Gum Disease: Causes, Symptoms, and Treatments

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If you have problems with gum disease or gingivitis, don’t worry, you’re not alone. Thousands of people in the U.S. currently have some form of the disease. Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.

Whether your gum disease is stopped, slowed, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless “plaque” on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form “tartar” that brushing doesn’t clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.

The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called “gingivitis.” In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.

What is Gum Disease (Gingivitis)?

Gum disease, also known as periodontal disease, is inflammation caused by bacterial growth in the mouth around the tooth and along the gum line. Unfortunately, this preventable disease can cause loss of teeth if not treated.

Is Gum Disease common?

Despite being preventable, gingivitis is quite common. An estimated 3 out of 4 American adults have gingivitis, the earliest form of gum disease.

What are the stages of Gum Disease?

There are four general stages of gum disease. If left untreated, gingivitis can progress to the more severe condition of periodontitis.

  • Stage 1: Gingivitis is the first stage of gum disease, and its symptoms include inflamed or red gums that may bleed when brushed.
  • Stage 2: In early periodontitis, slight loss of bone that supports the teeth occurs even though other symptoms may not be easily observed.
  • Stage 3: In moderate periodontitis, more bone and gum tissue is destroyed, and loosening of teeth may also occur.
  • Stage 4: Advanced periodontitis is the most severe stage of the disease. Symptoms become more severe; teeth can become very loose and biting, and chewing may hurt. Extensive dental treatment is typically required to try to correct the damage of advanced periodontitis.


Gingivitis is an early stage of gum disease caused by plaque buildup on teeth. If plaque isn’t properly removed, it will build up at the gum line and can result in inflammation of the gums. Symptoms of gingivitis include irritated or red gums that may bleed when brushing or flossing.

Gingivitis is quite prevalent. But while almost 80% of adults will experience some symptoms of gingivitis, that doesn’t necessarily mean it’s inevitable. It’s important to note that occasionally there might be no noticeable pain or apparent signs, leaving people unaware that they have it. That’s another good reason to schedule regular checkups with your dental professional every six months so he or she can identify it and suggest treatment options.


The term “periodontitis” is used to describe the later, more severe stages of gum disease. If gingivitis goes untreated, it can lead to periodontitis, which carries symptoms and health implications such as receding gums, damage to the bone and connective tissue around teeth, and (in the severe cases) tooth loss.

While gingivitis may be treated, the effects of periodontitis are typically not reversible. It is a chronic, long-term condition that should be addressed with the help of a dental professional.

What is Periodontitis?

Periodontitis is a severe infection that destroys the soft tissue and bone that support your teeth, and eventually, may cause tooth loss.

What’s more, long-term periodontitis can lead to even more serious problems, including higher blood sugar levels and an increased risk of heart attack and stroke. Gum disease may even affect your unborn child. Pregnant women with periodontitis are much more likely to give birth to premature babies than are women with healthy gums.

Periodontitis is both preventable and treatable. Although factors such as smoking, heredity, medications and lowered immunity make you more susceptible to gum disease, the most common cause is poor oral hygiene. Daily brushing and flossing and regular professional cleanings can significantly reduce your chances of developing periodontitis.

Signs and symptoms

In the earliest stages, periodontal disease causes few signs or symptoms, and you may not be aware of a problem until your gums become soft and bleed slightly when you brush your teeth. As the disease progresses, you may notice more serious changes, including:

  • Swollen, bright red or purple gums
  • Gums that feel tender when touched
  • Gums that pull away from your teeth (recede), making your teeth look longer than normal
  • New spaces developing between your teeth
  • Pus between your teeth and gums
  • Persistent breath odor or a bad taste in your mouth
  • Loose teeth or a change in the way your teeth fit together when you bite

Because several types of periodontitis exist, you may experience problems that are unique to a particular form of the disease. For instance, aggressive periodontitis, which affects otherwise healthy young people, causes an unusually rapid deterioration of their teeth and gums. The condition can also occur episodically, with periods of severe disease alternating with periods when signs and symptoms improve or even seem to disappear.

