What is gum disease?
Gum disease is an infection of the tissues and bones that surround and support the teeth. It is also called periodontal disease.
The two types of gum disease are called gingivitis and periodontitis. Gingivitis (say “jin-juh-VY-tus”) is mild gum disease that affects only the gums, the tissue that surrounds the teeth. Periodontitis (say “pair-ee-oh-don-TY-tus”) is more severe gum disease that spreads below the gums to damage the tissues and bone that support the teeth.
What causes gum disease?
Your mouth constantly makes a clear, sticky substance called plaque that contains bacteria. The bacteria in plaque make poisons, or toxins, that irritate the gums and cause the gum tissues to break down. If you don't do a good job of removing plaque from your teeth, it can spread below the gums and damage the bone that supports the teeth. With time, the plaque hardens into a substance called tartar that has to be removed by a dentist or dental hygienist.
You are more likely to get gum disease if you:
What are the symptoms?
It may be hard to tell if you have a mild case of gum disease. Healthy gums are pink and firm, fit snugly around the teeth, and do not bleed easily. But mild cases of gum disease (gingivitis) cause:
In more severe gum disease (periodontitis), the symptoms are easier to see, such as:
How is gum disease diagnosed?
To find out if you have gum disease, your dentist or dental hygienist will do an examination to look for:
Your dentist or dental hygienist may take X-rays of your teeth to look for bone damage and other problems.
How is it treated?
If you have a mild case of gum disease, you will probably be able to take care of it by brushing and flossing your teeth every day and getting regular cleanings at your dentist's office.
If your gum disease has become worse and you have periodontitis, your dentist or dental hygienist will clean your teeth using a method called root planing and scaling. This removes the plaque and tartar buildup both above and below the gum line. You may also need to take antibiotics to help get rid of the infection in your mouth. If your gum disease is severe, you may need to have surgery.
How can you prevent gum disease?
Gum disease is most common in adults, but it can affect anyone, even children. So good dental habits are important throughout your life:
If you think you have a mild case of gum disease, make sure to take care of it before it gets worse. Keeping your teeth and gums healthy and getting regular checkups from your dentist can keep the disease from getting worse.
Having gum disease may increase a pregnant woman's risk of having a premature, low-birth-weight baby.1 Also, studies have found a direct link between heart disease and the bacteria that cause gum disease.2 So taking good care of your teeth and gums may have benefits beyond keeping your mouth healthy.
Frequently Asked Questions
Learning about gum disease:
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|Dental Care: Brushing and Flossing Your Teeth|
Gum disease is caused by the growth of bacteria on the teeth and gums. Bacteria are present in plaque, a clear, sticky substance your mouth produces. If plaque is not removed promptly, it builds up on the teeth.
While bacteria are the direct cause of gum disease, a number of other things also affect the health of your gums. You are more likely to have gum disease if:
Milder types of gum disease (gingivitis) cause:
Because gingivitis usually isn't painful, you may not notice the symptoms and may not get the treatment you need. If you don't get treated, the disease may progress.
If you use tobacco, you have a higher risk of gum disease. Your gums may actually bleed less, even though they are unhealthy, and you may not realize it's a problem until its too late. If you use tobacco, you will need to see your dentist more often.
If a woman has gum disease during pregnancy, she may be at greater risk of having a premature, low-birth-weight baby.1
Studies have found a direct link between heart disease and the bacteria that cause gum disease.2 So taking good care of your teeth and gums may have benefits beyond keeping your mouth healthy.
You are more likely to have gum disease if you don't brush and floss your teeth regularly or well enough to remove plaque.
You are at greater risk for gum disease if:
Call a dentist if you have symptoms of gum disease, such as:
See your dentist regularly. If you have a history of dental problems, you may need to go two times a year. If you haven't gone to the dentist in the last year, make an appointment as soon as possible. A dental hygienist can remove plaque and scrape hard mineral deposits (tartar) from around your gum line. Regular checkups and cleanings will help you reverse and prevent further gum disease.
