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Gum Disease - Causes, Symptoms and Stages

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Last Reviewed 15 January 2022

Medically reviewed by Dr. Peter Doherty, Bachelor Dent. Sc. (Trinity College Dublin) 2003, MFDS (RCSI), PG Cert Implant Dentistry (Newcastle), Implant Dentist

Table of Contents

how to prevent gum disease dr Peter Doherty
Gum disease causes, symptoms and stages - Dr. Peter Doherty Gum Surgery
how to prevent gum disease dr Peter Doherty
Gum disease causes, symptoms and stages - Dr. Peter Doherty Gum Surgery

Did you know that gum disease is the leading cause of tooth loss in adults?

You are more likely to lose a tooth from gum disease than from an accident or a fistfight at your local bar!

Gum disease, medically known as periodontitis, occurs when bacteria is left to accumulate on your gums and teeth.

It is often typically caused by poor oral hygiene but can also result from various other factors that we will discuss later in this article.

An Overview Of Gum Disease (Gingivitis And Periodontitis)

Gum disease is an infection of the gums that develops when plaque and tartar are allowed to accumulate on your teeth and gums. 

Plaque refers to a buildup of food debris and bacteria, while tartar is hardened and calcified plaque. These substances form an avenue for naturally occurring bacteria to hide and multiply to harmful levels in your mouth, causing gum disease.

The infection (gum disease) occurs in stages, where it slowly progresses from gingivitis (gum inflammation) to periodontitis (full-blown gum disease). Most people will suffer from gingivitis at some point in their lives. Dr. Peter Doherty
gum surgery - gum disease - before - 3Dental
gum surgery - gum disease - after - 3Dental

However, if left to progress, it can become a bigger problem. The accumulated plaque and tartar can cause the inner layer of your gum to pull away from the teeth, forming pockets.

These pockets can provide an avenue for food debris and bacteria to accumulate and infect your mouth. Your body will naturally try to fight the infection.

Unfortunately, the enzymes released to accomplish this function break down the connective tissue and bone holding the tooth in place. The bacteria also release toxins that attack these bones and tissue. 

Thus, as the infection progresses, more bone and connective tissue are destroyed, causing the tooth to become loose and eventually fall out. This is periodontitis, and it is common enough to be the leading cause of tooth loss globally.

What Causes Gum Disease?

Gum disease is primarily caused by plaque. This is a soft, sticky film that builds up on your teeth when food, particularly starch and sugars, mixes with the bacteria present in your mouth. If the plaque is not removed, it hardens into tartar, harbouring more bacteria and causing periodontal disease. Dr. Peter Doherty

Several factors contribute to this condition, the most common of which is poor oral hygiene. Plaque forms almost every time you eat, but you remove it by brushing and cleaning between your teeth daily. 

So if you stopped brushing and flossing regularly, the plaque would accumulate, harden, and infect your gums and even the tissues that support your teeth.

Other Risk Factors

Other risk factors that may contribute to gum disease include:

Risk FactorsDescription
Hormonal ChangesHormonal changes in women during pregnancy, menstruation, or menopause. These changes can make the gums more sensitive and, thus, susceptible to bacterial infections.
Certain MedicationsCertain medications can affect your oral health by reducing the flow of saliva. This deny’s your teeth and gums the protective effects of saliva, leaving them vulnerable to infections. Drugs like phenytoin have also been shown to cause abnormal growth of gum tissue.
IllnessesIllnesses that weaken the immune system may also affect your gums. This includes diseases like HIV and cancer (leukaemia).
SmokingSmoking tobacco and marijuana also exposes one to periodontal disease.
Diabetic PatientsDiabetic patients face a higher risk of developing periodontal disease. This is because the condition affects the body’s ability to use blood sugar.
Genetic PredispositionSome people are genetically predisposed to gum infection, especially if their family has a history of periodontitis.
Vitamin C DeficiencyVitamin C deficiency may also contribute to gum disease.
Smokers are twice as likely as non-smokers to get a gum infection and treatments are usually less effective.  Dr. Peter Doherty

What Are The Symptoms Of Gum Disease?

risk factors of gum disease

Throughout the infection, periodontitis will produce different signs depending on the stage of the disease. But overall, the symptoms of gum disease include:

  1. Highly sensitive gums that bleed when you floss or brush your teeth. They will also appear red and/or swollen. 
  2. Persistent bad breath accompanied by a foul taste in your mouth. This is caused by the build-up of plaque, tartar, and bacteria on your teeth. 
  3. Receding gums.
  4. Pain when biting and chewing food.
  5. In the advanced stages of the infection, your teeth may change position and become loose. Tooth loss becomes a serious possibility.
  6. There may be an inflammatory response in other parts of your body caused by bacteria seeping into your bloodstream.

How Is Periodontitis Diagnosed?

The symptoms of gum disease are quite subtle in their early stages. Thus, you won’t be able to tell right away that you’re suffering from periodontitis. 