Other types of periodontitis and their characteristics include:

  • Chronic periodontitis. This most common type of gum disease is characterized by progressive loss of the bone and soft tissues that surround and support your teeth. The damage usually develops more slowly than it does in aggressive periodontitis.
  • Periodontitis as a manifestation of systemic disease. This usually develops at a young age and occurs in conjunction with another health problem, such as diabetes.
  • Necrotizing periodontal disease. A severe form of periodontitis, this causes the death of gum tissue, tooth ligaments, and even bone. People suffering from malnutrition or living with HIV/AIDS are especially vulnerable.

The difference between Gingivitis, and Periodontitis

There may be some confusion with the medical terminology surrounding gum disease, but it’s relatively simple. Gum disease is the general term used to describe all the stages of periodontal disease – including gingivitis and periodontitis. Gingivitis represents early (and reversible) gum disease, the kind marked by red, swollen gums that may bleed easily when brushed or flossed.

If gingivitis is not addressed, it can progress and develop into the more severe (non-reversible) stage of gum disease called periodontitis. Periodontitis attacks gums, bone and the connective tissue that holds teeth in place, eventually loosening teeth over time to the point that they could fall out. Gum disease is a leading cause of tooth loss.

Impact of Gum Disease

Although it is preventable, gum disease (or periodontal disease) can lead to loss of teeth if not treated.

What causes Gingivitis?

Gingivitis is the earliest form of gum disease and is caused by the buildup of plaque on teeth. Its symptoms are red, inflamed gums. If left untreated, gingivitis can lead to more severe forms of periodontal disease, known as periodontitis, which can ultimately result in tooth loss.

Improper Oral Health Care

Gingivitis is very common in children and adults and occurs when plaque is allowed to accumulate on the teeth. An inconsistent or inadequate oral care routine can lead to plaque buildup on the teeth.

That is why it is important to maintain good daily oral hygiene – brushing twice a day, flossing between the teeth once a day and rinsing twice a day with an efficient antiseptic mouthwash.

Plaque & Tartar

Gingivitis occurs when bacteria develop into a sticky film called plaque. If plaque is not removed on a daily basis, it can cause gum tissue to become inflamed, swollen, or may bleed. This condition is called gingivitis.

If plaque is not removed, it will eventually harden and turn into tartar. Tartar is hard, crusty, and porous. It is yellow or brownish in color and appears above and below the gum line. Tartar below the gum line can only be removed by a dentist or hygienist.

Brushing twice daily, flossing regularly, and rinsing with an antiseptic mouthwash can prevent tartar buildup above the gums and its damaging effects.

Other Oral Health Causes

Although plaque is the primary cause of gum disease, other issues can contribute as well. Crooked teeth can make for an environment more conducive to plaque buildup because they are harder to clean thoroughly. Family history can also be a factor, so this could raise your risk of developing gum disease.


Smoking alters the normal function of gum tissue cells and makes your mouth much more vulnerable to infection. Smoking weakens your gums’ defense and makes it much harder for them to recover. So whether it’s cigarettes, cigars, chewing tobacco, or pipe smoking, smoking in general significantly increases your risk for gum disease.


As you get older, preventing the damage from gum disease becomes essential. That is why it’s important to maintain good gum health throughout your life.

Older patients can be a greater risk for oral health problems because of declining physical and mental status, medications, or lack of routine dental care. Maintaining healthy oral care habits like brushing twice a day, flossing once a day and rinsing with an ADA-Accepted mouthwash can help keep the health of your mouth.

If you or a loved one are struggling to keep up with your oral care routine due to physical limitations, consider trying an electric toothbrush or interdental flossers.

If you wear full or partial dentures, follow your dentist’s advice about cleaning your dentures. Brush the denture each day with a brush designed for cleaning dentures or a soft-bristled toothbrush, to remove food deposits and plaque. Your dentist may also recommend placing your dentures in a soaking solution.

Other General Health Issues

During periods of heightened or shifting hormones, the gums become more susceptible to gum disease. If pregnant, or even on a typical monthly menstrual cycle, you may notice an increase in your gums’ sensitivity.