If you have gum disease, see your dentist right away. Waiting to have it treated will allow it to get worse and spread.
If your gum disease is severe, the dentist may refer you to a specialist, such as:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Your dentist or dental hygienist will examine your gums and teeth for gum disease during regular visits. Using a small mirror and a tool called a probe, your dentist will look for:
The dentist or dental hygienist may take X-rays of your teeth to look for bone damage and other problems.
Visiting your dentist or dental hygienist regularly is the best way to detect gum disease before it causes serious damage. Your dentist will determine how often you should be seen based on your risk for gum disease.
Early treatment of gum disease is very important. The goals of treatment are to prevent gum disease from permanently damaging tissues, control infection, and prevent tooth loss. For treatment to be effective, you will need to:
If you have a milder type of gum disease (gingivitis), you may be able to reverse the damage to your gums:
For more information on how to care for your teeth, see:
Your dentist will want to see you for regular checkups and cleanings. Professional cleaning can remove plaque and tartar that brushing and flossing missed. After you have had gum disease, you may need to see your dentist every 3 or 4 months for follow-up.
Your dentist may prescribe antibiotics to help fight the infection. They can be put directly on the gums, swallowed as pills or capsules, or swished around your teeth as mouthwash. Your dentist may also recommend an antibacterial toothpaste that reduces plaque and gingivitis when used regularly.
Milder types of gum disease (gingivitis) that are not treated promptly or that do not respond to treatment can progress to advanced gum disease (periodontitis). Periodontitis requires prompt treatment to get rid of the infection and stop damage to the teeth and gums, followed by long-term care to maintain the health of your mouth.
After treatment, you will need to keep your mouth disease-free by preventing plaque buildup. You will need to brush carefully and thoroughly after all meals and snacks and floss daily. Your dentist will probably prescribe an antibacterial mouthwash.
Your dentist will schedule follow-up appointments regularly for cleaning and to make sure that the disease has not returned.
You usually can prevent gum disease by brushing and flossing regularly, having regular dental visits for examinations and cleaning, and eating a balanced diet.
Practice good dental habits:
If your gums bleed when you brush or floss, the bleeding should stop as your gums become healthier and tighter to your teeth. But bleeding gums may be a symptom of gum disease and should be brought to the attention of your dentist.
For more information on how to take care of your teeth, see:
Making wise food choices can help you prevent gum disease:
If you smoke or use spit tobacco, one of the best things you can do for yourself is to quit. Tobacco reduces your ability to fight infection and delays healing. Tobacco users are much more likely to develop gum disease than non-smokers—up to six times more likely. They also have more serious gum disease that leads to tooth loss and that doesn't respond as well to treatment.5 Quitting is difficult. But many people find success through a combination of medicine, a stop-smoking program, and counselling. For more information on how to quit, see the topic Quitting Smoking.
If your gums are mildly swollen and red, flossing every day and brushing your teeth in the morning and before bedtime can help reverse these symptoms of gum disease. For more information on how to care for your teeth, see:
The following steps can also help to reverse or prevent gum disease:
If you smoke or use spit tobacco, the best thing you can do for yourself is to quit. Tobacco decreases your ability to fight infection and delays healing. Tobacco users are more likely than non-smokers to have serious gum disease that leads to tooth loss and that doesn't respond as well to treatment.5 Quitting is difficult. But many people find success through a combination of medicine, a stop-smoking program, and counselling. For more information on how to quit, see the topic Quitting Smoking.
If brushing and flossing aren't effective in reversing gum disease, your dentist may prescribe antibiotics to help fight the infection. Antibiotics can be put directly on the gums (topical), swallowed as pills or capsules, swished around your teeth as mouthwash, or inserted into the pockets of advanced gum disease. Your dentist may recommend that you use a medicated toothpaste that contains an antibacterial ingredient that reduces plaque and gingivitis when used regularly.
If used properly, antibiotics safely treat gum disease by giving swollen, infected gums a chance to heal. Practice good dental care during and after treatment so that your teeth and gums stay healthy.
