Gum disease
Bleeding or swollen gums can be signs of gum disease. Gingivitis affects the gums; periodontitis also damages the tissues and bone supporting the teeth. An examination will help determine the root cause of the concern and guide treatment.
What are the signs of gum disease?
Common signs include bleeding when you brush, red or puffy gums, and bad breath that does not go away. Gums may pull away from the teeth, and a tooth may feel loose or shift. Some people notice nothing at all.
Bleeding that keeps coming back deserves a dental check, even when your mouth does not hurt.
Gum disease is common. The CDC estimates that 42% of U.S. adults aged 30 and older have periodontitis.
When should you seek care?
Brushing too hard can irritate the gums. If bleeding comes back, happens without brushing, or concerns you, contact a dentist for advice.
Contact a dentist promptly for severe dental pain, swelling, or a tooth or implant that feels loose. If swelling makes it hard to breathe or swallow, seek emergency medical care now.
What causes gum disease?
Plaque is a sticky film of bacteria that forms on teeth. Bacteria in plaque can trigger inflammation in the gums. Plaque left on teeth can harden into tartar, which a toothbrush cannot remove.
Brushing and cleaning between the teeth help control plaque. Smoking and diabetes can increase the risk of gum disease and affect healing. Tell Dr. Smith about your health and any medicines you take.
What happens at the examination?
Dr. Smith measures the space between the gum and each tooth with a small probe. This measurement is called a pocket depth. He considers it alongside bleeding, gum recession, and the bone visible on X-rays.
The examination also covers your side of the story: your health, the medicines you take, whether you smoke, and anything you have noticed at home. Measurements can be compared with earlier records or later visits.
Why might I need a deep cleaning?
Treatment depends on whether inflammation is limited to the gums or has damaged the supporting tissues. For periodontitis, treatment often includes cleaning below the gumline, called scaling and root planing.
This cleaning removes plaque and tartar around affected roots. Ask which areas need treatment, how discomfort will be managed, and how the gums will be checked afterward. Your dentist also reviews how you clean your teeth at home.
Will I need surgery?
After cleaning, Dr. Smith reassesses the gums as they heal. Treatment is usually staged as follows: Clean, heal, re-check, then decide. Surgery is not needed in every case.
If deeper areas still need treatment, surgery may improve access for cleaning. Some procedures reduce deep pockets; others aim to rebuild lost support. The choice depends on the damage around the tooth.
What treatment can and cannot do
Gingivitis affects the gums and can usually be reversed. Periodontitis damages the tissues supporting the teeth and needs ongoing care. Treatment aims to stop further damage and allow teeth to function properly. Some lost support can be rebuilt in suitable cases, but treatment cannot restore every damaged area or save every tooth.
What happens if you wait?
Periodontitis can progress without pain. Left untreated, periodontitis can lead to further bone loss, gum recession, and loosening or shifting of the teeth. What happens if gum disease is left untreated? explains what delay can change and what to ask before deciding to wait.
What care is needed afterward?
Daily cleaning and periodontal maintenance help protect the result. Maintenance visits are usually every three months and often alternate between Dr. Smith's office and your general dentist, so both offices can watch for changes in your gums.
Terms you may hear
Pocket depth
The space between the gum and the tooth, measured in millimeters with a small probe. Healthy spaces are usually 1 to 3 mm.
Stage and grade
Periodontitis is described by stage, from I to IV, for how much damage has occurred, and by grade, from A to C, for how quickly it tends to progress.
Scaling and root planing
Cleaning below the gumline to remove plaque and tartar from the roots, often called a deep cleaning.
Periodontal maintenance
Regular professional cleanings and checks after treatment, usually every three months.
What does treatment cost?
Each office sets its own consultation fee, so ask when you book. Your treatment estimate depends on what the examination finds.
If surgery is recommended, ask which procedure is proposed and what its estimate includes.
Questions to bring to a consultation
- Do I have gingivitis or periodontitis?
- Which areas need treatment, and why?
- Will I need surgery, or could cleaning be enough?
- What will it cost, and when would I pay it?
- Which office will provide follow-up and maintenance?
Discuss your concern with Dr. Smith
Call the office you would like to visit and describe what you have noticed. If you are worried about discomfort or cost, mention it when you call.
Offices and contactSources for this guide
- CDC: gum disease facts
- American Academy of Periodontology: 2017 classification of periodontal diseases
- NIDCR: gum disease, diagnosis, and treatment
- American Dental Association: scaling and root planing
- American Academy of Periodontology: surgical and regenerative procedures
- MedlinePlus: tooth abscess
- MedlinePlus: dental infection that affects breathing (Ludwig angina)
Authorship and clinical review
Written and reviewed by John L. Smith, DDS, MS, periodontist. Last reviewed .