Gum (Periodontal) Disease

Overview

What is gum disease?

It is a gum infection that gets worse over time.

  • Early-stage gum disease (gingivitis) includes swollen, bleeding gums. Some people experience no symptoms. It is reversible with timely treatment.
  • Advanced gum disease (periodontitis) occurs when the gums' inner layer pulls away from the teeth and forms pockets. Periodontitis is defined by the loss of bone supporting the teeth.

Who gets gum disease?

You may face a higher risk of gum disease if you:

  • Use tobacco.
  • Have diabetes, arthritis, heart disease and immune system disorders like HIV and AIDS.
  • Do not have good dental hygiene habits.
  • Have crooked teeth, loose fillings or permanent dental appliances like bridges that don’t fit well.
  • Have an immediate family member with a history of gum disease or early tooth loss.
  • Avoid seeing the dentist.

How can it affect my health?

Gum infections in their early stages may cause uncomfortable symptoms.

Advanced periodontitis can cause you to lose your teeth, making it difficult to eat. The bacteria from periodontitis can also raise your risk of health issues, including:

How common is periodontal disease?

  • Nearly half of adults 30 years old or older have gum disease.
  • Seven in 10 adults 65 years old and older experience it.

Symptoms and Causes

What causes periodontal disease?

Bacteria in your mouth produce toxins that can irritate gum tissue. If the bacteria isn’t cleared away by brushing your teeth, it forms a film (plaque) that’s difficult to remove. Over time, plaque hardens and forms a substance called tartar that requires professional cleaning to get rid of.

Also, it’s now widely believed that there’s a genetic component to gum disease. Some people have an exaggerated immune response to the bacteria that cause periodontal disease.

What are the symptoms of a gum infection?

You may experience:

  • Bad breath, even after brushing your teeth.
  • Swollen, tender or bleeding gums.
  • Toothaches and pain while chewing.
  • Loose teeth.
  • Teeth sensitivity.
  • Teeth that appear longer than usual due to the gums wearing away.

Diagnosis and Tests

What type of healthcare provider can help me?

A dentist can diagnose and treat gingivitis. You may need to see a specialist called a periodontist for advanced gum disease or symptoms that do not respond to standard treatments. Periodontists are dentists with extra training in treating complex gum disease.

How is periodontitis diagnosed?

The evaluation starts by learning about your medical history and if you have any gum disease risk factors. Your dental care provider then assesses your gums for signs of inflammation. They may use an instrument (probe) to measure pockets around the teeth.

How will I know if I have gingivitis if I can’t feel the symptoms?

Dental providers check for signs of gum infections during a dental check-up. If your gums appear swollen or bleed easily, it may be due to gingivitis. Your dental care provider will use a probe to check for pockets. Gingivitis does not affect the bone surrounding your teeth and therefore usually can't be diagnosed from dental x-rays.

Management and Treatment

How is early-stage gum disease treated?

The best treatment for gingivitis is a professional cleaning. Your dental care provider detects and removes plaque and tartar even in hard-to-reach areas. Once these substances are gone, your gums will heal on their own, and no other treatments are necessary. Your provider will also review the tools and techniques you should do to be more effective at home at preventing gingivitis from recurring.

How do periodontists treat periodontitis?

Scaling and root planing is a procedure to clear away plaque and tartar that has spread to the tooth’s root. For many people with periodontitis, this is the only treatment that’s needed. In some cases, periodontists may need to do minor procedures to eliminate the periodontal disease. They may be able to rebuild the bone surrounding your teeth that was lost from the periodontal disease. Periodontitis treatments sometimes involve removal of the affected teeth.

What happens if my teeth fall out?

If you do end up losing teeth, there are options such as dental implants that can restore a natural-looking smile. Dental implants are devices that look and feel like teeth in that they can't be removed. They are similar to a joint replacement in that they fuse with your jawbone. The procedure to insert them is relatively quick and painless.

Prevention

How can I prevent periodontal disease?

Steps you can take to prevent periodontal disease include:

  • Brushing your teeth with a toothpaste containing fluoride.
  • Flossing to remove plaque deposits near the gum line.
  • Using mouthwash to get rid of bacteria that may remain on your teeth after brushing.
  • Getting regular teeth cleanings and dental exams.
  • Quitting smoking.

Outlook / Prognosis

What is the outlook for people with periodontal disease?

The impact of periodontal disease on your dental health depends on how serious it is and the treatments you receive. Seeing a periodontist and following their care instructions gives you the best chances for good results.

Can periodontal disease come back?

Even with successful treatment, periodontal disease can come back. If you start noticing symptoms, like swollen or bleeding gums, it’s important to get help from your dentist or periodontist.

Will I lose my teeth?

Even with advanced periodontal disease, many people avoid tooth loss. For the best chances of preserving your smile, seek treatment as soon as possible.

Living With

If my gums are bleeding but don’t hurt, do I need to seek care?

You should see a dentist or periodontist if you think you may have gum disease. It does not go away on its own and can get worse with time. Treating it in earlier stages can help you avoid discomfort from worsening symptoms or avoid a procedure.

Can I get gum disease treatment if I do not have dental insurance?

Some dentists take patients who do not have insurance, but you’ll have to pay for services out of pocket. Your dentist may know of community-based programs that enable you to get the care you need at a lower cost. You may also be eligible for state-sponsored dental plans that provide services at little or no cost.

A note from Cleveland Clinic

Gum disease is common. Even if you take good care of your teeth, you could be at risk. If you do end up with gum disease, timely care is important. Your dentist can treat gingivitis. More severe problems, like periodontitis, require care from a specialist and may include a procedure. Regularly brushing your teeth and staying up to date with dental cleanings can help you avoid gum disease.

Last reviewed by a Cleveland Clinic medical professional on 02/23/2021.

References

  • National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease. (https://www.nidcr.nih.gov/health-info/gum-disease/more-info) Accessed 2/10/21.
  • Centers for Disease Control and Prevention. Periodontal Disease. (https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html) Accessed 2/10/21.
  • American Academy of Periodontology. Periodontal Treatments and Procedures. (https://www.perio.org/consumer/periodontal-treatments-and-procedures) Accessed 2/10/21.
  • Oral Health Foundation. Could The Health of My Mouth Affect My General Health? (https://www.dentalhealth.org/healthy-gums-and-healthy-body) Accessed 2/10/21.
  • Health and Human Services. Where Can I Find Low-Cost Dental Care? (https://www.hhs.gov/answers/health-insurance-reform/where-can-i-find-low-cost-dental-care/index.html) Accessed 2/10/21.

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