What is gum disease?

Gum disease stages in pictures: teeth with healthy gum, gingivitis and periodontitis
Image borrowed from efp.org

Gum disease, also known as periodontal disease, is a disease that affects gum and bone than holds the teeth and results in their breakdown. Bone loss is a result of genetically predetermined body’s reaction to the bacteria in the mouth. When gum and bone reacts to the bacteria, initially it wants to fight it, so inflammation kicks in. But if the bacteria is not cleared and inflammation lasts for too long, the bone starts to “melt”. Bacteria resides in the plaque (food leftovers) on your teeth, therefore good teeth cleaning is extremely important for people who are prone to the gum disease. It is a very common disease, around 46% of adults have got it, while 9% of them have got severe form of the gum disease.

With good home-care routine and regular visits to your dentist, it is possible to prevent (or postpone) the start of the disease and also to limit the damage that is done once it starts.

Yet if the disease is left untreated, there is a risk of losing the teeth. This could causes your smile to not look good and it impact your ability to chew comfortably. Even if teeth are not lost, they may be sore, wobbly or unaesthetically looking.

It is also important to note that gum disease affects not only your oral health, but also general health. Periodontitis increases risk of heart diseases, poor pregnancy outcomes for women, worsens diabetes management. There is also emerging evidence about links with Alzheimer’s disease and rheumatoid arthritis.

Different types of gum diseases

Gingivitis

Gingivitis is inflammation of the gum, as a result of plaque build-up. It is the earliest stage of the gum disease. It only affects the gum: the gum appears reddened, swollen, bleeding, tender. You can reverse it by visiting hygienist regularly and improving your teeth cleaning routine.

Photograph of persons mouth showing gingivitis: red and swollen gums
Gingivitis

Periodontitis

Periodontitis is more advanced stage of gum disease. It develops if gingivitis is left untreated. The inflammation spreads deeper under the gums, which results in permanent loss of bone that holds the teeth. If periodontitis is left untreated, teeth will get wobbly without bone support, you may experience swelling, pain when eating. Teeth may fall out or will need to be removed.

Photograph of persons mouth showing periodontitis: receded gums, longer looking teeth, drifted teeth
Periodontitis

Peri-implantitis

Peri-implantitis is similar to periodontitis, but it affects implants rather the teeth. This means that bone loss around implants may occur and may lead to the loss of the implants. People with periodontitis are more at risk of developing peri-implantitis. Therefore it is always advisable to make sure that gum disease is stable before placing any implants.

Photograph of patients mouth showing periimplantitis: metal screws visible coming from the gum
Periimplantitis. Borrowed from Sarmiento et al. 2018

Receding gums

Gum recession, also known as gingival recession can be present together with periodontitis, or separately. Due to various reasons, gums may recede and roots become exposed, which cause sensitivity and impairs aesthetics. You can read more about receding gums here:

Photograph of persons mouth showing teeth that got receded gums and exposed roots
Gum recession

You can read more about gum disease on websites of the European Federation of Periodontology https://www.efp.org/for-patients/ and the British Society of Periodontology and Implant Dentistry https://www.bsperio.org.uk/patients.