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What is gum disease?

Gum disease refers to infections of the gum and bone tissues that surround your teeth. This kind of infection is also known by the technical names of gingivitis and periodontal disease. Gum diseases are generally caused by poor oral health habits that allow a buildup of sticky, bacteria-filled plaque to accumulate on the teeth. If allowed to remain long enough, the bacteria releases toxins that infect the gum and eventually affect the bone supporting the teeth.1

This infection typically causes irritation, redness and swelling along the gum line. If plaque is not removed from the teeth daily, then minerals in your saliva can transform that plaque into tartar. The presence of tartar can make it very difficult to clean your teeth properly and increase your likelihood of developing periodontal disease.2

While improper oral health habits are a main cause of gum disease, a complex mix of genetic, systemic, local, and environmental factors also play a role in its development and progression.

 

Types of gum disease

There are two main types of gum disease. This includes:

 

Gingivitis3

Gingivitis is the mildest form of gum disease and is usually the result of improper oral hygiene habits. While, typically, people experience very little or no discomfort, gingivitis causes inflammation of the soft tissue surrounding your teeth. Generally, your gums will become red, swell, and bleed easily. Gingivitis can be localized to one or more teeth or may affect the entire mouth.

The good news is, gingivitis is usually reversible. To remedy this infection, simply improve your oral health habits and at-home oral care routine. It is equally important to continue - or start - regularly visiting the dentist for professional cleanings as a dental professional can help to remove tartar that may be building upon your teeth and can help to identify early indicators of gum disease. It is important to note that, if left untreated, gingivitis can progress to a more serious form of gum disease, periodontitis.

 

Periodontitis3

Periodontitis is a more advanced stage of gum disease in which the infection spreads beyond the gum line and irreversibly destroys the bone tissue that supports the teeth. During this process, gums become unattached from the tooth root and invading bacteria causes an inflammatory response that results in the destruction of gum tissue and the loosening of teeth from the bone. In some cases, periodontitis can also result in tooth loss.

Periodontitis is often categorized as mild, moderate, or severe, based on how much bone has been lost and if the inflammation is localized to one or more teeth or has spread throughout the mouth. When gum disease becomes this advanced, it becomes nearly impossible for an individual to clean their teeth properly below the gum line and professional care becomes necessary. Once you have progressed to periodontitis, continuous professional maintenance will always be required to prevent the disease from worsening.

 

Gum disease is usually the result of improper oral hygiene, like improper and/or inconsistent brushing and flossing, which leads to a buildup of plaque on the teeth. Plaque then turns to tartar due to the minerals in your saliva, which, in turn, leads to the trapping of more plaque below the gum line. This then results in more inflammation along the gum line, as well as redness, tenderness, and sensitivity..2

Other causes and influences on gum disease can include:

  • Smoking
  • Genetics
  • Diabetes and other systemic diseases
  • Stress
  • Crooked or grooved teeth that are not easily cleaned
  • Pregnancy, puberty, menstruation, other hormonal influences
  • Poor nutrition
  • Tooth grinding or clenching
  • Certain medications including steroids and oral contraceptives 

Yes, when gum disease is in its mildest form, it can usually be reversed easily with better oral care. However, once gum disease has progressed far enough that it begins to destroy the bone and gum around the teeth, an ordinary cleaning is not enough to stop its progression.

If you have progressed beyond gingivitis to periodontitis, then you may need a procedure called periodontal scaling and root planning. This is more time-consuming and extensive than a routine cleaning but has the ability to remove tartar and plaque from the root surface that is causing the infection below the gum line.

Surgery may be recommended when deep pockets of infection persists after periodontal scaling. With surgical treatment, dental professionals can help correct defects by facilitating the growth of new, healthy gums and bone.3

Gingivitis is a milder form of gum disease. With gingivitis the gums may become red, swollen, tender, or inflamed and may bleed easily. Gingivitis may or may not be painful and could be localized to just a couple of teeth or be a general issue throughout your mouth.

Without treatment, gingivitis can lead to periodontitis where the inflamed gum tissue starts to pull away from the teeth and form pockets. This can lead to greater infection, recession of the gums, pus, and will affect the bone that supports the teeth, leading to loose teeth or tooth loss.4

There are a number of indicators that gingivitis has progressed to periodontitis including:5

  • Gum recession
  • Bone loss around your teeth
  • Loose or shifting teeth
  • Gums that separate from the tooth root and form deep pockets that are difficult, if not impossible, to clean
  • Pus filled gums
  • Sores in the mouth
  • Bad mouth odor

Luckily, when gum disease is in a milder form, it can usually be reversed by implementing better oral hygiene habits at home. Additionally, you can prevent its progression by:6

  • Regularly seeing your dentist and receiving professional cleanings
  • Quitting smoking, if you smoke
  • Letting your dentist know of all systemic diseases you have, as well as, any prescription and over-the-counter medications that you take. Certain diseases and medications can cause gum inflammation or abnormal growth.
  • Following your dentist's recommendations for keeping your gums and teeth healthy 

Sources:

1Kinane, D. F. (2002, January 13). Causation and pathogenesis of periodontal disease. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1034/j.1600-0757.2001.22250102.x?sid=nlm:pubmed

2Gum (Periodontal) Disease Causes, Symptoms, Diagnosis, Treatment. (n.d.). Retrieved from https://www.nidcr.nih.gov/health-info/gum-disease/more-info

3American Academy of Periodontology. (n.d.). Types of Gum Disease. Retrieved from https://www.perio.org/consumer/types-gum-disease.html

4Gingivitis and periodontitis: Overview. (2020, February 27). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279593/

5American Academy of Periodontology. (n.d.). Gum Disease Symptoms. Retrieved from https://www.perio.org/consumer/gum-disease-symptoms.htm

6American Academy of Periodontology. (n.d.). PREVENTING PERIODONTAL DISEASE. Retrieved from https://www.perio.org/consumer/prevent-gum-disease