It’s up to your dentist to detect the infection in its early stages and stop it from getting any worse. This is why it is important to go for regular screenings at a local dental clinic near you

During your examination, your dentist will probe your teeth and gums for signs of tartar. They will also use a tiny ruler (called a probe) to measure the size of your gum pockets. If the pockets are deeper than 5mm, that’s considered a sign of gum disease. 

Your dentist may take dental x-rays for further testing.

What Are The Stages Of Gum Disease?

Gum disease begins with inflammation (gingivitis). During this stage, your gums are slightly sensitive and may bleed when you floss or brush your teeth.

You may also notice some discoloured teeth due to plaque. But overall, gingivitis results in nothing that can’t be treated by putting some extra effort into your dental hygiene routine

If you don’t and gingivitis persists, periodontitis will start to develop. This usually happens in three stages; early, mild, and severe.

EarlyPlaque and tartar cause your gums to recede. As they pull away from your mouth, they form small pockets between your teeth and gums. Bleeding during flossing and brushing.Visit your dentist ASAP for a dental cleaning. Pay close attention to your oral hygiene.
MildBleeding around the affected area becomes more severe. You’ll also experience pain. Your teeth become loose as attacks from bacteria and enzymes damage the supporting bone. If the bacteria seeps into your blood, you may experience an inflammatory response throughout your body.Deep teeth cleaning from a dental hygienist. Antibiotics. Pay close attention to your oral hygiene.
SevereThe bone and connective tissue holding the teeth further deteriorate. The infection also destroys your teeth and gums. Bad breath and a persistent bad taste in your mouth Pain when chewing. You may lose your teeth.Deep cleaning is unlikely to work. Surgery is the only way to save your teeth and heal your gums.

How Do I Prevent Gum Disease?

How to prevent and treat gum disease - 3Dental
How to prevent and treat gum disease - Dr. Peter Doherty Gum Surgery

Gum disease can be prevented by maintaining good oral hygiene. This is possible if you:

  • Brush your teeth at least twice a day, in the morning and evening, to remove food debris from your teeth.
  • Floss at least once a day. This helps remove any food particles that get trapped between your teeth in areas where your toothbrush cannot reach. 
  • Avoid smoking or chewing tobacco. Tobacco use makes it more likely to develop periodontitis while making it harder to treat the infection. 

Schedule dental cleaning from your dentist at least twice a year.

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How Is Gum Disease Treated?

Gum disease treatment depends on the stage. But overall, it involves cleaning the teeth and gums to remove plaque, tartar, and bacterial deposits from your mouth. These procedures are usually done by a dental hygienist or periodontist.

1. Oral Hygiene

The easiest way to treat gum disease is by practising good oral hygiene. If the infection is in its early stages, maintaining your oral hygiene should be sufficient to heal your gums and teeth.

Usually, your dental hygienist will provide you with instructions to keep your mouth clean and stop bacteria from accumulating.

2. Deep Cleaning

dental hygiene - gum disease - 3Dental

Deep cleaning becomes necessary if plaque and tartar have accumulated below your gum line, resulting in periodontal pockets forming on your gums.

Thus, deep cleaning is much more complicated and focused than regular cleaning and can only be performed professionally by a dentist. 

The procedure involves scaling and root planing. The goal is to remove plaque and tartar buildup from your teeth all the way to the roots. This removes bacteria from the pockets, allowing your gums to heal and begin reattaching to your teeth. 

Your dental hygienist may also polish your teeth and strengthen them with fluoride. You’ll then schedule several follow-up appointments where they will check your progress. 

Depending on the situation, the first appointment will come a few weeks after the procedure and the subsequent one after three to six months. 

3. Treatment With Antibiotics

Deep cleaning is often enough to stop gum disease from causing more damage. But if the follow-up appointments show persistent gum infections, your dentist will prescribe antibiotics to stimulate healing. These will come as an oral tablet, gel, or a special mouthwash.

4. Surgery

how to treat gum disease with surgery - 3Dental

If all else fails or is impossible due to the extent of the infection, then your dentist will explore surgical treatment options for periodontitis. These include:

  • Bone grafts use synthetic bone or fragments of yours or a donated bone to replace the bone destroyed by periodontitis.
  • Soft tissue grafts to fill the spaces left by the receding gums. 
  • Flap surgery/pocket reduction surgery, where the gums are lifted back and the plaque and tartar removed. The gums are then fitted tightly around the teeth to reduce the pocket size. 
  • Bone surgery is performed after flap surgery to reshape the damaged bone around the tooth. 
  • Guarded tissue regeneration may also be used to stimulate bone growth.


What do I do if I notice that my gums are bleeding?

See a dentist as soon as possible. Bleeding gums are often a symptom of gingivitis, which can quite easily be treated with the help of a dental hygienist.

Is gum disease linked to other health problems?

Shannon Dolan - dental nurse

Yes. Gum disease may increase your chances of experiencing other health problems like diabetes, heart disease, and even stroke.


Gum disease may be a pretty common problem, but it can have devastating consequences if left untreated.

Therefore, it is important to maintain your dental hygiene by brushing and flossing your teeth and visiting a dentist for regular checkups. 

Call us today or visit one of our clinics to schedule your free consultation.

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