Gum Disease

Written By Sharon Boyd, RDH, BS.       |       Reviewed by Lara T. Coseo, DDS

Contents

 1   Definition of Gum Disease
 2   The Effects of Gum Disease
 3   Diagnosing Gum Disease
 4   Stages of Gum Disease
        i.   Gingivitis
        ii.  Early Periodontal Disease (Early Periodontitis)
        iii. Moderate Periodontal Disease (Moderate Periodontitis)
        iv. Advanced Periodontal Disease (Advanced Periodontitis)
 5   The Causes of Gum Disease
 6   Signs and Symptoms of Gum Disease
 7   Dangers and Health Risks Associated with Gum Disease
 8   How to Prevent Gum Disease 
 9   Gum Disease Treatments
        i.  Conventional Gum Disease Treatments
        ii. Natural and Home Remedies for Treating Gum Disease
 10   Your Questions About Gum Disease Answered
 11  References

What is Gum Disease

Dentist MirrorGum disease is the generic term used to describe the presence of inflammation, infection, change of color and active disease conditions in the gums that surround the teeth. This condition is due to the body’s immune response to plaque biofilm and bacteria in areas that have not been efficiently cleaned on a routine basis such as through daily flossing or proper brushing.

Gum disease occurs when dental plaque is not regularly removed and begins to irritate the gums. This plaque is made from many types of bacteria in the mouth and when these bacteria feed off sugars and food particles in the mouth they produce waste that is toxic to gum tissue. If the proper measures are not taken, these bacteria spread below the gum line and lead to more serious complications as they can eventually destroy the supporting bone structure that holds teeth in place.

Gum disease is known by several other names such as:

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The Effects Of Gum Disease

As bacteria invade the areas just under the gum lines, it causes the loss of attached support tissue. This condition ultimately leads to bone loss and tooth mobility. Gum disease is the most common cause of tooth loss, so early diagnosis and intervention is key for effective treatment.

Diagnosing Gum Disease

How do you know if you have gum disease? What does gum disease look like? While your dentist or hygienist can easily screen for the condition, it is also possible to identify it for yourself. Early stages of gum disease begin in the simple form of gingivitis, with more advanced stages leading to severe periodontal disease and tooth loss.

Gum disease is fairly simple to acknowledge as its warning signs can be identified visibly. Some of the changes you may notice more easily are mouth ulcers, gums that bleed, change from bright pink to dark red, are sensitive to touch, are swollen and tender, or have a shiny texture.

If you're not noticing any of these symptoms and fear that you have gum disease, the most imperative action to take is to review your daily oral hygiene practices to make sure that it covers all the necessary bases for treating gum disease. The majority of cases are due to oral bacteria that are left to flourish by neglect in dental care. The good news is that if you have the correct plan and tools at your disposal, gum disease can be easy to treat in the early stages.

It is estimated that upwards of 90% of adults in the U.S. have gingivitis. The CDC finds that approximately 50% of adults have some form of periodontitis.1

Stages Of Gum Disease

Gum disease starts out as mild gingivitis and progresses to different levels of periodontitis or periodontal disease. While all stages are part of the same disease condition, knowing how to identify gum disease developing in your mouth can allow you to be proactive about the treatment earlier on.

Gingivitis

The beginning stage of gum disease manifests itself as gingivitis. This is when you will notice your gums bleeding during flossing, and may have swollen or red gums just near the borders. Because gingivitis is just the initial inflammation of gums, it can easily be reversed within about two weeks.

Signs and Symptoms of Gingivitis may include:

  • Mild to moderate inflammation along the gumlines
  • Red or tender gums
  • Bleeding when flossing

Early Periodontal Disease

When gingivitis goes untreated, your gums begin to break down around the teeth. Early symptoms will include persistent inflammation, bleeding, and bone loss seen on your dental X-rays. You may also start to see mild gum recession in some areas. Early periodontal disease starts out localized, but if left untreated becomes more generalized throughout the mouth.

Signs and Symptoms of Early Periodontal Disease (Periodontitis) may include:

  • Bone loss up to four millimeters around the teeth
  • Early signs of gum recession

Moderate Periodontal Disease

This more advanced stage of gum disease is easier to spot. If you haven’t dedicated a lot of preventive care to your teeth, or do not see your dentist regularly, it may have allowed your disease condition to worsen without you realizing it. By the time you have developed moderate periodontal disease, gum recession may be evident and there may be signs of tooth mobility. You may also start to notice dark areas between the teeth, where the gums have faded away.

Signs and Symptoms of Moderate Periodontal Disease (Periodontitis) may include:

  • Bone loss up to six millimeters around the teeth
  • Signs of moderate gum recession
  • Early signs of tooth mobility

Advanced Periodontal Disease

The most severe form of gum disease is advanced periodontal disease. Once you have lost several millimeters of bone around the teeth, your teeth become mobile, show severe signs of recession, and may even fall out. Specialized professional care is needed to delay tooth loss.

