What is gum disease?

Gum disease is a bacterial infection of the tissues and bones that surround and support the teeth. It is also called periodontal disease.

Gingivitis is mild gum disease that only affects the gingiva, or gums, the tissue surrounding the teeth. Gum disease that progresses and spreads below the gum line to damage the tooth-supporting tissues and bone is called periodontitis.

• Gingivitis causes red, swollen gums that bleed easily when brushed. Because gingivitis usually doesn't cause pain, many people don't get the treatment they need.

• Periodontitis develops if gum disease progresses. The gums pull away from the teeth, leaving deep pockets where bacteria can grow and damage the bone that supports the teeth. Gums can also shrink back, or recede. This can make the teeth look longer. Teeth may become loose, fall out, or have to be removed.

What causes gum disease?

Your mouth constantly produces a clear, sticky substance called plaque that contains bacteria. The bacteria in plaque make poisons, or toxins, that irritate the gums and cause the tissues to break down. If you don't do a good job of removing plaque from your teeth, it can spread below the gum line and damage the bone that supports the teeth. With time, 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:

• Do not clean your teeth well.

• Smoke or use spit tobacco.

• Have gum disease in your family.

• Have a condition that makes it harder for your body to fight infection, such as:

o Uncontrolled diabetes,

o A high level of stress.

o A diet low in nutrients.

What are the symptoms?

Healthy gums are pink and firm, fit snugly around the teeth, and do not bleed easily. Early-stage gum disease (gingivitis) causes:

• Gums that are red, swollen, and tender.

• Gums that bleed easily during brushing or flossing.

As gum disease advances, it causes more noticeable symptoms, such as:

• Gums that pull away or recede from the teeth.

• Persistent bad breath.

• Pus coming from the gums.

• A change in how your teeth fit together when you bite.

• Loose teeth.

How is gum disease diagnosed?

To diagnose gum disease, your dentist will do an exam to look for:

• Bleeding gums.

• Hard deposits (calculus or tartar) above and below the gum line.

• Areas where your gums are pulling away or receding from your teeth.

• Pockets that have formed between your teeth and gums.

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 gingivitis, you will probably be able to reverse it with daily brushing and flossing and regular cleanings at your dentist's office.

If your gum disease has advanced to 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 I prevent gum disease?

While gum disease is most common in adults, it can affect anyone, even children, so good dental habits are important throughout your life:

• Brush your teeth at least twice a day with a fluoride toothpaste.

• Floss once a day.

• Visit your dentist for regular checkups and teeth cleaning.

• Don't use tobacco products.

Having gum disease may increase a pregnant woman's risk of having a premature, low-birth-weight baby. 1 Also, a recent study of older adults 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.