Gum disease: causes, early signs and treatment

Illustration: gingivitis affects the gum only; in periodontitis a pocket forms and the supporting bone is lost. Simplified. Not a patient photograph.

Causes and risk factors for gum disease

Plaque is the main cause. Other factors make gum disease more likely or more severe:

• Not removing plaque well enough, especially between the teeth and along the gum line
• Smoking and tobacco use, which raise the risk of gum disease, hide some of its signs (such as bleeding) and slow healing
• Diabetes, particularly when blood sugar is poorly controlled
• Hormonal changes, such as during pregnancy or puberty, which make gums more prone to inflammation
• Some medicines, including those that cause a dry mouth or gum overgrowth
• Family history, as some people are more susceptible
• Crowded teeth and overhanging fillings that are hard to clean

Early signs of gum disease

Gum disease is often silent at first. Early signs include:

• gums that bleed when you brush, floss or eat hard food
• red, swollen or tender gums
• persistent bad breath or a bad taste
• gums that are receding, so the teeth look longer

Later signs of more advanced gum disease include:

• pus between the gums and teeth
• teeth that feel loose, drift apart or change the way they bite together

Bleeding gums are the most common early sign and are never normal; read why gums bleed when flossing. Gums that pull back from the teeth are covered in our guide to receding gums.

How gum disease is diagnosed

The dentist examines your gums and measures the depth of the space between each tooth and the gum with a thin probe, records bleeding and any loose teeth, and takes X-rays to check the bone level. These findings show whether you have gingivitis or periodontitis and, for periodontitis, its stage and grade.

Gum disease treatment, step by step

The European Federation of Periodontology's clinical guideline describes treatment as a series of steps, adapted to each person:

1. Step 1: plaque control and risk factors. You are shown how to clean your teeth and between them effectively, plaque and tartar above the gum are removed, and risk factors such as smoking and diabetes are addressed. For gingivitis, this step with a professional cleaning is often enough.
2. Step 2: deep cleaning under the gum. For periodontitis, the dentist cleans the root surfaces below the gum line to remove plaque and tartar from the pockets (often called scaling and root planing or subgingival instrumentation), usually with local anaesthetic. Medicines such as antibiotics are used only in selected cases.
3. Step 3: treating deep pockets that remain. After a few months the gums are re-measured. Pockets that are still deep may need further cleaning or gum surgery, and some bone defects can be treated with regenerative procedures.
4. Step 4: supportive care. Regular maintenance visits, at intervals set by your dentist, keep the disease stable. Without them, periodontitis often returns.

Laser-assisted gum treatment is offered by some clinics, including ADC (see our LANAP laser therapy page). It does not replace thorough cleaning and good daily care, and your dentist will explain whether it is suitable for you.

Illustration: deep cleaning removes tartar and plaque from the root under the gum so that the inflamed gum can heal and the pocket can become shallower. Simplified. Not a patient photograph.

After deep cleaning, follow your written aftercare; ADC patients can read our instructions after scaling and deep cleaning. Our deep cleaning page explains the treatment, and deep cleaning vs regular cleaning helps you see which one you need.

Preventing gum disease

The NHS advises:

• brush your teeth with fluoride toothpaste at least twice a day, and spit rather than rinse after brushing
• clean between your teeth every day with floss or interdental brushes
• do not smoke
• see a dentist and hygienist for regular check-ups, especially if you are pregnant or have type 2 diabetes

Learn effective brushing techniques and read whether a water flosser can replace brushing.

Gum disease, implants and tooth loss

Untreated periodontitis is a common reason for losing teeth in adults. If teeth are lost, a history of gum disease also matters for implants, because it raises the risk of inflammation around implants later. Gum disease should be treated and stable before implants are placed; see our dental implants in Chandigarh page.

Gum disease treatment at ADC, Chandigarh

At ADC – Centre for Restorative and Implant Dentistry, a gum check is part of the examination. The dentist measures your gums, takes X-rays where needed, explains whether you have gingivitis or periodontitis and gives you a written treatment plan and estimate. Learn more on our gum disease and bleeding gums pages. The clinic is in Sector 21, Chandigarh, within easy reach of Mohali, Panchkula and Zirakpur.

Frequently asked questions

Can gum disease be cured?
Gingivitis can be reversed with professional cleaning and good home care. Periodontitis can be treated and kept stable, but bone that has been lost does not grow back by itself. Regenerative surgery can rebuild bone only in selected defects, and regular maintenance is needed for life.

Is gum disease treatment painful?
Deep cleaning is usually done with local anaesthetic. The gums may feel tender and the teeth more sensitive for several days afterwards.

How long does gum disease treatment take?
Step 1 and deep cleaning usually take one or more visits, followed by a re-check after a few months. Supportive care then continues at intervals your dentist recommends.

Is gum disease contagious?
The bacteria involved can pass between people through saliva, but whether gum disease develops depends mainly on plaque control and your own risk factors, such as smoking and diabetes.

What does gum disease treatment cost?
It depends on the stage and how many areas need treatment; you receive a written estimate after the examination. Instalment and financing options are available; ask our team for details.

Book a gum check in Chandigarh

If your gums bleed, look swollen or your teeth feel loose, book a consultation at ADC – Centre for Restorative and Implant Dentistry:

• Online booking: ADC Zoho Bookings
• Phone: +91-708-780-0016
• Email: help@theadc.dental
• Clinic: ADC- Centre for Restorative and Implant Dentistry, 1197, Sector 21B, Chandigarh 160022

Mon–Fri 10:00 AM–6:30 PM; Sat 10:00 AM–5:00 PM; Sunday closed. You can also request a consultation online.

Reviewed by Dr. Mohit Dhawan, MDS (Prosthodontics, Crown & Bridge and Implantology).

References

1. American Academy of Periodontology. Gum disease information — perio.org
2. NHS. Gum disease — nhs.uk
3. Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I–III periodontitis: the EFP S3 level clinical practice guideline. J Clin Periodontol. 2020 — PubMed 32383274
4. Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop. J Periodontol. 2018 — PubMed 29926944
5. Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop. J Periodontol. 2018 — PubMed 29926951
6. Cleveland Clinic. Periodontal disease (gum disease) — clevelandclinic.org