What to think about
Antibiotics alone usually cannot cure severe gum disease. In some cases, root planing and scaling combined with antibiotics is enough to stop severe gum disease, but surgery may be required.
Other procedures may be needed to repair badly damaged gums:
For surgery to be successful, you will need to:
What to think about
Gum surgery can introduce harmful bacteria into your bloodstream. You may need to take antibiotics before and after surgery if you have a condition that puts you at high risk for a severe infection or if infections are particularly dangerous for you. You may need to take antibiotics if you:
If you have gum disease, your dentist may do a procedure called root planing and scaling. Root planing and scaling is one of the most effective ways to treat gum disease before it becomes severe. Root planing and scaling removes plaque and tartar buildup between the gums and the teeth down to the roots.
Your dentist may give you antibiotics to speed healing after root planing and scaling.
If your dentist can remove all the plaque and tartar from the roots of your teeth, and if you follow treatment with good dental care, your gums should heal and reattach to the teeth. You must brush and floss daily after root planing and scaling. Without proper dental care, your gum disease may get worse.
Other non-surgical procedures that may be done to cure or prevent gum disease are:
|American Dental Association|
|211 East Chicago Avenue|
|Chicago, IL 60611-2678|
The American Dental Association (ADA), the professional membership organization of practicing dentists, provides information about oral health care for children and adults. The ADA can also help you find a dentist in your area.
|Canadian Academy of Periodontology|
|#105 - 1815 Alta Vista Drive|
|Ottawa, ON K1G 3Y6|
The mission of the Canadian Academy of Periodontology is to serve the members of the Academy as the national voice of periodontists, to promote excellence in the practice of periodontics by setting the standards of care and guidelines for therapy, and to advance the periodontal health of the public. This site provides information on periodontology, as well as the possibility of finding a licensed periodontist in Canada.
|Canadian Dental Association|
|1815 Alta Vista Drive|
|Ottawa, ON K1G 3Y6|
The Canadian Dental Association, the professional membership organization of dentists, provides information regarding oral health care for children and adults.
|Canadian Dental Hygienists Association (CDHA)|
|96 Centrepointe Drive|
|Ottawa, ON K2G 6B1|
The Canadian Dental Hygienists Association (CDHA) is a professional association of dental hygienists in Canada and helps represents them in the development of policies and standards related to dental hygiene practice, education, research, and regulation. The CDHA Web site offers an Oral Care Centre with a variety of information about dental hygiene for the general public.
This website is sponsored by the Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This website offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly emails about your area of interest.
|National Institute of Dental and Craniofacial Research (NIDCR)|
|National Institutes of Health|
|Bethesda, MD 20892-2190|
The National Institute of Dental and Craniofacial Research (NIDCR) is a governmental agency that provides information about oral, dental, and craniofacial health. By conducting and supporting research, the NIDCR aims to promote health, prevent diseases and conditions, and develop new diagnostics and therapeutics.
- Task Force on Periodontal Treatment of Pregnant Women (2004). American Academy of Periodontology statement regarding periodontal management of the pregnant patient. Journal of Periodontology, 75(3): 495.
- Humphrey LL, et al. (2009). Periodontal disease and coronary heart disease incidence: A systematic review and meta-analysis. Journal of General Internal Medicine, 23: 2079–2086.
- Famili P, et al. (2007). The effect of androgen deprivation therapy on periodontal disease in men with prostate cancer. Journal of Urology, 177(3): 921–924.
- Robinson PG, et al. (2005). Manual versus powered toothbrushing for oral health. Cochrane Database of Systematic Reviews (2). Oxford: Update Software.
- Hodges KO (2009). Periodontal diseases. In NO Harris et al., eds., Primary Preventive Dentistry, 7th ed., pp. 46–66. Upper Saddle River, NJ: Pearson.
|Primary Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Specialist Medical Reviewer||Steven K. Patterson, BS, DDS, MPH - Dentistry|
|Last Revised||October 5, 2011|
Last Revised: October 5, 2011
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