Gum Disease

Overview

Gum disease, also called periodontal disease, is an infection that causes inflammation of the tissues that hold your teeth in place. It is typically caused by poor brushing and flossing habits that allow plaque, or a sticky film of bacteria, to build up on the teeth and harden. Hardened dental plaque is called tartar (also known as calculus). Tartar cannot be removed by brushing or flossing your teeth. It needs to be removed by a dentist or dental hygienist.

Gum disease starts with swollen, red, or bleeding gums. The mild, early stage of gum disease is called gingivitis. If left untreated, it can spread to the bones surrounding the gums, and it can become painful to chew. This is called periodontitis, which is the more severe, advanced stage of gum disease. In the worst cases, teeth may become loose or need to be removed.

The good news is that you can prevent and treat gum disease with good daily habits and regular visits to the dentist.

Watch a video on gum disease:

Signs and Symptoms

Talk to your dentist if you notice any of these symptoms:

Gums

• Are red, swollen, or tender
• Bleed easily when you brush or floss
• Pull away from the teeth, making teeth look longer

Teeth

• Are loose or sensitive
• Hurt while chewing
• Shift from their usual position

Other Symptoms

• Persistent bad breath that does not go away when you brush
• Dry mouth or a bad taste in the mouth

Advanced Stages

• Sore, bleeding gums,
• Painful chewing problems
• Bone loss
• Loose teeth
• Eventually tooth loss

Related Health Effects

Diabetes

People with diabetes are at increased risk for developing gum disease. High blood glucose levels raise the likelihood that gum disease will progress from mild to severe. In turn, glucose levels may become harder to control.

Pregnancy

Unhealthy teeth and gums during pregnancy has been linked to adverse birth outcomes, such as preterm birth and low birth weight. Because of hormonal changes, pregnant women may develop gingivitis and experience gums that are swollen and bleed easily.

Causes and Risk Factors

Dental plaque that is not removed every day can harden and form tartar, and tartar build-up can lead to gum disease. Only a professional cleaning by a dentist or dental hygienist can remove tartar.

There are several risk factors for gum disease:

• Sex: Gum disease is more prevalent and severe in men compared to women.
• Smoking or using tobacco products including e-cigarettes is a major modifiable risk factor for gum disease. Tobacco use can also delay healing and make treatment less successful.
• Diabetes: People with diabetes are more likely to have gum disease.
• Hormonal changes: Girls and women may be at increased risk for gum disease due to hormonal changes, including changes during pregnancy.
• Certain illnesses: Conditions such as AIDS and their treatments can increase risk of gum disease.
• Genetics: Some people are more prone to gum inflammation than others. Children with certain rare genetic conditions called primary immunodeficiency disorders are nearly ten times more likely to develop gum disease due to their weakened immune systems.

Prevention Guidance

Keep your gums and teeth healthy by following these steps:

• Brush your teeth twice a day with a fluoride toothpaste. Angle the bristles toward the gum line and brush gently using small, circular motions.
• Clean between your teeth regularly. Aim for once a day. Use dental floss, an interdental brush, a wooden or plastic pick, or a water flosser recommended by a dental professional.
• Visit the dentist routinely for a check-up and professional cleaning. Tell your dentist about any medical conditions you have and medicines you take.
• Quit all forms of tobacco. Tobacco use increases your chance of gum disease, and quitting can improve your treatment results.

See the Oral and Dental Health page for more information.

Diagnosis

A dentist or dental hygienist can diagnose gum disease during a regular dental visit using these methods:

• Gum examination: The dentist examines your gums for signs of inflammation and uses a tiny ruler called a “probe” to measure the spaces (pockets) around the teeth. In a healthy mouth, the pockets are usually between 1 and 3 millimeters. Deeper pockets can be a sign of periodontal disease.
• Teeth examination: The dentist will check for any looseness or shifting of teeth which can occur in advanced gum disease when the bone supporting the teeth is lost.
• Medical history survey: The dentist asks questions about your medical history. Certain conditions or risk factors, like smoking or using tobacco products such as e-cigarettes or diabetes, can contribute to gum disease.
• X-ray: X-ray images of the teeth and mouth are taken. An X-ray can show if any bone loss has occurred.

Treatment and Management

The main goal of treatment is to control the infection. The number and types of treatments will vary depending on how severe the gum disease is. Any type of treatment requires that the patient maintain good daily oral healthcare at home.

Gingivitis

Gingivitis can often be prevented or reversed by brushing and flossing every day. Gingivitis caused by plaque buildup is a mild form of gum disease, and you can usually reverse it with daily brushing and flossing.

Periodontitis

People with periodontal disease will need to receive treatment from a dentist or dental hygienist. He or she may do a deep cleaning of the teeth and may discuss how best to clean your teeth and gums. The dentist may also prescribe a specialized mouth rinse. They may also suggest changing certain behaviors, such as quitting tobacco products, as a way to improve treatment results. Your dentist may refer you to a periodontist, a specialist in the diagnosis and treatment of gum disease, for gum surgery.

Living With Gum Disease

Good oral health helps you enjoy life. It lets you speak clearly, taste and chew nutritious foods, and show your feelings through facial expressions, such as smiling.

If you notice that brushing or flossing causes your gums to bleed or hurts your mouth, see your dentist. Your dentist can tell you the best ways to take care of your oral health.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on gum disease.

Find Treatment

See the Oral and Dental Health page on how to find affordable care.

Community Support

• Health Resources and Services Administration Information Center
• American Dental Association

Note: This resource list is for informational purposes only. It is not comprehensive, and an organization’s inclusion does not constitute an endorsement by NIH.  

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.

NIH continues to fund research to study gum disease and its connections to overall health.

• NIH-supported scientists are studying many aspects of diabetes and gum disease, such as how certain genes may play a role in diabetes, gum disease, heart disease, and bone loss.
• Studies are identifying links between poor oral health and dementia risk.
• NIH is supporting research on the “inflammasome” (a network of proteins that regulates inflammation) may transform the treatment of periodontal disease and other oral diseases involving inflammation.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.