Gum Disease: How to Spot It and How Dentists Treat It

How do I know if I have gum disease?

You may notice red, swollen, or tender gums, gums that bleed when you brush or floss, or breath that stays bad. The ADA lists these warning signs. But you can also have gum disease and no warning signs, which is why regular exams matter.

The ADA’s list of signs includes:

• Gums that bleed easily
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath or a bad taste
• Adult teeth that are loose or separating
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures

NIDCR adds that gums may pull back and make teeth look longer, and that chewing may hurt in later stages.

One bleeding episode does not prove you have gum disease. Bleeding that keeps coming back is worth an exam.

What is gum disease, in plain words?

Gum disease is an infection that inflames the tissues holding your teeth in place. NIDCR says it is typically caused by plaque, a sticky film of bacteria, that builds up on the teeth. If plaque is not removed, it hardens into tartar. NIDCR says only a professional cleaning by a dentist or dental hygienist can remove tartar.

The bacteria in plaque and tartar can trigger inflammation. Over time, that inflammation can damage the gums and the bone below them. Left untreated, NIDCR says it can spread to the bones supporting the teeth. In the worst cases, teeth may become loose or need to be removed.

The medical term is periodontal disease. Our dentists call the two main forms gingivitis and periodontitis.

What is the difference between gingivitis and periodontitis?

Gingivitis is the early stage and affects the gums only. Periodontitis is the later stage, when the supporting bone is involved. Cleveland Clinic describes four stages, and the table puts them in order.

Cleveland Clinic notes that the breakdown of tissue happens gradually, and that most people do not feel pain in the early stages. So the time to catch it is before it hurts.

Our blog post on gingivitis vs periodontitis in plain words goes further.

What raises the risk of gum disease?

Poor brushing and flossing let plaque build up, but they are not the only cause. The ADA lists these factors:

• Poor oral hygiene
• Smoking or chewing tobacco
• Genetics
• Crooked teeth that are hard to keep clean
• Pregnancy
• Diabetes
• Certain medications

NIDCR says smoking or tobacco use is the most significant risk factor. It can also delay healing and make gum treatment less successful. If you use tobacco, tell your dentist. Quitting can improve your results from treatment.

None of this means gum disease is your fault. Genetics and health conditions play a part. What helps is finding it early and treating it.

How does a dentist check for gum disease?

A dentist or dental hygienist checks your gums, measures the spaces around each tooth, and takes X-rays. NIDCR lists a gum exam, a teeth exam, a medical history, and X-rays.

The measuring tool is a tiny ruler called a probe. The dentist gently slides it into the space between tooth and gum to measure the pocket. NIDCR says pockets in a healthy mouth are usually between 1 and 3 millimeters deep. Deeper pockets can be a sign of periodontal disease. Cleveland Clinic adds that the deeper the pocket, the more severe the gum disease. The dentist also checks how loose your teeth are and how far the gums have pulled back.

X-rays show bone loss. NIDCR says an X-ray can show whether the bone has been damaged. Your dentist may compare today’s X-rays with older ones to see how your bone has changed.

A medical history matters too. Certain conditions, such as diabetes, and tobacco use can contribute to gum disease, so your dentist will ask about them.

How is gum disease treated?

Treatment depends on the stage. NIDCR says the main goal is to control the infection and that the number and types of treatments vary with how far the disease has gone. Home care is part of every plan.

Some dentists send advanced cases to a periodontist, a dentist with extra training in gum disease. NIDCR says your dentist may refer you. Your dentist will tell you whether your case can be treated in the office.

What happens during a deep cleaning?

A deep cleaning, called scaling and root planing, cleans below the gumline. Cleveland Clinic says it is like a regular cleaning, but it reaches deeper beneath the gums. It is a nonsurgical treatment.

Here is the usual sequence, based on Cleveland Clinic’s description:

1. You get local anesthesia to numb your gums.
2. The dentist or hygienist removes plaque and tartar above and below the gumline. This is scaling.
3. The tooth roots are smoothed so bacteria have a harder time reattaching. This is root planing.
4. The dentist may place antibiotics around the roots or prescribe them to take afterward.

Cleveland Clinic says the cleaning takes one to two hours. The dentist might do everything in one visit or split it into two. You do not need incisions or stitches. Most people return to normal routines the same day.

Expect a few side effects. Your gums might feel sore for a couple of days. Cleveland Clinic says teeth may be sensitive to heat and cold, and that this should go away in a month or two. Some bleeding is normal, but tell your dentist if heavy bleeding does not stop. Gums may shrink back as swelling goes down, so you might see a little more of the tooth roots.

What happens if gum disease is not treated?

It tends to get worse slowly. NIDCR says gum disease starts with swollen, red, and bleeding gums. If it is left untreated, it can spread to the bones supporting the teeth and make chewing painful. In the worst cases, teeth may become loose or need to be removed.

Cleveland Clinic adds that untreated gum disease can affect your oral and overall health, because the infection can spread to other areas of your mouth. That is not a reason to panic. It is a reason to book an exam if you have signs, because early stages are the easiest to treat.

Can I treat gum disease at home?

Home care is essential, but it cannot do the whole job. NIDCR says only a professional cleaning can remove tartar, and that anyone with periodontal disease needs treatment from a dentist or dental hygienist. Brushing twice a day, cleaning between your teeth, and quitting tobacco support that treatment. They do not replace it.

Be careful with online tips that promise to fix gum disease with a rinse or an oil. None of them removes tartar. If you try a product, look for one with the ADA Seal of Acceptance and tell your dentist what you are using.

What happens after treatment is finished?

Treatment is not the end of the plan. Cleveland Clinic says that after a deep cleaning, regular dental cleanings and good oral hygiene should help keep you on track. Your dentist may suggest more frequent cleanings, often called periodontal maintenance, and will set a schedule based on your pocket measurements and how your gums respond.

Between visits, watch for the same signs that brought you in: bleeding, swelling, a bad taste, or teeth that feel loose. If they return, call your dentist. Early attention keeps treatment simple.

Does treatment make gum disease go away?

It depends on how far the disease has gone. In the earliest stage, daily care and a professional cleaning can bring gums back to health. The ADA says gingivitis can usually be addressed with a professional cleaning followed by daily brushing and flossing.

After bone has been lost, the picture changes. Cleveland Clinic says gum disease is manageable with appropriate treatment, but once the structural support around teeth is lost you do not usually get all of it back. That is why dentists talk about control and maintenance. Regular visits and daily home care keep it quiet.

Ask your dentist to explain your stage, your pocket measurements, and what a good result looks like for you.

How do I take care of my gums at home?

NIDCR lists these habits:

• Brush twice a day with fluoride toothpaste.
• Floss regularly, or use an interdental brush, a pick, or a water flosser your dental team recommends.
• See your dentist for routine checkups and professional cleanings.
• Quit all forms of tobacco.

Home care alone cannot remove tartar. The professional visit does that. Home care keeps new plaque from building up between visits.

Is gum disease linked to other health problems?

Researchers are studying the link. The ADA says that research on systemic diseases and periodontal disease is ongoing, and that while a link is not conclusive, some studies indicate severe gum disease may be associated with conditions such as diabetes or stroke. Tell your dentist about your health conditions, and tell your doctor about any gum problems.

What does gum care cost?

Fees depend on the stage of disease, the number of visits, and your insurance. The practice gives each patient their own estimate after an exam. For how benefits and payment questions are handled, see insurance and financing.

Next step

Read how the practice describes gum care on our periodontal care page. Call Town Center Dental at (636) 273-5866 or request an appointment, and your dentist will talk with you about what to expect.