What is gum disease?
Gum disease is an infection of the tissues and bones that surround and support the teeth. It is also called periodontal disease.
There are two types of gum disease:
- Gingivitis (say "jin-juh-VY-tus") is gum disease that affects only the gums, the soft tissue that surrounds the teeth.
- Periodontitis (say "pair-ee-oh-don-TY-tus") is more severe. It spreads below the gums to damage the tissues and bone that support the teeth.
What causes gum disease?
Gum disease is caused by the growth of germs called bacteria on the teeth and gums. Bacteria are present in plaque , a clear, sticky substance that your mouth produces.
- The bacteria in plaque feed on sugars in the foods you eat and drink and make poisons (toxins) and other chemicals. The toxins irritate your gums, causing them to swell and bleed easily when brushed.
- In time, plaque can harden into a buildup called calculus or tartar. This irritates the gums even more and causes them to pull away from your teeth.
Things that make you more likely to get gum disease include:
- Not cleaning your teeth well at home and not getting regular dental cleanings.
- Smoking or chewing tobacco. People who use tobacco are much more likely to get gum disease than those who don't. They also have more serious gum disease that leads to tooth loss and is hard to treat.
- Having gum disease in your family.
- Having a problem that weakens your immune system , such as a high stress level or a disease like diabetes, AIDS, or leukemia.
- Eating a diet that is low in vitamins and minerals, which can weaken your immune system, or high in sugary foods and carbohydrates, which help plaque grow.
What are the symptoms?
Healthy gums are pink and firm, fit snugly around the teeth, and do not bleed easily. Gingivitis causes:
- Gums that are red, swollen, and tender.
- Gums that bleed easily during brushing or flossing.
Gingivitis usually isn't painful, so you may not notice the symptoms and may not get the treatment you need.
In periodontitis, the symptoms are easier to see, such as:
- Gums that pull away from the teeth.
- Bad breath that won't go away.
- Pus coming from the gums.
- A change in how your teeth fit together when you bite.
- Loose teeth.
If you think you have gum disease, see your dentist right away. Early treatment can keep it from getting worse.
How is gum disease diagnosed?
To find out if you have gum disease, your dentist or dental hygienist will do an exam to look for:
- Bleeding gums.
- Hard buildups of plaque and tartar above and below the gums.
- Areas where your gums are pulling away or shrinking from your teeth.
- Pockets that have grown between your teeth and gums.
Your dentist or dental hygienist may take X-rays of your teeth to look for bone damage and other problems.
How is it treated?
Early treatment of gum disease is very important. It can help prevent permanent gum damage, control infection, and prevent tooth loss. For treatment to work:
- Brush your teeth 2 times a day and floss 1 time a day.
- See your dentist regularly for checkups and cleanings.
- Don't smoke or use any tobacco products.
For gingivitis, your dentist may prescribe antibiotics to help fight the infection. They can be put directly on the gums, swallowed as pills or capsules, or swished around your teeth as mouthwash. Your dentist may also recommend an antibacterial toothpaste that reduces plaque and gingivitis when used regularly.
For periodontitis, your dentist or dental hygienist may clean your teeth using a method called root planing and scaling. This removes the plaque and tartar buildup both above and below the gum line.
You may need surgery if these treatments don't control the infection or if you have severe damage to your gums or teeth. Surgery options include:
- Gingivectomy to get rid of the pockets between the teeth and gums where plaque can build up.
- A flap procedure to clean the roots of a tooth and repair bone damage.
- Extraction to remove loose or very damaged teeth.
After surgery, you may need to take antibiotics or other medicines to aid healing and prevent infection.
After treatment, keep your mouth disease-free by brushing and flossing to prevent plaque buildup. Your dentist will probably prescribe an antibacterial mouthwash.
How can you prevent gum disease?
Gum disease is most common in adults, but it can affect anyone, even children. So good dental habits are important throughout your life.
- Brush your teeth 2 times a day, in the morning and before bedtime, with a fluoride toothpaste.
- Floss once each day.
- Visit your dentist for regular checkups and teeth cleaning.
- Don't use tobacco products.
Other Works Consulted
- Famili P, et al. (2007). The effect of androgen deprivation therapy on periodontal disease in men with prostate cancer. Journal of Urology, 177(3): 921–924.
- Hodges KO (2009). Periodontal diseases. In NO Harris et al., eds., Primary Preventive Dentistry, 7th ed., pp. 46–66. Upper Saddle River, NJ: Pearson.
- Robinson PG, et al. (2005). Manual versus powered toothbrushing for oral health. Cochrane Database of Systematic Reviews (2). Oxford: Update Software.
- Task Force on Periodontal Treatment of Pregnant Women (2004). American Academy of Periodontology statement regarding periodontal management of the pregnant patient. Journal of Periodontology, 75(3): 495.
Current as of: March 25, 2020
Author: Healthwise Staff
Adam Husney MD - Family Medicine
Martin J. Gabica MD - Family Medicine