Gum disease is an inflammation of the gum line that can progress to affect the bone that surrounds and supports your teeth. The three stages of gum disease — from least to most severe — are gingivitis, periodontitis and advanced periodontitis.

Signs & Symptoms

Gum disease can be painless, so it is important to be aware of any of the following symptoms:

  • Gums that easily bleed when brushing or flossing
  • Swollen, red or tender gums
  • Gums that recede or move away from the tooth
  • Persistent bad breath or bad taste in mouth
  • Loose teeth
  • A change in the way your teeth come together
  • A change in the fit of partial dentures
  • Visible pus surrounding the teeth and gums
  • Sharp or dull pains when chewing foods
  • Teeth that are overly sensitive to cold or hot temperatures

Cause

Bacteria in plaque, a sticky, colorless film that constantly forms on your teeth, cause gum disease. If plaque is not removed it can harden and turn into tartar (calculus). Additionally, dental plaque will continue to form on the tartar. Brushing or flossing cannot remove tartar; a dental professional will need to conduct a dental cleaning to remove it.

Diagnosis

If not removed through daily brushing and flossing, plaque turns into tartar, which becomes a rough and retentive surface encouraging further build up plaque. The plaque bacteria can infect your gums and teeth, and eventually, the gum tissue and bone that support the teeth will be impacted. There are three stages of gum disease:

  • Gingivitis – This is the earliest stage of gum disease. It is the inflammation of the gums, caused by dental plaque buildup at the gum line. You may notice some redness or swelling of the gums, or some bleeding during brushing and flossing. At this early stage gum disease can be reversed since the bone and connective tissue that hold the teeth in place are not yet affected.
  • Periodontitis – At this stage, the supporting bone and fibers that hold the teeth in place are irreversibly damaged. The gums begin to form a pocket below the gum line, which encourages penetration and growth of plaque below the gum line. Professional periodontal therapy and improved personal oral hygiene can usually help prevent further damage to the gum tissue and supporting tissue and bone.
  • Advanced Periodontitis – In this more advanced stage of gum disease, the fibers and bone of your teeth are being destroyed, which can cause your teeth to shift or loosen. This can affect your bite and how you eat and communicate. If aggressive periodontal therapy can’t save them, teeth may need to be removed by a dental specialist. Your dentist will provide restorative options if teeth are removed due to periodontal disease.

Prevention

Proper brushing and flossing go a long way toward keeping gum disease at bay. Using an antibacterial toothpaste or mouth rinse can kill bacteria and lessen the amount of plaque in your mouth. Removing dental plaque is the key to preventing gum disease and improved mouth health.

Treatment

A professional cleaning by your dentist or dental hygienist is the only way to remove plaque that has built up and hardened into tartar. By scheduling regular checkups — twice a year — early stage gum disease can be treated before it leads to a much more serious condition.

If gum disease is more advanced, scaling and root planning can be performed to treat diseased periodontal pockets and gum infection. A dental hygienist uses an ultrasonic scaling device to remove plaque, tartar and food debris above and below the gum line, and hand scales the tooth and root surfaces to make them smooth and disease free. Laser treatments are also sometimes used to remove tartar deposits. If periodontal pockets are more than 5 millimeters deep, that is, if you have moderate to severe periodontitis, gingival flap surgery may be performed by a periodontist to reduce periodontal pockets, as well as bone grafting to restore lost bone.