Signs and Symptoms of Advanced Periodontal Disease (Periodontitis) may include:

  • Bone loss over six millimeters around the teeth
  • Severe gum recession
  • Tooth mobility
  • Tooth loss

As if having different severities of gum disease were not enough, there are also variations to further describe the classification of your gum disease:

  • Localized Gum Disease– Restricted to a limited number of teeth in the mouth without having spread to surrounding teeth. Abnormal areas of bone loss are present in up to a few areas.
  • Generalized Gum Disease – Affecting most of the teeth in the mouth with generalized loss of surrounding bone structure throughout the entire mouth.
  • Necrotizing Ulcerative GingivitisAn ulcerative condition that involves necrotic “punched out” tissue, combined with swelling of the lymph nodes. A very aggressive form of gum disease, necrotizing ulcerative gingivitis is usually accompanied by a very bad smell and rapid progession.
  • Hyperplasia Thickness of gums associated with causes such as trauma, medication or irritation.
  • Pregnancy Gingivitis Some women experience hormonal imbalances during their pregnancy, which results in the inflammation and bleeding of their gum tissues. This is usually atypical of their normal oral health, and it subsides after the birth of their baby.

Do you know what causes gum disease? In order to understand the etiology and factors that contribute to gum disease, it is important to first understand the anatomy of the tooth, and how the gums relate to it.

Dentist studying an x-ray
Tooth Anatomy

Each of your teeth is designed to have a natural, shallow gum pocket surrounding it. This area is called the sulcus – pocket – or if disease is present a periodontal pocket. At the base of this pocket lies connective tissue including ligaments and bone. These structures adhere to the tooth, holding it into the socket. A healthy pocket will be no deeper than three millimeters.

The Invasion Of Bacteria
Plaque biofilm is a byproduct naturally produced by our bodies. As we consume food, that food mixes with our saliva and breaks down into smaller particles. Biofilm then begins to develop and deposit itself onto the surfaces of teeth, and along the gumlines. Plaque biofilm enters into the gum pocket during chewing or by accumulation in the absence of good oral hygiene.

The Destruction Of Gum Attachment And Bone Structure
When plaque is not removed efficiently through careful flossing or brushing, your body’s own immune system begins to attack the bacteria. As the blood supply brings antibodies to attack the biofilm under your gumlines, it destroys the attached gum around the tooth in order to access the area of infection. As this attachment is lost it causes your gum pocket to deepen, destroying bone along with it. After a certain point these pockets become too deep for you to efficiently care for them through normal brushing and flossing.

Heightened Risk Factors
Certain risk factors and health conditions can also contribute to the development and severity of your gum disease.2 3 Some of these risk factors may include:

  • Age
  • Family history
  • Tobacco use
  • Diabetes
  • Stress
  • Osteoporosis
  • Cardiovascular disease

Signs And Symptoms of Gum Disease

A combination of signs and symptoms may be present, depending on what severity of gum disease you may have. Typically the early signs of gingivitis involve minor irritation such as bleeding or swelling of your gums.

Bleeding gums – Healthy gums should not bleed. If you floss regularly and brush along the gumlines, bleeding is not normal. However, infrequent flossing may result in your gums bleeding due to the development of gingivitis.

Swollen, Red Gums – Gums that are red, puffy or swollen are a sign of inflammation. Just as if you had another area on your body that was inflamed, swelling and redness would occur, alerting you to the condition.

Bad Breath – A bad taste in your mouth or bad breath may be a sign that there is biofilm or food lodged deep under your gums.

Gum Recession – The loss of your gum attachment causes the gums to creep slowly down the root of the teeth.

Tooth Mobility – As gum and bone loss occurs, your tooth has less stability. This may cause your teeth to shift into other positions or make them mobile.

Sore Teeth – When limited support structures are all that is holding your teeth into place, the delicate ligaments around your teeth can become strained.

Pus – Clear, white or yellow pus may begin to drain between your teeth and along the gum lines.

If you're noticing any of these symptoms and fear that you have gum disease, the most imperative action to take is to review your daily oral hygiene practices to make sure they cover all the necessary bases for treating gum disease. The majority of cases are due to oral bacteria that are left to flourish by neglect in dental care.  The good news is that if you have the correct plan and tools at your disposal, gum disease can be easy to treat in the early stages.

    Dangers And Health Risks Associated With Gum Disease

    If action is not taken during the early stages of gum disease, it can lead to a number of much more serious conditions such as periodontal disease, oral infection, loss of teeth, abscesses and trench mouth - also known as Acute Necrotizing Ulcerative Gingivitis. These conditions are quire serious but they can easily be prevented if the first warning signs are noticed early enough. 

    Having gum disease doesn’t just affect the way your teeth look or feel, but it can also make you more likely to suffer from severe health conditions in other parts of your body. Research shows a direct correlation in the severity of your gum disease and the severity of other health conditions.4

    Health concerns that are associated with gum disease include: 5 6

    • Heart attack
    • Stroke
    • Cardiovascular diseases
    • Diabetes
    • Erectile dysfunction
    • Obesity
    • Premature labor
    • Low birth weight

    If you suffer from any of these conditions along with gum disease, it places a strain on the body’s immune system and makes it difficult to battle a combination of conditions. Bacterial plaque from the mouth can enter into the blood vessels when gum disease is present, spreading to other areas of the body. These bacteria within your bloodstream can increase the likelihood of occurrences such as a heart attack.

    How To Prevent Gum Disease

    Gum disease is a preventable disease condition, but at times you may still find that even with proper care there may be areas in your mouth that are more prone to persistent problems than others. The most effective way to prevent gum disease is to have absolutely impeccable oral hygiene habits.

