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Understanding Gum Disease

Gum disease, periodontal disease, gingivitis, periodontitis … these similar-sounding terms can be confusing. And while they are all related, they mean slightly different things.

Plaque, a sticky film made of bacteria and the acids it releases, attaches to teeth, eats away at their enamel, and calcifies over the course of a few days—after which it is known as tarter. Plaque and tarter inflame oral tissues and lead to the chronic inflammation and infection of the gums known as gum—or periodontal—disease. It includes two main stages—gingivitis and periodontitis.


A mild form of gum disease, gingivitis is often painless and may go undetected for quite some time. The American Academy of Periodontology cites poor oral hygiene as the common perpetrator for this condition and says that it is usually reversible with professional treatment and good home care.

Gingivitis symptoms include gums that bleed easily, have sores, are shiny and/or swollen, appear bright red or red-purple, and are tender to the touch but otherwise painless.


When gingivitis goes untreated, it advances into periodontitis. At this time, the infection spreads below the gum line and into the ligaments and bone supporting the teeth, according to the U.S. National Library of Medicine. This type of gum disease is the primary cause of adult tooth loss.

Periodontitis symptoms include bad breath; loose teeth; gums that appear bright red or red purple, shiny, or swollen; gums that bleed easily; and tender gums that are otherwise painless.

More common than you think, more than a poor hygiene

Few of us look at our mouths and think we have gum disease—especially those of us with good brushing and flossing habits. However, statistics show that an estimated 75 percent of Americans reportedly have some form of it, according to the American Dental Hygienists’ Association.

Poor oral hygiene is a major risk factor for gum disease, but it is not the only cause.

Others include:

  • Smoking—Studies have shown tobacco may be one of the most significant risk factors
  • Female hormones—Increased risk for gingivitis has been linked to pregnancy, adolescence, menopause and oral contraceptives
  • Disease—Diabetes, osteoporosis, autoimmune diseases, and others have been associated with periodontal disease
  • Medications—Many prescription and over-the-counter drugs decrease saliva production. Since saliva protects the mouth from bacteria, this can lead to infection.
  • Genetics—Some of us are simply more susceptible to gum disease than others. The University of Maryland Medical Center reports that up to 30 percent of the population may have some genetic susceptibility to periodontal disease.

While we may not be able to avoid plaque, we can do our best to prevent its buildup. Brushing twice a day and flossing daily will help. But regular checkups and professional cleanings every six months are especially important to preventing and controlling gum disease. Your dentist and hygienist have tools that allow them to clean with more precision. They will also look for subtle warning signs when examining your mouth.

Remember: Gingivitis often starts without pain. Should you notice any symptoms yourself between checkups, make an appointment sooner. Catching gum disease in its earliest stages, when it is most treatable, can prevent it from advancing to periodontitis which can be painful and expensive to treat.

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