Take extra care during these times to offset this risk. Other factors can lead to gum disease as well, like stress, certain illnesses, and genetic history.

How do I treat Gum Disease?

Your dentist will evaluate your mouth during a dental cleaning appointment where the dental hygienist removes any plaque and tartar that is building up on your teeth and polishes the teeth to remove external stains. A dental probe may be used to measure any pockets that develop at the gumline that will determine if your gingivitis has turned into periodontitis. Any newly found cavities must be repaired. Abnormalities of the teeth can hinder dental hygiene, leading to gingivitis if the teeth and gums are not cleaned properly.

Your dentist or dental hygienist can also give instructions on proper dental techniques for brushing and flossing at home. Make a habit to visit your dentist often for checkups and cleanings.

When a person has gingivitis, the goal is to rid the gums of inflammation and restore them to a healthy pink color. Although you have been brushing your teeth for decades, are you using the correct technique? First make sure you brush and floss your teeth at least twice a day. Use a soft-bristled toothbrush and place it at a 45-degree angle against your gum line and massage the gums in a back and forth motion.

Then, move the brush up and down and back and forth motion using short strokes to clean the outer and inner surfaces of your teeth. Don’t forget about the chewing surfaces too. Be gentle with brushing; you don’t want to provoke sensitive gums and teeth. After brushing, floss in between each tooth during this daily dental task. Make sure to spend at least two minutes brushing and replace your toothbrush about every three months or when you see the bristles becoming frayed.

Gargle and rinse with a mouthwash to flush harmful bacteria and plaque away from your gums. Another helpful tool is the WaterPik which can assist in removing food particles and plaque bacteria by a jetted stream of water that goes below the gumline and between your teeth.

Are there home remedies for Gingivitis?

Here are 7 natural home remedies for gum disease that will make your dentists’ head spin at your next appointment:

Oil Pulling: This method has been raved about not only for curing swollen, red gums, but even reversing gum disease with bone loss. Oil pulling does just what the name infers, ‘pulls’ toxins right out of your mouth and gums. It removes plaque build up and has been studied in several triple-blind studies to be very effective. Just be sure to use 100% organic oil (sesame, olive, or coconut is best) because you wouldn’t want to be swishing pesticide-laden oils around in your mouth for several minutes at a time.

Sage Leaf Decoction:This is an old folk remedy for gingivitis and gum disease. All you need to do is boil around 50 fresh organic sage leaves in some distilled water and then gargle the decoction several times a day as well as use it like a mouthwash. You can also make a sage tea and drink it throughout the day. Sage has huge amounts of antioxidants and it also contains it anti-inflammatory, antioxidant, and antimicrobial properties.

Garlic and Turmeric Paste: Use garlic cloves on irritated gums, or simply make a garlic & turmeric paste to use like toothpaste, then rinse after it has been in your mouth for several minutes. Both of these naturally-occurring foods are full of antibacterial properties, and turmeric is a great anti-inflammatory agent.

Neem:This plant is used in India for a thousand different healing remedies; among them is better dental health. You can use neem in a mouthwash, or even find neem toothpaste. It has both antimicrobial and antifungal properties. In one study involving three different groups with gum disease: one using traditional mouthwash, one treated with neem gel, and the last a placebo, the neem group had the best outcome.

Mustard Oil: This method has been used for hundreds of years to combat bad dental hygiene. It destroys bacteria in the mouth and heals the gums very fast. It also has pain-reducing qualities along with being anti-microbial and anti-bacterial.

Aloe Vera Gel: Best when it comes straight from the plant, aloe vera is a great anti-inflammatory that is especially helpful if your gums are red and inflamed.

Eat more fruits and vegetables: Not only do fruits and vegetables with skins help clean the teeth, but the antioxidants in both fruits and vegetables also prevent plaque build up in the mouth.

Gingivitis treatment is of utmost importance when you first see the symptoms appear in your mouth. Between professional dental care and oral hygiene habits at home your gum issues should begin to get better with continuous care.


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