    Tooth with toothbrush
    Brush Your Teeth


    Brushing is something we all do, but do you do it the correct way? Using a soft-bristled brush isn’t always someone’s first method of choice, but it is the gentlest, safest way to remove plaque deposits from along the gumlines without causing tooth abrasion or gum recession.7 Gently angle the toothbrush 45 degrees toward the gumlines, making circular motions. You should focus on only two or three teeth at a time and apply just enough pressure that the tissue blanches, no more.

    High-quality electric toothbrushes can remove plaque more efficiently from your teeth than manual brushes.8 Because the bristles vibrate thousands of times per second they disrupt the plaque better than a few strokes back and forth with a manual toothbrush. These brushes work best when you hold the toothbrush in place on just two or three teeth at a time, allowing the brush to do the work for you.

    Toothpaste

    Although conventional wisdom may tell you to use commercial toothpastes filled with fluoride and other chemicals, you may be surprised to learn of the potential dangers that go along with these substances. Click here to learn about the dangers in your toothpaste. It’s best to use toothpaste with natural botanical ingredients that will help destroy the bad bacteria on an ongoing basis
    It’s better to use toothpaste with natural ingredients that help destroy bad bacteria on a daily basis.

    Most toothpastes that are found in stores contain a number of chemical agents that, while good in theory, are terrible in execution. Take sodium lauryl sulfate (SLS) for example. SLS is a detergent that is used in toothpaste to make it foam. When this is happening, you think that it's foaming to reach all the areas in and around your mouth to clean them. While this may be true, SLS is a clinical skin irritant that has been proven to weaken the tissues of the mouth, and in many cases, even cause canker sores and mouth ulcers. Additionally, in being a detergent it also has a drying effect in the mouth. Because of this there is less saliva. When saliva is absent, so is your mouth's natural bacteria fighter and cleanser.

    The majority of toothpastes on the market today also contain fluoride and even tout it as a major accomplishment in preventative dental care. While most of us have grown up hearing and believing this, it is simply not true. Did you know fluoride is the active ingredient in numerous poisons and insecticides? That it is a by product of fertilizer and heavy metal manufacturing? That it was an integral part in developing nuclear weapons? While those facts carry an impressive amount of weight on their own, it doesn't mean much regarding oral health directly. Well, how about the fact that fluoride destroys cells in tendons and ligaments - specifically the ones that attach the gums to teeth? Since this is a major issue regarding gum disease, it should be carefully considered if you already have pockets in the gums caused by bacteria and plaque. If this is the case, using a toothpaste with fluoride could actually prevent the pockets from ever healing.

    Mouthwash

    Most mouthwashes use alcohol as its active ingredient to kill germs. You can't fault the manufacturers for this claim because alcohol will kill germs. In fact, it kills everything including your mouth's ability to produce saliva. Alcohol has a drying effect in any capacity that it is used in. These bacteria thrive in an environment without oxygen and saliva. Essentially, most mouthwashes will instantly cause bacteria population to skyrocket.

    Floss Daily
    Brushing does not remove plaque deep below the gums or between the teeth. If you do not clean these areas, you are placing your oral health at risk for an increased chance to develop tooth decay and gum disease.

    To floss properly you should:

    • Use approximately 18 inches of floss, wrapped around the fingers or tied in a circle, allowing you to move to a “clean” portion as you go along
    • Wrap the floss in a “C” shape around each tooth
    • Glide gently up and down against your tooth, sliding under the gumlines
    • Allow the floss to slide down under the gums as deep as it will go, making three to four strokes against the side of the tooth
    • Come up over the gums before wrapping the floss against the adjacent tooth to prevent gum trauma

    Gums that have gingivitis or periodontal disease will almost always bleed when flossed (an exception is in smokers, who almost always have no bleeding). If your gums bleed, continue daily flossing for approximately two weeks before expecting to see the bleeding stop.

    Use A Water Floss

    Water flossing with an irrigation device such as a WaterPik™ allows you to remove plaque between your teeth and under the gums without using traditional floss. The stream of water is actually believed to remove more plaque than traditional floss because it can reach several millimeters deeper under the gums in areas of gum disease.9 Traditional floss can only get about three millimeters under the gums, where water flossing is believed to reach up to seven millimeters below them.

    Get Routine Preventive Screenings And Cleanings

    Seeing your dentist and hygienist regularly can help identify areas of gum disease that you might have otherwise been unaware of, allowing for early intervention. By having your hygienist clean your teeth regularly, she is able to remove the calcified plaque deposits from your teeth (tartar) that contribute to the advancement of gum disease.

    Even people with exceptional oral hygiene will usually still develop small areas of plaque calcification. These tartar deposits cannot be removed on your own and require special instrumentation and training. When tartar is removed from the tooth, it creates a healthy gum environment that helps prevent the loss of bone support. Otherwise, the tartar accumulates and harbors bacteria that contribute to gum detachment.

    The most important thing to do to correct gum disease before it is too far gone is to implement a solid oral hygiene program. If you're already doing that and still suffering, it may very well be due to the chemical-laden products you're using. Combine good oral hygiene with a natural product that will eliminate the bacteria which cause the problems. 

