Medically reviewed by Dr. James Ko

Gum Disease: Causes, Risk Factors and Symptoms

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Gum disease is a very common oral health condition where the gums are inflamed due to bacterial buildup, causing them to become sore, swollen, and bleed.

More than half of adults in the world are suffering from gum disease (or gingivitis) to some degree, and most people experienced gum disease at least once in their lives.

One of the most common signs of gum disease is when you bleed your gums after brushing your teeth, as well as halitosis or bad breath. It is, however, important to understand that gum disease can be differentiated into two different stages: gingivitis and periodontitis.

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Gingivitis VS Periodontitis

We can consider gingivitis, gum inflammation, as the earlier stage of gum disease that usually precedes periodontitis or gum infection. However, gingivitis doesn’t always progress to periodontitis.

Gingivitis: during this stage, the gums are inflamed, become tender, and easily bleed due to bacteria accumulation in plaque. However, the gums are not yet infected, the bones are not yet damaged, and the tooth is still firmly attached to the gum. In most cases, all the damages during gingivitis are reversible (not permanent.)

Periodontitis: the most prevalent sign when gingivitis already advanced to periodontitis is the presence of gum pockets (also referred to as periodontal pockets or gingival). The inner layer of the gum that should be attached to the tooth pulled away, creating a pocket. This small space created between the teeth and gums can collect food particles and bacteria (plaque), increasing risks for infections.

Bacteria in plaque accumulation will then ‘fight’ with the body’s immune system, releasing toxins, acids, and various enzymes that will also attack the surrounding bone and connective tissue that hold the tooth in place. As the periodontitis progresses, the pocket deepens as more tissues (gum and bone) are destroyed. As a result, the tooth is no longer attached properly, causing it to be loos and ultimately will cause tooth loss.

It is also worth noting that gum disease is the number one cause of tooth loss of more than 70% of total cases.

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The Causes of Gum Disease

As discussed above, plaque is the most common cause of gum disease. Yet, other factors can contribute to gum disease:

  • Smoking and/or tobacco consumption is one of the most prominent causes of gum disease. Nicotine will reduce blood flow and disrupt our immune system, so it’s harder for damaged gum tissue to repair itself
  • Not maintaining good oral hygiene practices, brushing twice a day, flossing daily, etc., will encourage plaque buildup
  • Overall health issues can increase risks of gum disease and infections, such as HIV or cancer. Diabetes patients are also at a higher risk to develop infections because the disease affects the body’s ability to regulate sugar.
  • Pregnancy, menopause, menstruation, and other situations with hormonal change can also cause gums to be more sensitive than usual, and so makes it easier for gum disease to develop.
  • Medications that suppress saliva production can increase the risks of gum disease. Saliva is the body’s natural protection against oral bacteria, and so less saliva means more bacterial growth.
  • In rarer cases, gum disease can be caused by genetic factors.

Symptoms of Gum Disease

Gingivitis can progress without any symptoms at all (and can be 100% painless), in rare cases, even until the very late stage. However, in most cases, there are warning signs and symptoms pointing to the progression of gum disease, including:

  • Swollen and reddened gums, accompanied by tenderness
  • Foul breath, and a bad, metallic taste in the mouth
  • Bleeding gums during and after brushing
  • Receding gums
  • Formation of periodontal pockets (not visible unless examined by a professional)
  • Loose teeth, or shifting teeth during biting down. Partial dentures might not fit as intended due to shifting.

Since, as mentioned, some of these symptoms are not easily detected, you might still have some degree of gingivitis or periodontitis even if you don’t notice any of the above signs. Your dentist or periodontist can check whether you are suffering from gum disease mainly by recognizing these signs:

  • Periodontal pocket depth, the amount of space created between the gum and the tooth, the langer the pocket, the more progressed the gum disease is.
  • The firmness of your gum, swelling (and degree of swelling), whether there’s any bleeding
  • Teeth sensitivity
  • Teeth movement and misalignment
  • Overall health of the jawbone, to check whether gum disease has progressed to destroy the jawbone

Preventions for Gum Disease

As mentioned above, gingivitis is generally reversible, and the progression of gum disease can be 100% stopped when it’s treated early enough. Periodontitis, however, can produce irreversible damage to your gum tissue, teeth, and jawbone.

Thus, early treatment is crucial in ensuring 100% recovery, but preventing gum disease is even more important.

The most important factor in preventing gum disease is plaque control, which consists of mainly two things:

  • Proper oral hygiene practice, mainly brushing twice daily and flossing at least once daily
  • Professional cleaning at the dentist/periodontist, at least twice a year (once every six months)

Brushing regularly can effectively remove food particles and bacteria from the teeth’s surfaces, while flossing can clean the spaces between the teeth and just below the gum line. Professional dental cleaning like scaling and root planing can then clean the areas not covered by these ‘at-home’ practices.

Also, rinsing your mouth regularly with an antibacterial mouthwash can help reduce plaque buildup, and thus help lower the risks of gum disease.

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Potential Treatment For Gum Disease

Gum disease might be treated with surgical or non-surgical treatments depending on many different factors, especially the severity of the disease.

There are several goals of gum disease treatment:

  1. Reduce swelling and inflammation
  2. Stop infection and/or the risk of infection
  3. Reduce the depth of periodontal pocket(s)
  4. Stop damage to the surrounding gum tissue and bone
  5. Stop disease progression

End Words

Here at Markham Smile Centre dentistry, we provide various treatment options for gum disease according to the severity of the case and other possible factors. Don’t hesitate to contact us immediately and schedule an appointment, so our dental specialist can help plan the best possible course of action for your gum disease situation.

Andrea Galick

Andrea Galick is an accomplished Dental Hygienist (RDH) with a passion for helping patients achieve optimal oral health. Andrea has built a reputation as a caring and skilled practitioner who puts her patients at ease and provides individualized care that meets their unique needs.

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