Plain Facts About Gum Disease

What it means to have swollen gums and what to do about it.

What Is Gum Disease?

Gum disease, also called periodontal disease, is defined as an infection of the tissues that surround and support the teeth. There are two primary types:

• Gingivitis (jin-ji-VI-tis)—The type that involves inflammation of the gums is called gingivitis. It is a reversible condition that you can prevent and treat with good brushing, flossing and regular professional cleaning and checkups.
• Periodontitis (per-e-o-don-TIE-tis)—This is an irreversible form of periodontal disease, which involves bone loss around the teeth. With professional care by your dentist or hygienist, the disease progression can be decreased and managed.

What Causes Periodontal Disease?

Gum disease starts with plaque. Plaque is the sticky film that forms on your teeth when starches and sugars in your diet interact with the bacteria in your mouth. Plaque can cause gingivitis. The good news is that gingivitis is reversible with good oral care and professional treatment.

If you do not remove all the plaque from around your gum line when you brush and floss, plaque will eventually harden into tartar. A dentist or hygienist can remove tartar as part of your professional cleaning. Without professional cleaning, plaque and tartar can build up and work its way below your gum line. As it continues to build up, your gums become increasingly irritated and bone loss occurs. This ongoing process causes periodontitis and eventually, your gums may pull away (recede) from your teeth. This would leave pockets between your gums and teeth, which fill with even more plaque and tartar. As time goes by, periodontitis can lead to tooth loss.

What Are the Stages and Symptoms of Periodontal Disease?

The stages and symptoms of periodontal disease include:

Stage 1: Gingivitis

• First and most common phase
• Red and swollen gums
• Blood while brushing and flossing
• Gum recession
• Bad breath

Stage 2: Mild Periodontitis

• More advanced than gingivitis
• Bright red, swollen and tender gums
• Bacteria beneath the gums begin to damage the bone
• Gums pull away from the teeth and pockets form
• Bad breath/bad taste

Stage 3: Moderate Periodontitis

• Supporting ligaments, soft tissues and bone around the teeth erode
• Pus around the gum line
• Increase in pocket depths
• Bad breath/bad taste
• Pain may develop

Stage 4: Advanced Periodontitis

• Ongoing bone loss
• Severe gum recession
• Deep pockets
• Loose, drifting and flaring teeth
• Teeth may fall out, bite collapses
• Chronic bad breath/bad taste

Diagnosing Periodontal Disease

When you visit your dentist, an exam to check the condition of your teeth and gums is typically done. As part of this process, the dentist or hygienist measures the gum tissue around each tooth with a tool called a periodontal probe. The measurements and any bleeding areas are recorded. These will help your dentist or hygienist determine if gum disease is present and to what degree.

X-rays are also necessary for diagnosing periodontal disease. They help to identify if bone loss has occurred and the amount of tartar on the roots of your teeth. If your dentist diagnoses periodontitis, you may be referred to a periodontist (gum specialist) for an exam and advanced treatment.

Treatment for Periodontal Disease

The treatment for periodontal disease varies depending on the stage and severity of symptoms.

The treatment of gingivitis may include:

• Increased frequency and attention to home care/brushing and flossing
• The use of specialized cleaning devices recommended by your dentist or hygienist
• Increased frequency for professional cleanings

The treatment for periodontitis may require the following:

• The use of prescription medications, such as antibiotics
• Deep cleaning (scaling and root planing)
• Periodontal pocket reduction surgery
• Bone grafting
• Tooth extraction(s)

Risks of Not Treating Periodontal Disease

See your dentist for an exam if your gums are tender or you notice blood when brushing or flossing. Talk with them about these symptoms because they can be a sign of gum disease.

Tartar and bacteria on the tooth and root surfaces beneath your gums can only be removed by a professional cleaning. Without professional treatment, the disease can progress and cause tooth loss. It can also contribute to any overall health problems you may have. Untreated gum disease has been associated with:

• Difficulties controlling blood sugar in people with diabetes
• An increased risk of heart attack or stroke for those with cardiovascular disease
• An increased risk of infections like bronchitis or pneumonia for those who may have a chronic respiratory condition

Prevention of Periodontal Disease

The easiest way to prevent periodontitis is to practice good oral hygiene–brushing twice daily for two minutes using a soft bristled brush and flossing daily.

Regular dental visits with cleanings are also necessary to maintain a healthy mouth. Cleanings should generally occur every six to 12 months. Your dentist may recommend more frequent regular cleanings because of a habit or condition, such as smoking or diabetes. For this reason, BCBS FEP Dental coverage allows preventive cleanings up to 3 times per year.

However, if you have had surgical or nonsurgical treatment for gum disease, dentists typically advise that periodontal maintenance cleanings occur every 3 or 4 months. These are especially important to prevent disease progression. With BCBS FEP Dental, your coverage allows for 4 of these per year.

Understanding what gum disease is and how it can affect overall health is a good reason to see your dentist for regular checkups. Talk with them about your oral health concerns and how you can minimize your risk of gum disease.

Note: The information in this article is not meant to replace the advice of your dentist or another licensed healthcare professional. Talk to your dentist for any specific dental advice.

Sources: Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473 Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/21482-gum-periodontal-disease American Dental Association: https://www.mouthhealthy.org/all-topics-a-z/plaque