    Gum Disease Treatments

    dentists performing laser surgery


    Conventional Treatments

    Traditional treatment methods for gum disease typically involve one or a combination of several of the following procedures:

    • Deep Cleaning/Scaling And Root Planing
      Most dental patients with moderate to severe gum disease will undergo deep cleanings at their dental office. A deep cleaning allows the patient to have their mouth numbed in order to allow the hygienist to comfortably remove all of the biofilm and tartar deposits deep below the gums. This procedure can be moderately uncomfortable, but local or topical anesthetics are usually used to alleviate any discomfort. Some soreness may follow the procedure for a day or two. Most deep cleanings are only partially covered under dental insurance plans, leaving you responsible for the remainder of the charges. Deep cleaning procedures are performed and charged as four different quadrants: upper right, upper left, lower right, lower left; with fees approximately $200 to $300 per quadrant.
    • Periodontal Maintenance/Prophylaxis
      Periodontal maintenance and routine cleaning appointments are the best methods for maintaining gum health or managing cases of mild gum disease. Prophylaxis appointments are typical cleaning visits that you have every six months, but a periodontal maintenance visit is the term for a similar recall cleaning after a deep cleaning has been performed. These allow your hygienist to monitor your gum health and remove any new areas of bacteria. Typically these appointments are covered 100% by your dental insurance company. These visits average around $200.
    • Gum Flap Surgery
      If gum disease is severe enough, you may need to see a periodontal specialist. The gums will be retracted to allow access for the removal of all bacteria that lies deep below on far portions of the root surface. Because this is an actual surgery there will be some recovery time needed for healing and discomfort. Because it is an invasive surgical procedure it can be more expensive than deep cleanings and is usually only partially covered by dental insurance. Gum flap surgeries are typically several hundred to several thousand dollars depending on how many teeth are affected.
    • Crown Lengthening
      Another treatment for severe gum disease is crown lengthening. This procedure follows a gum flap surgery, but when your gums are put back in place, a portion of the tissue is removed in order to create a shallower gum pocket around the tooth. Shallower pockets are easier to keep clean, allowing you to better care for the diseased area. The result is a tooth that is longer in appearance with some exposed root surfaces. While it may be easier to care for the gum disease condition, it can result in aesthetic concerns and tooth sensitivity. Because it is an invasive surgical procedure it can be more expensive than deep cleanings and is usually only partially covered by dental insurance. The fee is based on how many teeth are involved, but fees usually begin at several hundred dollars per tooth.
    • Local Antibiotic Therapy
      Some types of locally-administered antibiotics can help areas of advanced gum disease respond quicker to deep cleaning or surgical procedures. After the medication is put in place you may need to wait up to two weeks before flossing the area. Typically the charge is only around $30 to $40 per dose. A separate dosage must be placed in each area of concern, so it cannot be used for more than a few locations. Some commonly used topical medications include:
      1. Actisite
      2. PerioChip
      3. Arestin
      4. Elizol
      5. Atridox
    • Prescription Medications
      Prescription medications such as mouthwash or oral antibiotics may be prescribed and are relatively inexpensive. You’ll want to be careful with mouthwash containing alcohol, because it can dry out the mouth. A dry mouth can be a breeding ground for bad bacteria – the very kind that can lead to gum disease and other oral health problems.
      • Chlorhexidine
      • Tetracycline
      • Periostat

      Topical drugs like mouthwash, such as Chlorhexidine, may be used for approximately two weeks to help reduce inflammation and bacteria in the mouth. Rinses can be used throughout the entire mouth or placed on a toothbrush and used at the site of infection. Long-term use of Chlorhexidine can cause staining of the teeth.

    • Orthodontic Therapy
      Correcting misaligned teeth with orthodontic therapy (braces) has been shown to be part of a comprehensive treatment for periodontal disease.10 This is because it makes your teeth straighter and easier to keep clean. Crowded areas are more difficult to clean as they often harbor bacteria and are more likely to develop gum disease than areas where your teeth are aligned correctly. Unfortunately, many people dislike the amount of time and the thousands of dollars associated with the investment of orthodontic treatment. Most orthodontic treatment costs between $3,000 to $5,000.
    • Gum and Bone Grafting
      Surgical procedures such as gum grafts or bone grafts may help to stabilize the support structures around your teeth. Gum grafting is typically best for areas of recession that suffer from tooth sensitivity and can at times be a moderately invasive procedure. Bone grafting is useful when there is advanced bone loss and you are at increased risk to lose teeth. Both of these grafts may be taken from your own body or from a donor bank. Because it is an invasive surgical procedure it can be more expensive than deep cleanings and is usually only partially covered by dental insurance. Gum grafting can cost several hundred dollars per tooth.

    Natural And Home Remedies for Treating Gum Disease

    What Dentists Really Want You To Do

    The best remedies for gum disease are those that allow you to get rid of gum disease on your own at home. Any hygienist will tell you that she can clean the bacteria from your mouth twice a year, but the other 363 days a year are up to you to keep your mouth healthy and clean. The best treatment is daily prevention. Specifically, using a daily oral hygiene program that includes brushing, flossing and rinsing. Be sure to select [products that truly help], and use them in an educated manner for them to reach their full potential.

