacteria, the inflammatory response also breaks down the bone and connective tissue that hold the teeth in place. Over time, this bone loss can cause teeth to become loose, shift position, or need to be removed. Periodontitis is not reversible, but it can be managed and controlled with proper treatment.
Severe Periodontitis
In severe periodontitis, the bone loss is extensive. Teeth may be noticeably loose, painful to chew on, or may shift out of alignment. Deep periodontal pockets harbor large amounts of bacteria. At this stage, aggressive treatment and often surgical intervention are needed to save the remaining teeth.
Symptoms of Gum Disease
Gum disease can develop slowly and painlessly, which is why many people do not realize they have it until significant damage has occurred. Knowing the warning signs can help you get treatment early.
Early Warning Signs
- Gums that bleed when you brush or floss
- Red, swollen, or tender gums
- Persistent bad breath or a bad taste in the mouth
- Gums that look puffy or feel soft
Signs of Advanced Gum Disease
- Gums pulling away from the teeth (receding gums), making teeth look longer
- Teeth that feel loose or shift position
- Changes in how your teeth fit together when you bite
- Pus between the teeth and gums
- Pain when chewing
- New spaces developing between your teeth
What Causes Gum Disease?
The primary cause of gum disease is bacterial plaque. When plaque is not removed through daily brushing and flossing, it hardens into tartar (calculus), which can only be removed by a dental professional. Tartar along and below the gum line creates an environment where bacteria thrive and inflammation worsens.
Risk Factors That Increase Your Chances
- Smoking or tobacco use: The single greatest modifiable risk factor for gum disease. Smoking weakens the immune response in the gums and makes treatment less effective.
- Diabetes: Poorly controlled blood sugar increases susceptibility to infections, including gum disease. The relationship is bidirectional, as gum disease can also make blood sugar harder to control.
- Hormonal changes: Pregnancy, menstruation, and menopause can make gums more sensitive and more prone to gingivitis.
- Medications: Some drugs, including certain blood pressure medications, immunosuppressants, and anticonvulsants, can cause gum overgrowth or reduce saliva flow, increasing the risk.
- Genetics: Some people are genetically more susceptible to gum disease even with good oral hygiene.
- Poor nutrition: A diet lacking in essential nutrients can weaken the immune system and make it harder for the body to fight gum infections.
How Is Gum Disease Treated?
Treatment for gum disease depends on how far the condition has progressed. The goal is always to control the infection and stop further damage to the gums and bone.
Non-Surgical Treatment
For gingivitis and mild to moderate periodontitis, non-surgical treatment is usually the first approach. Scaling and root planing, often called a "deep cleaning," is the most common non-surgical treatment. The dental hygienist or periodontist removes plaque and tartar from above and below the gum line (scaling) and smooths rough spots on the root surfaces (planing) to help the gums reattach to the teeth.
Antibiotics, either in pill form or applied directly into the periodontal pockets, may be used alongside scaling and root planing to help control bacterial infection. Improved daily oral hygiene at home is essential to keep the bacteria under control between professional visits.
Surgical Treatment
When gum disease has progressed to a point where non-surgical treatment is not enough, surgical options may be needed. Flap surgery (pocket reduction surgery) involves lifting the gums to remove tartar from deep pockets, then repositioning the gums to fit more closely around the teeth.
Bone grafts can help regenerate bone that has been lost to periodontitis. Soft tissue grafts can cover exposed roots and reduce further gum recession. These surgical procedures are typically performed by a periodontist.
Can Gum Disease Be Cured?
Gingivitis can be fully reversed with professional cleaning and consistent oral hygiene. If caught early, the gums can return to a completely healthy state with no lasting damage.
Periodontitis, however, cannot be fully cured. Once bone loss has occurred, it does not grow back on its own, though bone grafting procedures can help rebuild some of the lost structure. The realistic goal of periodontitis treatment is to stop the disease from progressing, reduce pocket depths, eliminate active infection, and maintain the teeth and bone you still have. With consistent treatment and good home care, many people with periodontitis keep their teeth for life.
How to Prevent Gum Disease
Gum disease is largely preventable with consistent oral care. These habits significantly reduce your risk.
Daily Prevention Steps
- Brush your teeth at least twice a day with fluoride toothpaste, especially along the gum line
- Floss daily to remove plaque from between the teeth where your toothbrush cannot reach
- See your dentist for regular cleanings and checkups, typically every 6 months
- Quit smoking or using tobacco products
- Manage health conditions like diabetes that increase your risk
- Eat a balanced diet and limit sugary snacks and drinks
When to See a Periodontist
A periodontist is a dentist who completed 3 years of additional residency training focused on the gums, bone, and supporting structures of the teeth. General dentists treat many cases of gingivitis and early gum disease. However, a periodontist should be involved when the condition is more advanced or when initial treatment has not been effective. You can learn more about periodontists on our periodontics specialty page at /specialties/periodontics.
See a Periodontist When
- Your gum disease has not responded to initial treatment by your general dentist
- You have moderate to severe periodontitis with deep pockets or bone loss
- You are losing gum tissue (receding gums) and want to discuss treatment options
- You have been told you need gum surgery or bone grafting
- You have diabetes or another systemic condition that complicates gum disease
- You need dental implants to replace teeth lost to periodontal disease
Find a Periodontist Near You
If you have signs of gum disease or have been diagnosed with periodontitis, a periodontist can provide specialized treatment. Every periodontist on My Specialty Dentist has verified specialty credentials. Search by location to find periodontists in your area and schedule a consultation.
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