It’s normal for your mouth to contain bacteria. However, when the bacteria build up, gum disease can develop. Gum disease is caused by a buildup of plaque, a sticky film of bacteria that coats the teeth.
The early stage of gum disease is called gingivitis. It involves gum inflammation, but it doesn’t always cause symptoms. It’s possible to have gingivitis without realizing it.
If left untreated, gingivitis can progress to periodontitis. This is the more advanced stage of gum disease. It can damage the gums and lead to tooth loss over time.
To learn more about gingivitis and periodontitis, read on. We’ll explain the different symptoms and treatment, as well as how to prevent gum disease.
Gingivitis, or gum inflammation, is mild gum disease. It typically causes minor issues, which might come and go. When treated early, the condition is reversible.
Common symptoms of gingivitis include:
- red, swollen gums
- gums that bleed when you floss or brush your teeth
- gums that randomly bleed
Often, gingivitis causes no pain or other symptoms.
The goal of treatment is to minimize inflammation. Treatment includes:
- Oral hygiene. This includes regular brushing and flossing — and using the right techniques when doing so. A dentist can show you how to properly brush and floss your teeth.
- Professional dental cleaning. A dentist will remove plaque and tartar from your teeth and gumline.
- Antiseptic mouthwash. This prescription mouthwash contains chlorhexidine, which reduces bacteria in your mouth.
Without treatment, gingivitis can progress to periodontitis, or severe gum disease. Periodontitis is inflammation of the periodontium, which is the gum tissue and bone that keep your teeth in place. As the condition progresses, it can cause teeth to loosen.
Periodontitis happens in stages. The later the stage, the more severe the symptoms.
Symptoms of periodontitis include:
- red, swollen gums
- bleeding gums
- sensitive teeth
- sore gums
- bad breath
- loose teeth
- teeth that change positions
- pain during chewing
- gums that recede (pull away) from the teeth
When the gums pull away from a tooth, they form spaces called gum pockets. These spaces can become infected.
Because periodontitis is an advanced stage of gum disease, it requires additional treatment. Again, the goal is to reduce inflammation.
- Oral hygiene. Maintaining oral hygiene can slow down periodontitis and prevent additional tooth loss.
- Professional dental cleaning. A dentist will perform a deep cleaning. They’ll remove tartar and plaque from teeth and below the gumline, which can help the gums reattach to the teeth.
- Antibiotics. In severe cases, your dentist might prescribe oral antibiotics or apply a topical antibiotic.
- Open surgery. During this procedure, your dentist cuts open the inflamed gums and cleans the root of the tooth. Next, they stitch the gum tissue together so it can reattach to the teeth.
If gingivitis is left untreated, the plaque can accumulate and spread to the gumline. Bacteria in the plaque release toxins, which irritate and inflame the gums.
This triggers a chronic inflammatory response in the body, which damages the gum tissue and bone that keep the teeth in place. The result is periodontitis.
As the gums break down, they pull away from the teeth, creating gum pockets. These gaps can become infected by bacteria in the mouth, causing even more tissue damage.
The tissue damage can also make the gum pockets deeper. If the gaps become too big, the teeth may loosen due to bone loss. Deeper pockets may also mean it’s harder to reach the bacteria when you brush and floss.
The following factors can increase your risk for gingivitis and periodontitis:
- not maintaining oral hygiene
- smoking or chewing tobacco
- substance use
- misaligned teeth that are difficult to clean
- lack of nutrients
- hormone changes
- certain medical conditions, like diabetes or HIV
- some medications, like steroids or cancer therapy drugs
The most common cause of gingivitis and periodontitis is a buildup of plaque.
The bacteria in the plaque “eat” sugars in your mouth, then release waste byproducts. These byproducts can irritate your gums and cause inflammation.
Other factors affecting gum disease include:
- Hormone changes. During pregnancy, changes in hormones may increase the inflammatory response of gum tissue. Similarly, hormone fluctuations during puberty might make gum tissue more susceptible to plaque-related inflammation.
- Medications. Some prescription drugs might enlarge the gums, making teeth more difficult to clean. Other medications might reduce saliva, which normally helps clean the teeth and control bacteria.
- Nutrition. A low intake of vitamin C or high intake of refined carbohydrates can increase inflammation in gum disease.
You can prevent gingivitis and periodontitis by maintaining oral hygiene. When done consistently, an oral hygiene routine can prevent plaque from building up and causing gum disease.
Oral hygiene basics
A good oral hygiene routine includes:
- brushing your teeth twice per day
- flossing between your teeth every day
- eating a balanced, nutritious diet
- scheduling routine dental cleanings
- not smoking
In addition to your regular visits, you should see a dentist if you have:
- red or swollen gums
- bleeding while flossing, brushing, or eating
- painful gums
- separating gums
- loose teeth
- persistent bad breath
- pain while chewing
- teeth that look longer than usual (due to receding gums)
If you already have gum disease, be sure to attend your follow-up appointments. This is especially important if you have received treatment for periodontitis, which requires follow-up care.
The outlook for gum disease depends on the stage.
Gingivitis is reversible. It can go away with proper oral hygiene and professional dental cleaning. If gingivitis progresses to periodontitis, you’ll need additional treatment. The exact outlook also depends on the severity of periodontitis.
Generally, early periodontitis is easier to treat and control. Early treatment reduces the risk of damage and tooth loss. If you have periodontitis, it may mean more frequent trips to the dentist so they can monitor your condition.
In both cases, you’ll have to maintain oral hygiene habits at home. Visit your dentist regularly for the best outlook. During each visit, your dentist can identify early signs of gingivitis before it progresses.