    The Cost

    Natural and home remedies for gum disease are typically very inexpensive compared to conventional therapies. Different techniques and treatments work in different ways. If one does not work for you, try out others to determine what is most effective.

    Addressing The Body As A Whole

    You’ve already seen how gum disease is directly correlated with numerous systemic health conditions. Treating gum disease from the inside out can allow you to address your gum disease in a way that improves the overall health of the entire body, not just a specific area in the mouth.

    Home Remedy Options

    Bacteria Removal

    • Alcohol-free Mouthwash can assist in the increased removal of bacteria from your mouth and tongue without drying it out.
    • Not only should you brush the teeth and gums, but you can also brush inside of the cheeks, lips, roof of the mouth and tongue for more efficient plaque removal.
    • Water flossing and oral irrigators can help reach areas that traditional brushing and flossing do not, stopping the advancement of gum disease.

    Warm Salt Water Rinse

    Salt water rinses with table or sea salt can allow an osmosis effect to occur, decreasing the amount of swelling in your gums.

    Here’s 6 ways to fight gum disease at home.

    Holistic Dental Options

    Essential Oils And Herbs

    Several types of essential oils are useful in treating symptoms of gum disease. You can place one or two drops of oil onto your toothbrush and rub it onto the area of concern or mix it with a glass of water to use as a mouthwash.

    Common essential oils and herbs that aid in gum disease treatment include:

    • Peppermint
    • Almond
    • Spearmint
    • Eucalyptol
    • Menthol
    • Geranium
    • Lemon
    • Thyme
    • Marigold
    • Bloodroot

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    Diet And Supplements –

      • Vitamin C
        Foods rich in vitamin C can promote gingival healing and reduce the symptoms of gum disease.
      • Vitamin A
        Oils such as those from olive and sunflower sources contain vitamin A, which can help promote a healthy immune system and increase healing in areas of gum infections.
      • Fibrous Fruits And Vegetables
        Eating fibrous foods like apples and carrots not only helps cleanse and massage the teeth and gums as you eat them, but they contain nutrients that your body needs to have a balanced diet and healthy cardiovascular system.
      • CoQ10
        According to The Mayo Clinic, CoQ10 may be an effective supplement to aid in the reduction of gum disease symptoms.
      • Altering Your Lifestyle
        Refraining from consuming too many processed foods, refined sugars, and alcohol and tobacco products can improve your body’s immune system and activity level. Combined with increased activity from regular exercise, symptoms from both oral and systemic diseases are likely to improve.

     

    Your Questions About Gum Disease Answered

    Can gum disease be cured? Yes, but it is easier to cure gum disease while it is in the earliest stages of gingivitis or mild periodontitis. More severe stages of gum disease can be halted, but the damage that they incur cannot be undone.

    Can gum disease be reversed? Yes. Intervention to remove the infection and maintain a healthy oral environment can prevent the disease from progressing. In some cases there may even be a mild amount of tissue reattachment in areas where loss once occurred.

    How do I stop my gum disease from progressing further? The only way to stop your gum disease from progressing further is to take action today. Delaying treatment or changes in your home care can allow the infection to continue or worsen. Even moderate changes to improve your oral hygiene habits can have an affect on gum disease, especially in its early forms.

    Is gum disease contagious? Gum disease can be passed between family members, such as spouses and parents to children, making it even more important for you to treat and prevent the condition.11

    Can gum disease kill you? While gum disease probably hasn’t ever been the explanation or cause of someone’s death, the condition does place you at an increased risk to suffer from other health conditions such as heart attack, stroke, diabetes and elevated blood pressure. (4,5)

    What will happen if I delay treatment for gum disease? Delaying any type of dental care only causes the disease to progress to a more severe form, which typically results in more expensive treatment options. As gum disease is allowed to progress, it compounds into more severe forms of bone loss that are irreversible or require invasive treatments to prevent progression.

    I’m a smoker. Can I treat my gum disease? Smokers have a very difficult time treating their gum disease because of the atrophy that has occurred in the blood vessels surrounding the teeth. Many treatment regimens may not produce results. Even if bleeding is not present, severe disease can be present in smokers. To effectively treat your disease condition you should undergo a smoking cessation program.

    I’ve already lost several teeth to gum disease. What should I do? Regardless of whether or not you’ve already lost teeth to gum disease, there is nothing like having your natural teeth, even if it is only a few. Dental professionals also recommend trying to retain as many natural teeth as possible for the most effective functions like speech and eating. You should attempt to heal your gum disease no matter how many teeth are left to prevent other systemic health problems.

    What does gum disease look like? Gum disease or periodontitis, can range from mild swelling and redness along the edges of your gums to aggressive inflammation, bleeding, blue/red/purple gum tissues, and receding gum lines.

    Is gum disease the same thing as gingivitis? Gingivitis is the earliest stage of gum disease and is reversible. Moderate to severe gum disease is not gingivitis. These more aggressive infections extend into the bone and supporting tissues around the roots of your teeth.

    Would a dentist notice if I have gum disease? Absolutely. Your dentist and hygienist will screen for gum disease regularly, as your gum health plays a major role in the integrity of your teeth. It’s one of the major reasons why regular six-month cleanings are recommended.

    What does gum disease feel like? Some people never realize they have gum disease, while other individuals experience symptoms like itchy, tender, swollen, or bleeding gums. Your gums may hurt when you’re brushing and flossing.

