Gum Disease

Overview

Gum disease is an infection of the gums and the tissues that support your teeth. It usually starts with a sticky film of bacteria called plaque that builds up on your teeth. If plaque is not removed, it can cause your gums to become swollen, red, and bleed easily. Early gum disease is called gingivitis. If it gets worse, it can damage the bone that holds your teeth, which is called periodontitis.

Yes. It is one of the most common health conditions worldwide. Many adults have at least a mild form of gum disease, especially gingivitis.

Gum disease can affect anyone, but it becomes more common with age. Men, people who smoke, people with diabetes, and those who don't brush or floss regularly are at higher risk. Hormonal changes during pregnancy can also make gums more sensitive.

Symptoms

Common symptoms

• Red, swollen, or tender gums
• Bleeding when you brush or floss
• Bad breath that doesn't go away
• Gums pulling away from teeth, making teeth look longer
• Loose teeth or a change in how teeth fit together when biting
• Pus between the teeth and gums

Symptoms in children

• Gums that bleed when brushing
• Bad breath
• Gums that look red or swollen
• Pain when chewing

Symptoms in older adults

• Gums that pull away from the teeth
• Loose teeth or new gaps appearing between teeth
• Difficulty eating or chewing due to sore gums
• Changes in the fit of dentures or partial dentures
• A persistent bad taste in the mouth

Causes

Main causes

• Plaque buildup: a sticky film of bacteria that forms on teeth when sugars and starches are not cleaned away
• Tartar (hardened plaque): plaque that has hardened on the teeth and can only be removed by a dental professional
• Smoking or using tobacco products
• Certain long-term conditions that affect the immune system, such as diabetes
• Medicines that reduce saliva flow or cause gum overgrowth (ask your doctor or pharmacist about your own medicines)

Risk factors

• Poor oral hygiene
• Smoking or chewing tobacco
• Diabetes
• Stress
• Family history of gum disease
• Hormonal changes, such as pregnancy or menopause
• Older age
• Crooked teeth or badly fitted dental work that are hard to clean
• Clenching or grinding teeth

When to see a doctor

See a doctor urgently if:

• You have severe gum pain, swelling, or an abscess
• You have a fever along with gum symptoms
• You have bleeding from the gums that won't stop
• You notice a loose tooth

Book a routine appointment if:

• Your gums bleed when you brush or floss
• You have persistent bad breath or a bad taste in your mouth
• Your gums are red, swollen, or painful for more than a few days
• You notice your gums pulling away from your teeth
• You haven't had a dental check-up in over a year

Diagnosis

A dentist or dental hygienist usually diagnoses gum disease by looking at your gums and teeth. They may also ask about your medical history, your home care routine, and whether you smoke.

Tests that may be done

• Visual examination of gum color, swelling, and bleeding
• Periodontal probing: a small, ruler-like tool gently measures the space between your teeth and gums
• Dental X-rays to check for bone loss around the teeth
• Checking for loose teeth or changes in how your teeth fit together

What to expect at your appointment

The examination is usually quick and painless. If your gums feel tender, tell the dentist. They will explain what they find in plain words and suggest next steps, which may include a professional cleaning or a referral to a gum specialist.

Treatment

Treatment depends on how far the gum disease has progressed. The main goals are to remove plaque and tartar, control infection, and prevent further damage. Early gum disease can often be reversed with a professional cleaning and better care at home.

Self-care at home

• Brush your teeth twice a day with a soft-bristled toothbrush and fluoride toothpaste
• Floss or use interdental brushes every day to clean between your teeth
• Ask your dentist or pharmacist about a suitable antibacterial mouth rinse
• Quit smoking or get help to quit — it is one of the best things you can do for your gums
• Clean your tongue gently to reduce bacteria

Medical treatments

A dentist may perform a deep cleaning called scaling and root planing to remove plaque and tartar below the gumline. They may also prescribe a special antibacterial mouth rinse or place antibiotic treatments directly into the gum pockets. Always ask your healthcare provider for advice about any prescription or over-the-counter products — do not start any treatment on your own.

When is surgery considered?

If gum disease is severe and bone or tissue support has been lost, a gum specialist may suggest surgical options such as flap surgery to clean deep pockets, or gum grafts to cover exposed roots. These are generally considered only when other treatments have not worked.

Living with this condition

Gum disease is a long-term condition for many people, but that doesn't mean you can't manage it. With regular professional care and a consistent home routine, you can keep your gums stable and avoid further damage. Think of it like managing any long-term condition: small daily steps add up to big improvements.

Lifestyle tips

• Brush and floss every day, even when your gums feel sore
• Keep regular dental check-ups — your dentist will tell you how often to come back
• Stop smoking and avoid secondhand smoke as much as possible
• Manage stress, because stress can weaken your immune system and make gum disease worse
• Replace your toothbrush every 3 months or sooner if the bristles fray

Diet and exercise

A balanced diet with plenty of fruits and vegetables helps keep your immune system strong. Limit sugary snacks and drinks, because these feed the bacteria that cause plaque. Drink water regularly to keep your mouth moist and help wash away food particles. Regular physical activity can also help reduce inflammation throughout your body, including in your gums.

Mental health and emotional wellbeing

Living with gum disease can sometimes make people feel self-conscious about their breath or appearance, and some worry about losing teeth. These feelings are normal. It can also be stressful to manage a long-term condition. If you're feeling low or anxious about your oral health, talk to your doctor or a counsellor. And if you ever have thoughts of self-harm or suicide, please reach out to a mental health crisis service right away — you matter, and support is available.

Prevention

Yes, gum disease is largely preventable. Good oral hygiene, regular dental visits, and avoiding tobacco are the most effective ways to prevent it. Even if you already have early gum disease, catching it early can stop it from getting worse.

Vaccines

There is currently no vaccine for gum disease.

Screening programmes

Regular dental check-ups are a form of screening. Your dentist will check your gums as part of a routine examination, so you don't need any special testing. See your dentist at least once a year — or more often if they recommend it.

Complications

If left untreated

• Progression from mild gingivitis to periodontitis, a deeper infection that damages the bone supporting teeth
• Receding gums that expose tooth roots and cause sensitivity
• Loose teeth that may eventually fall out or need to be removed
• Painful abscesses (pockets of pus) in the gums
• Increased risk of other health problems, such as heart disease and complications with diabetes

Long-term outlook

The outlook is positive. With early detection and proper care, gum disease can usually be managed or even reversed. Even if you have advanced gum disease, treatments can help you keep your teeth for years. It takes commitment, but many people manage gum disease successfully every day.

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