Gum Disease 101: Stages, Causes, Symptoms, and Treatments

When you think about having a healthy smile, you may first consider keeping your teeth clean and free from decay. Taking proper care of your teeth is undeniably important, but equally important is staying alert for warning signs of gum disease.

“Healthy gums are the foundation of a healthy smile,” says Dr. Dorrin Reyhani, instructor in periodontics at the University of Pennsylvania School of Dental Medicine. Watch our interview with Dr. Reyhani, then keep reading for more information about what gum disease is and how it is caused, as well as practical steps you can take to promote your gum health.

Understanding the Stages of Gum Disease

“Gum disease is extremely common,” says Dr. Reyhani, “and many people don’t realize they have it because it often starts without pain.” Indeed, more than 42% of all U.S. adults age 30 and older have some form of gum disease.

Healthy gums are firm, pink, and fit snugly around your teeth, playing an essential part in maintaining your bite’s integrity. When infection strikes the gums, not only tooth loss but also systemic health problems can result.

Also known as periodontal disease, gum disease begins with gingivitis, the milder form. The gums become inflamed, red, and may bleed easily, primarily due to a buildup of plaque—the sticky biofilm constantly being formed by oral bacteria—on the tooth surface. “Gingivitis is reversible with good oral hygiene and professional dental care,” Dr. Reyhani points out.

Left untreated, gingivitis can advance to periodontitis. In this more severe stage, the inflammation spreads below the gum line, causing the gums to pull away from the teeth, forming pockets. These pockets harbor more bacteria, leading to the destruction of gums and bone.

Exploring What Causes Gum Disease

Bacteria are naturally present in the mouth. When they combine with food particles, especially sugars and starches, they form plaque on the tooth surface.

If plaque isn’t removed through diligent hygiene, it hardens into tartar, also known as calculus. Tartar is rough and porous. It provides an even more hospitable environment for bacteria and makes removing plaque more difficult. This continuous bacterial presence irritates the gums, triggering an inflammatory response that is the hallmark of gum disease.

While bacteria are the direct cause of gum disease, several factors can increase your susceptibility to it or accelerate its progression, including:

• Poor oral hygiene
• Inconsistent brushing and flossing
• Smoking
• Diabetes
• Hormonal changes (such as those experienced during pregnancy)
• Certain medications
• Genetic predisposition

Grasping the Links Between Gum Disease and Systemic Health Issues

The inflammatory processes gum disease initiates can have far-reaching effects on your entire body.

The connection between gum disease and diabetes is particularly strong. High blood sugar levels associated with diabetes can fuel the inflammation in gum tissues, making individuals more prone to periodontal infections. Conversely, severe gum disease can make it harder for individuals with diabetes to control their blood sugar levels—a challenging cycle.

Research has also established a significant association between gum disease and an increased risk of such cardiovascular issues as heart disease and stroke. Periodontal infections can lead to bacteria entering the bloodstream, potentially contributing to inflammation in blood vessels and the formation of clots.

“Periodontal disease is likely to cause a 19% increase in the risk of cardiovascular disease, and this increase in relative risk reaches 44% among individuals aged 65 years and older,” writes Dr. Muhammad Ashraf Nazir in the International Journal of Health Sciences.

Beyond diabetes and cardiovascular health, gum disease is also linked to other conditions, including pregnancy complications like premature birth and low birth weight, respiratory infections, and rheumatoid arthritis.

Recognizing Early Signs of Gum Disease

When you know the warning signs to watch for, you can receive earlier gum disease treatment and avoid the irreversible damage of periodontitis.

“Early signs of gum disease are often subtle,” cautions Dr. Reyhani. “You may notice bleeding when brushing or flossing, gums that look red or swollen, persistent bad breath, or recession of your gums. Because these symptoms may not be painful, people often ignore them.”

As gum disease progresses to periodontitis, symptoms become harder to ignore. For example, you might see pus between your teeth and gums, experience a persistent foul taste in your mouth, or notice your teeth are becoming loose. Changes in how your teeth fit together when you bite can also occur.

“Pay attention to your gums,” urges Dr. Reyhani, “and book an appointment with your dentist if you recognize any of the early signs of gum disease.”

Getting Gum Disease Treatment That Works

Preventing gum disease is significantly easier, not to mention less costly, than treating it.

To proactively keep your gums healthy, brush your teeth thoroughly at least twice a day with fluoride toothpaste. Use dental floss daily to remove plaque and food particles from between your teeth and along the gum line. You can also use a tongue scraper to help remove germs that contribute to infections and bad breath.

Beyond brushing and flossing, limit your intake of sugary and acidic foods and drinks to reduce the fuel for plaque-forming bacteria. If you smoke, quitting is one of the most important things you can do for your gum health and your overall well-being. Managing stress and ensuring adequate sleep also supports a robust immune system, essential for fighting off infections.

Additionally, regular visits to a dental professional are nonnegotiable for gum health. Dentists can perform professional cleanings to remove tartar, detect early signs of gum disease you might miss, and provide personalized advice on your oral hygiene routine.

“If concerns are identified early,” says Dr. Reyhani, “treatments such as deep cleaning, also called scaling and root planing, can be very effective. In more advanced cases, a referral to a periodontist may be needed for surgical treatment to clean beneath the gums and reshape the damaged gum and bone tissue.”

If you have any questions or concerns about your gums and your risk for gum disease, the dental professionals at Penn Dental Family Practice are ready to help you. Schedule your appointment online now, or call us at 215-898-PDFP (7337).