What You Need to Know About Gum Disease

If you’ve been told that you have periodontal or gum disease, you’re not alone. But do you know what causes it, what warning signs to look for, and what to do once you have it?

Nearly half of all adults 30 years of age and older in the United States have some form of periodontal disease, according to the Centers for Disease Control and Prevention (CDC). Along with tooth decay, gum disease poses the biggest threat to dental health.

Types of Gum Disease

Early-stage gum disease is known as gingivitis. Most commonly the result of poor oral health, gingivitis causes the gums to become red and swollen. Other signs are bad breath and bleeding gums when you brush your teeth or floss.

“There is a tight cuff around your gums,” explains Vera W. L. Tang, doctor of dental surgery and clinical assistant professor of periodontology and implant dentistry at NYU College of Dentistry in New York City. “When irritated, it becomes swollen and forms a gap between the tooth and gum. It can become enlarged, and it allows food and bacteria to get trapped and embedded around the tooth.”

As Dr. Tang points out, “preventing gingivitis comes down to oral hygiene and keeping your teeth clean.” If it’s caught early on, gingivitis is usually treatable. Treatment typically involves a thorough professional cleaning, known as scaling. The condition usually clears up if you maintain good oral hygiene and get regular checkups.

If it’s not properly treated, gingivitis can progress to periodontitis, a serious condition that causes the gums to pull away from the tooth and form pockets. Bacteria can collect in these pockets, leading to infection and potential bone loss. Teeth can become loose and require extraction.

Certain factors can increase the risk of gingivitis turning into periodontitis, Tang says. “If you are a smoker or a diabetic, you tend to be at much higher risk.” Having a family history of gum disease or early tooth loss can also play a role. If you have any of these risk factors, “you need to address periodontal disease proactively,” she adds.

How to Prevent Serious Gum Disease

Clearly, you want to catch gingivitis before it becomes periodontitis, says Angelo Mariotti, PhD, doctor of dental surgery and chair of the division of periodontology at the Ohio State University College of Dentistry in Columbus. That requires a three-pronged approach:

Practice Good Oral Hygiene

Your gum disease prevention regimen starts with brushing twice a day and flossing regularly. “Use a soft tooth brush and be gentle when brushing,” Tang says. “Foods tend to get caught along the gum line between the gum and tooth. Angle the brush towards your gum line and loosen the debris using a small, circular motion. Be very gentle and sweep away from the gum line.”

Tang says it’s okay to scrub a bit on the chewing surfaces of your teeth, just not along the gum line. If you brush too aggressively, you can overdo it and wear away your tooth enamel or cause your gums to recede.

Flossing helps remove debris left after brushing. “Most periodontal disease occurs in between your teeth, not as much on the brushing surface,” says Peter Loomer, MD, chair of periodontology and implant dentistry at NYU College of Dentistry in New York City. “That’s why it’s so critical to floss in between.” Dr. Loomer says your dentist can train you how to floss properly. “If you’re not taught, you [may not] do an effective job,” he explains.

Reduce your risk

“Talk to your dentist about controlling your risk factors,” says Dr. Mariotti. If you smoke, an increased risk of gum disease is another reason to quit. A healthy diet can help prevent gum disease and keep your whole body healthy. “Hard crunchy foods like carrots are great for cleaning teeth surfaces and removing debris,” Tang says. “Chewing sugarless gum after eating also gets saliva flowing and helps wash debris around your teeth away.” Minimize how much sugar you consume, and eat plenty of fresh fruits and vegetables.

See the dentist regularly

The dentist is your partner in good oral health and preventing gum disease. But according to an analysis published in December 2016 in the journal Health Affairs, Americans are more likely to skip regular dental care than other types of healthcare. Early gum disease generally doesn’t hurt or produce symptoms, Mariotti says. So, it can progress for years if you’re not seeing your dentist routinely. A dentist can monitor your gums over time to see how they change. Most people should see their dentist twice a year for a checkup and cleaning to remove the tartar (calcified plaque) from your teeth. “You can’t brush off plaque,” Loomer says. “It has to be removed with special instruments.”