    What does gum disease smell like? Gum disease has a very potent, foul odor that differs from the type of halitosis you get from eating typical bad breath foods. It’s caused by necrotic dying tissues and bacteria down under the gums and next to the tooth.

    What will gum disease do? Once gum disease starts, it causes your gums and bone tissue to shrink away or pull back and detach from your teeth. Over time this process creates pockets under your gums. Teeth eventually become mobile and can fall out.

    How does gum disease start? Gum disease is caused by plaque bacteria collecting along and just under the gum tissues. It’s preventable with good oral hygiene daily brushing and flossing. If you do not brush your gums well or floss on a daily basis, gum disease can start to develop very quickly.

    How gum disease diagnosed? Once gum disease progresses into something worse than gingivitis, your dentist or hygienist will use a periodontal probe to measure your gum attachment levels in other words, to see how deep the pocket is around your tooth. Depending on the depth of your periodontal pocket, a degree of severity is diagnosed.

    Does gum disease hurt? It depends. Some people never realize their gums are infected until they’re about to lose their teeth. Other people experience sensitive gums, soreness, and bleeding. Your teeth may hurt when you’re biting/chewing.

    Does gum disease spread? If one or two teeth in your mouth have gum disease and you do not treat the infection, it can and will spread to your adjacent teeth. Treating gum disease early can prevent it from spreading and affecting your entire mouth. We also know from research that the oral bacteria associated with gum disease can be passed through kissing or to a fetus through the placenta.

    Is gum disease common? Yes. Gum disease is one of the most common adult infections, with approximately 80-90% of adults having at least a minor form of gingivitis.

    Who treats gum disease? When caught early, gingivitis, the first stage of gum disease can be treated at home. But left untreated, it will progress into periodontal disease. At that point, you will need a dental professional’s services to treat the infection.

    Can I reverse my gum disease? Only if it is still gingivitis. Moderate to severe periodontal disease cannot be reversed due to the destruction of bone support. Care protocol consists of eliminating the infection and maintaining current gum and bone levels so they don’t have a chance to get worse.

    Can gum disease kill me? Science shows us that the more severe your gum disease is, the more likely you are to suffer from a heart attack, stroke, diabetes, or pneumonia. While gum disease itself may not kill you, it can allow for bacteria to spread elsewhere in your body and raise your chances of suffering from another terminal medical event.

    Will gum disease shorten my life? If you have underlying cardiovascular disease, diabetes, or respiratory problems, there’s a greater chance of gum disease making those conditions worse thus threatening your chances of recovery. Even though you may think gum disease bacteria are isolated to your mouth, science shows that they can spread directly into your bloodstream due to infected, bleeding gums.

    Is gum disease hereditary or genetic? Gum disease sometimes runs in families in the fact that oral health priorities and habits tend to be a learned skill. If flossing or preventative dental care was not a priority or accessible, there is a greater chance for the entire family to suffer from gum disease. But just because your parents or grandparents lost their teeth to periodontitis at a young age doesn’t mean you will. Even if bacteria are spread through kissing or sharing food, good preventative habits can prevent gum disease from developing in someone else’s mouth.

    Can gum disease cause heart disease? We’ve learned that gum disease bacteria can spread through bleeding gums into the cardiovascular system and then lodge in the heart. If you have an underlying heart condition, the extra bacteria can make it harder for your body to recover and raise your risk of heart disease. But whether or not it actually causes heart disease has yet to be determined.

    How does it affect the heart? Studies have shown that dental plaque can lodge itself within the heart and blood vessels. Such conditions could raise your chance of suffering from a heart attack or stroke.

    How does gum disease affect your body? Researchers have shown that if you have a medical condition – such as diabetes or respiratory illness, for example – and then have gum disease on top of it, it’s too difficult for your body’s immune system to combat each one of them for a full recovery. But treating your gum disease and eliminating oral bacteria can help to make your immune system more effective and thus increase your chances of improving other health conditions.

    Where does gum disease hurt? Your gums may be sore, or your teeth hurt when you chew down on them due to the infection around their roots.

    Does gum disease smell? Yes. Gum disease has a specific odor that is fairly easy for dentists or dental hygienists to identify. It differs from the type of halitosis caused by odorous foods or smoking.

    Will gum disease cause cancer? It’s unknown whether or not gum disease is linked to any type of cancer.

    Will gum disease cause headaches? While gingivitis isn’t going to cause a headache, there’s a chance that people with severe gum disease, periodontitis may exhibit referred symptoms. A headache could be due to aggressive infection in upper back molars or from clenching.

    Can gum disease cause dry mouth? No. Saliva production is not dependent on whether there’s gum disease. However, dry mouth or xerostomia can raise your chances of developing gum disease to begin with.

    Can gum disease cause sinus problems? Infected upper teeth may lead to referred pain or inflammation near the nasal sinuses simply due to how close your tooth roots are in relation to your sinus cavities.

    Can gum disease cause mouth ulcers? There is a specific type of gum disease called acute necrotizing ulcerative gingivitis or ANUG aka: trench mouth that can cause ulcers inside of your mouth.

    Can gum disease cause dizziness? It’s highly unlikely that gum disease would cause symptoms of dizziness.

    Can gum disease cause tooth pain? Yes. However, the tooth pain from gum disease is different than what you feel when you have a cavity or cold sensitive teeth. In this instance your teeth are more likely to be sore when there’s pressure applied like biting or chewing.

    Can gum disease cause bone loss? Yes. Gum disease causes deterioration of the jaws and bone structure around your tooth roots.

    Can gum disease cause diabetes? No. But if you have diabetes, gum disease is scientifically proven to make it more difficult to manage your blood glucose levels. Treating your gum disease can help improve how well your diabetes responds to normal diabetic care.

    Can gum disease cause a sore throat? Not likely. But if there are higher levels of bacteria inside of your mouth because of chronic gum disease, there’s a chance that some could potentially spread to your throat.

    Can gum disease cause inflammation in the body? Yes. Oral bacteria from gum disease increase your body’s inflammatory response and leads to a heightened immune system. If you have co-existing medical conditions, you may find it more difficult to recover.

    Is gum disease an autoimmune disease? No. Gum disease is caused by a bacterial infection. But if you have an autoimmune disease, it can make it more difficult for your body to fight off periodontitis.

    Can gum disease cause jaw pain? Depending on the severity of your periodontal disease, gum infections can cause pain and soreness in the areas immediately around your teeth.

    Can gum disease cause weight loss? If your teeth and gums hurt from severe gum disease, it could make eating uncomfortable and difficult. As a result, weight loss could occur.

    Can gum disease cause a miscarriage? Although the link between gum disease and miscarriage has yet to be determined, periodontal disease is linked to fertility in both men and women.

    Why did I get gum disease during pregnancy? It may be that you didn’t notice your gum disease symptoms until now. However, pregnancy gingivitis may cause pseudo-symptoms that mimic gum disease and is caused by hormonal changes.

    Does gum disease affect pregnancy? Yes. We know that if a woman has gum disease it can raise her chances of preeclampsia, preterm labor, and having a baby with a low birth weight. Additionally, couples with gum disease tend to take longer to conceive than those who do not.

    Is gum disease contagious by kissing? Although oral bacteria can be transmitted through kissing and sharing food, gum disease is unlikely to occur unless the other person has poor oral hygiene habits.

    Will gum disease just go away on its own? No. Just as an infection on another part of your body doesn’t resolve without cleaning it and caring for the wound, gum disease requires attentive care to eliminate the bacteria in that area.

    Can you treat gum disease at home? Yes, but only if it’s in the earliest stage of gingivitis. Once bone and gum detachment begin, a deep cleaning will be crucial to treating your gum infection.

    Will Corsodyl cure gum disease? No. Although over-the-counter mouthwash can help minimize the number of bacteria in your mouth, they will not physically remove plaque buildup or calcified deposits under your gums where the disease is most prevalent.

    Will Amoxicillin treat gum disease? No. Unless the buildup is physically removed, antibiotics like amoxicillin will not reverse gum disease. However, they can be used in conjunction with gum treatment to lower the number of live bacteria and improve your chances of recovery.

    Is gum disease permanent? The bone loss caused by gum disease is permanent. Identifying symptoms of gum infection can help limit the extent of damage it has on your teeth.

    What will gum disease lead to? Ultimately, untreated gum disease will lead to gum and bone recession as well as tooth mobility and loss. Bad breath and sunken in facial features are common.

    Does gum disease affect my lips? No. Normally you cannot tell whether someone has gum disease by the way their lips look. That being said, if the gum disease has lead to extensive bone and tooth loss, it can cause their lips to look sunken-in.

    What will help my gum disease? Good oral hygiene including thorough brushing, daily flossing, and antimicrobial mouth rinse are essential. Eating a balanced diet with plenty of fresh fruits and vegetables as well as upping your intake of Omega-3s is also helpful.

    Do Waterpiks help with gum disease? Yes. Waterpiks and other types of water flossers can reach well under the gums into deep pockets that aren’t accessible with regular flossing.

    Do antibiotics help with gum disease? The only time dentists will prescribe antibiotics for gum disease is if the infection is severe; and even then, physical cleaning of the pockets and tooth roots is essential. The antibiotic itself will not eliminate the infection.

    If I get dentures will it cure gum disease? Some people assume that it’s easier to get all of their teeth pulled and just get dentures. But in most cases, the best thing for your diet, speech, and quality of life is to treat and maintain the teeth you already have.

    Can I floss with gum disease? Not only can you, you should. Flossing helps disrupt and remove the plaque bacteria under your gum lines which are responsible for causing periodontal infections.

    Is gum disease covered by Medicare? Gum disease treatments like deep cleanings periodontal scalings and root planings and periodontal maintenance visits are covered at different rates than routine preventative cleanings.

    What mouthwash is best for gum disease? Mouthwash for gum disease should not replace brushing and flossing. But used together, it can be beneficial. Any type of antimicrobial rinse with essential oils is helpful. If your gum disease is severe, your dentist may prescribe a two-week round of a stronger rinse such as chlorhexidine.

    What toothpaste should I use for gum disease? The type of toothpaste you choose isn’t as important as how well you’re physically brushing and removing the plaque bacteria along your teeth and gums. But there are some types of toothpaste with added ingredients for gingivitis and gum disease, which may help with inflammation.

    Will peroxide help gum disease? Peroxide is usually used in whitening products, not those designed to treat gum disease. Rinsing repeatedly with peroxide can alter the levels of natural, healthy bacteria in your mouth and lead to unwanted consequences like black hairy tongue.

    Did my braces cause my gum disease? Having braces creates extra surfaces inside of your mouth where plaque can accumulate. If you do not brush well around brackets and next to the gum lines, gingivitis can develop rather quickly.

    Is there a gum disease test or quiz you can take? Since a gum disease diagnosis only takes a matter of minutes, the most important questions to ask yourself are Do my gums bleed?, Are my gums swollen? and Are my gums receding? Note: if you use tobacco products, your symptoms of gum disease may not be visible!

    Why does smoking cause gum disease? Smoking masks the symptoms of gum disease because it inhibits inflammation, swelling, and bleeding. As a result, gum detachment and bone loss often go unnoticed unless you see a dentist.

    Does vaping cause gum disease? Do Juuls? Various types of inhalants affect your gums and teeth. There is not enough research to know for certain how bad the effects of vaping or Juuls are on your mouth. However, we do know that smoking and inhaled drugs including prescription medication can be bad for teeth.

    How can I cure gum disease if I have no insurance? If your gum disease is still in the earliest stage of gingivitis, then you can treat and reverse it on your own at home. However, more advanced forms of gum disease can’t be treated properly without the help of a dentist. If you do not have insurance you may be able to find a dentist who offers cash discounts, a local public dental clinic, or a dental school in your area who offers comprehensive services at discounted rates.

    Can gum disease kill my dog? Don’t overlook cases of canine gum disease. If the infection is severe enough it could cause a suppressed appetite and allow bacteria to spread elsewhere in your dog’s body making it more difficult for them to fight off other medical problems.

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    References:

    1. 1P.I. Eke, B.A. Dye, L. Wei, G.O. Thornton-Evans, and R.J. Genco.; Prevalence Of Periodontitis In Adults In The United States: 2009 and 2010.; J Dent Res Aug 2012. ↩
    2. 2Fehrenbach, M.Risk Factors For Periodontal Disease; The Preventive Angle; Vol VI, Issue II. ↩
    3. 3Kim, J; Amar, S.; Periodontal Disease And Systemic Conditions: A Bi-Directional Relationship; Odontology; 2006 Sept; 94(1):10-21. ↩
    4. 4Amabile N., Susini G., Pettenati-Soubayroux I., Bonello L., Gil J-M., Arques S., Bonfil J.J., Paganelli F.(2008). Severity Of Periodontal Disease Correlates To Inflammatory Systemic Status And Independently Predicts The Presence And Angiographic Extent Of Stable Coronary Artery Disease.; Journal of Internal Medicine, 263, 6, 644-652. ↩
    5. 5Jepsen S, Kebschull M, Deschner J.; Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. {Relationship Between Periodontitis And Systemic Diseases}.{Article in German} 2011 Sep;54(9):1089-96. ↩
    6. 6Zuo Z, Jiang J, Jiang R, Chen F, Liu J, Yang H, Cheng Y.; Effect Of Periodontitis On Erectile Function And Its Possible Mechanism.; J Sex Med. 2011 Sep;8(9):2598-605. ↩
    7. 7Zanatta FB, Bergoli AD, Werle SB, Antoniazzi RP.(2011). Biofilm Removal And Gingival Abrasion With Medium And Soft Toothbrushes. Oral Health Prev Dent. 2011;9(2):177-83. ↩
    8. 8Moritis K, Jenkins W, Hefti A, Schmitt P, McGrady M.; A Randomized, Parallel Design Study To Evaluate The Effects Of A Sonicare And A Manual Toothbrush On Plaque And Gingivitis.; J Clin Dent. 2008;19(2):64-8. ↩
    9. 9Barnes CM, Russell CM, Reinhardt RA, Payne JB, Lyle DM.; Comparison Of Irrigation To Floss As An Adjunct To Tooth Brushing: Effect On Bleeding, Gingivitis, And Supragingival Plaque.; J Clin Dent. 2005;16(3):71-7. ↩
    10. 10Harrel SK, Nunn ME; The Effect Of Occlusal Discrepancies On Periodontitis. II. Relationship Of Occlusal Treatment To The Progression Of Periodontal Disease.; J Periodontology, (April 2001) 72, 4, 495—505. ↩
    11. 11S Asikainen, C Chen, S Alaluusua, and J Slots; Can One Acquire Periodontal Bacteria And Periodontitis From A Family Member?; JADA September 1, 1997 128(9): 1263-1271. ↩

    Article Written By Sharon Boyd

    Sharon has been a Registered Dental Hygienist since 2001. She also holds a Bachelor of Science degree in Human Relations and Business. In 2011, she began implementing her dental knowledge into freelance writing services that aided dentists, product designers, continuing education providers and web marketing firms for their online and distribution purposes. She has since bridged her services into the medical and cosmetic surgery fields.

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     Lara T. Coseo, DDSArticle Reviewed by Dr. Lara Coseo

    Lara T. Coseo, DDS, is a 2004 graduate of Baylor College of Dentistry.  She has 13 years of experience practicing general dentistry.  She currently serves as a part-time faculty instructor at Texas A&M College of Dentistry and writes dental website content and blog material.

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