1. What causes gum disease?

There are a number of factors that can cause, increase the risk of, or worsen gum disease. A main cause is improper teeth cleaning. When teeth aren’t cleaned properly, plaque (a thin film of normal bacteria) can build up, get trapped under the gums and harden into tartar. If tartar builds up, it can interrupt the healthy connection between the teeth and gums and lead to tooth loosening, decay and loss. Other risk factors include:

Smoking or chewing tobacco

Genetics

Crooked teeth that are hard to keep clean

Medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives

2. What are the symptoms of gum disease?

Because gum disease is usually painless, you may not know you have it. Look for tell-tale symptoms if you think you might have a problem with the health of your gums. It’s also important to recognize that healthy gums are pale pink and firm. Symptoms of gum disease include:

Bright red, purplish, or dusky red gums

Red, swollen, or tender gums

Receding gums, which can make teeth look longer than normal

Bleeding gums

New spaces developing between teeth

Bad breath or a bad taste in the mouth

Permanent teeth that are loose or separating

A change in the way teeth fit together when biting

Any change in the fit of partial dentures

3. What is the difference between gingivitis and periodontitis?

Gingivitis, characterized by red and irritated or bloody gums, is the milder form of gum disease. Without proper treatment it can lead to the more serious periodontitis, which is defined as inflammation and infection that destroys the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets. Both are considered to be treatable and, to a certain extent, preventable with consistent, proper oral hygiene.

4. How is gum disease diagnosed?

During an examination, your dental professional will evaluate the health of your gums and measure any pockets that may have formed around your teeth. They also may order x-rays to determine the health of your jaw. From there, they will develop a treatment plan and recommend prevention methods.

5. How can I treat gum disease?

Treatment methods for gum disease depend upon how far the condition has progressed. While this first-stage of gum disease usually gets better or reverses after a professional cleaning, proper oral hygiene must be continued at home, or the condition can easily and quickly return.

How to Treat Gingivitis

During a therapeutic deep cleaning, the dentist or dental hygienist will remove all plaque and tartar (hardened plaque) with processes called “scaling,” and “dental root planing”. Scaling is the process of removing built-up bacteria above and below the gum line. Dental root planning goes a bit deeper and actually smoothes and cleans the tooth root to help healthy gums reattach to the tooth. Your dentist may need to complete this deep cleaning in more than one visit and will most likely use a local anesthetic like Novocaine to manage your discomfort level during the procedure.

Your dentist may also discuss fixing misaligned teeth or poorly fitting fillings, crowns or bridges to help reduce the chance of plaque building up in hard-to-reach places. They may also recommend an over-the-counter or prescription mouthwash to help reduce and remove bacteria and plaque on your newly clean teeth. Diligent home care, and twice-yearly professional cleanings will help to keep gingivitis at bay.

How to Treat Periodontitis

If gingivitis is not treated, it may lead to periodontitis, which is a much more serious level of gum disease. Periodontitis can lead to the destruction of gums, mouth bones, tissue, and teeth, and is the number one cause of tooth loss in adults.

If plaque spreads too far below the gum line, toxins can cause the tissues and bone that support the teeth to break down and pull away from the teeth and form spaces called pockets. Pockets can become infected, and if not treated, teeth may cause teeth to become loose, fall out, or have to be removed.

There are both non-surgical and surgical treatments for periodontitis, depending on its severity. Non-surgical treatments are similar to the treatments for gingivitis: scaling, deep root planing, and prescription antibiotics. If surgical intervention is required, your dental professional will discuss the recommended surgical treatment based on the unique details of your situation.

6. How can I prevent gum disease?

When caught early, gum disease can usually be treated before tooth loss occurs. But, even better than catching it early, is to prevent it altogether. Good and consistent at-home oral care (brushing and flossing) and regular dental checkups and cleanings can go a long way to help keep your gums healthy and disease-free. Some tips include:

Brush your teeth twice a day. It takes about two minutes to do a thorough job, so don’t rush through it. Don't brush immediately after eating, and don't forget to clean your tongue with a toothbrush or tongue scraper – tongues also collect bacteria.

Use the proper equipment. Use fluoride toothpaste and a soft-bristled toothbrush that fits your mouth comfortably. Electric or battery-operated toothbrushes also help reduce plaque, sometimes even better than a manual brushing.

Practice good technique. Hold your toothbrush at a slight angle and aim the bristles towards the area where your tooth meets your gum. Gently brush with circular short back-and-forth motions. Don’t press too hard – brushing too hard or with hard bristles can hurt your gums.

Don’t forget the backs of your teeth. It’s easy to only focus on the fronts, so remember to brush the outside, inside, backs, and chewing surfaces of your teeth.

Floss gently. Grip the floss tightly between your thumbs and forefingers, but don’t floss too hard. Guide the floss between your teeth using a gently rubbing motion. When the floss reaches your gum line, curve it against one tooth, making a ‘C’ shape. Don't “saw” the floss or snap it roughly into your gums.

Floss one tooth at a time. Use the floss to gently rub the side of each tooth in an up-and-down motion. Unwind fresh floss as you progress to the rest of your teeth.

Keep in mind that it doesn't matter if you brush or floss first, as long as you consistently do a thorough job of both.

7. Is gum disease reversible?

When caught early, gum disease can usually be treated before tooth loss occurs. During a regular dental visit, your dentist can determine the extent of the damage and work with you on a treatment plan. Both types of gum disease are fairly common among adults in the United States, and both generally can be reversed, or their symptoms lessened, with effective care consisting of professional cleaning at your dental office followed by daily brushing and flossing.

Even better than catching it early, is to prevent it altogether. Good – and consistent – at-home oral care and regular dental checkups and cleanings can go a long way to help keep your gums healthy and disease-free.