Gum Disease

Definition Of Gum Disease

Dentist Mirror
Gum 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 is known by several other names such as:


The Effects Of Gum Disease

As bacteria invade the areas just under the gumlines, 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.


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.

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


Classifications of gum disease include:



  • Mild to moderate inflammation along the gumlines
  • Red or tender gums
  • Bleeding when flossing
  • Subsides within two weeks with thorough preventive care


Periodontal Disease/Periodontitis


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



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



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


The Cause Of Gum Disease

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

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 – Healthy gums should not bleed. If you floss regularly and brush along the gumlines, bleeding is not normal. However, infrequent flossing may always 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 infection. Just as if you had another area on your body that was infected, 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 gumlines.


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.


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.

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.

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 is 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.

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.

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 Gingivitis– An ulcerative condition that involves necrotic “punched out” tissue, combined with swelling of the lymph nodes.
  • 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.


Dangers And Health Risks

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.


Brush Your Teeth
Tooth with toothbrush
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 short back and forth 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.

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. [Click here] to learn more about brushing with safe botanical ingredients.


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.



Conventional Treatments

dentists performing laser surgery
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:
      • Actisite
      • PerioChip
      • Arestin
      • Elizol
      • 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

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

OraMD Ingredients Proven To Kill Bacteria That Cause Gum Disease


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.

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.

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.

OraMD is an all natural solution that is clinically proven to kill periodontal bacteria.




  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. ↩


Gum Disease
Article Name: Gum Disease
Description: Gum 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.
Author: Sharon Boyd

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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