Gum disease starts with a bacterial infection called gingivitis. If not treated, it can lead to tooth loss and other serious health problems. Brushing, flossing, using mouthwash regularly and a healthy diet are key to preventing gum disease. People with certain health conditions like diabetes or who take medications that lower the immune system are more at risk.

Signs and Symptoms

There are a number of signs that gum disease is getting worse, but it’s important to catch these warning signs early because treatment can save teeth and prevent the serious health problems that are associated with untreated gum disease.

Gingivitis, the first stage of gum disease, is characterized by red and swollen gums that bleed easily when brushed or flossed. During this stage, the bacteria in plaque and the calcium from saliva harden to form tartar (also known as calculus). Germs in these calcified deposits irritate gum tissue, leading to a chronic inflammatory response that damages the tissues and bones that support your teeth.

These damaged tissues create pockets that fill with plaque and debris, causing bad breath, called halitosis. As gum disease progresses to the later stages, these pockets deepen and more tissue and bone are destroyed. Loose or falling teeth, loose jawbone and a change in the way your teeth fit together when you bite are also symptoms of advanced gum disease.

Prevention

Gum disease isn’t curable, but it can be stopped from getting worse. Treatment is usually effective if you get it early.

One of the first signs of gum disease is bleeding gums. It might happen when you brush or eat, and it can be painful. It might also indicate gingivitis, which is an early stage of gum disease. Gingivitis is reversible with good oral hygiene and regular cleanings by your dentist or dental hygienist.

Brush twice a day and floss daily to remove plaque and bacteria. If you’re not sure how to brush properly, ask your dentist or hygienist for advice. Limit the amount of sugar you eat, as sugar fuels bacteria that cause plaque. Avoid clenching or grinding your teeth, as this can put excess pressure on your gums and bones, accelerating the rate of tissue and bone loss. Eat a healthy diet that is rich in vitamins and minerals. This will help your immune system fight off infections.

Treatment

Generally, the dentist removes plaque and tartar to help gums heal and tighten around teeth. The dentist also shows you how to brush and floss effectively to prevent the disease from returning.

Mild periodontitis: Left untreated, bacteria begin to erode the ligaments and bone that hold your teeth in place. You may develop pain, bad breath or pus as the tissue is destroyed. This stage is often more serious in women due to a hormone imbalance caused by pregnancy, menstruation or certain medications (such as phenytoin for epilepsy, birth control pills and some blood thinners).

The dentist can usually reverse the damage done by mild periodontitis with a deep cleaning procedure called scaling and root planing. This involves removing the bacteria hiding in pockets, smoothing out the surface of roots and applying antibiotics to reduce infection. Antibiotic mouth rinses or gels (such as chlorhexidine) or gelatin-filled chips (Peridex, PerioChip or PerioGard) that release medication into periodontal pockets can also reduce bacteria. Surgery is sometimes necessary to remove damaged tissue and bone or to perform tissue or bone grafts.

Complications

Gum disease can lead to a host of serious health problems if it’s not treated. These complications can include heart disease, stroke, respiratory disease (such as chronic obstructive pulmonary disorder, or COPD) and cancer.

The bacteria in gum disease, especially gingivitis and periodontitis, can enter the bloodstream and travel to distant parts of the body. This can contribute to the development of conditions like rheumatoid arthritis, diabetes and Alzheimer’s disease.

Often there are no symptoms in the earliest stages of gum disease, which is why it’s important to get regular dental cleanings and checkups. Treatments for gum disease vary from nonsurgical treatments that control bacterial growth to surgery that restores damaged tissue and bone.

The most common signs of gum disease are red, swollen and tender gums that bleed easily when brushing or flossing. Gums that are irritated and inflamed can also develop deep pockets that fill with plaque, tartar and bacteria. Several factors can increase the risk of developing gum disease, including: