Gum disease

Gum disease is a common condition where the gums bleed, or become swollen, sore or infected.

Many adults have gum disease to some degree, and most people have it at least once. It's much less common in children. It's one of the main reasons adults lose teeth, but it can be prevented.

Healthy gums are pink and firm, and they fit tightly around your teeth to hold them securely in place. They shouldn't bleed when you touch or brush them. Normally you shouldn't see the roots of your teeth either.

Gum disease isn't always painful, so you may have it without knowing. That's why regular dental check-ups matter.

The early stage of gum disease is called gingivitis. The first symptoms can include:

• red and swollen gums
• bleeding gums after brushing or flossing your teeth
• bad breath (halitosis)
• an unpleasant taste in your mouth

Gingivitis can be reversed, and it doesn't damage the bone that holds your teeth in place. If you have gingivitis, it means your gums are inflamed. You need to control that inflammation at this early stage, so it doesn't spread to the bone holding your teeth in place.

If gingivitis isn't treated, the tissues and bone that support your teeth can be affected too. This happens when the inflammation behind gingivitis spreads to the bone holding your teeth in place. The condition is called periodontitis.

Periodontitis can't be reversed, but treatment can control it and stop it from getting worse.

Symptoms of periodontitis can include:

• bleeding gums after brushing or flossing your teeth
• pain or sensitivity from the gums or teeth
• bad breath (halitosis)
• an unpleasant taste in your mouth
• loose teeth that can make eating difficult
• teeth that have moved from their original position, for example a gap opening between your front teeth that wasn't there before
• gum abscesses (collections of pus that develop under your gums or teeth)
• loss of teeth

• your gums are painful or swollen
• your gums bleed when you brush your teeth
• you have loose teeth
• the gaps between your teeth are increasing or changing

Your dentist can check the health of your gums.

Gum disease starts with plaque, a sticky substance that builds up on your teeth and contains bacteria. Some of those bacteria are harmless, but others are bad for your gums.

If you don't brush plaque off your teeth, it builds up and irritates your gums. That can lead to redness with bleeding, swelling and soreness.

Some people are more likely to get gum disease than others. You may be at higher risk if you smoke, have diabetes, or have someone in your family who has lost teeth because of gum disease.

• brush your teeth and gums with a toothbrush twice a day, for 2 minutes at a time
• use fluoride toothpaste
• clean between your teeth regularly, with interdental brushes or dental floss
• visit the dentist for check-ups

It's important to have regular dental check-ups, so any problems with your teeth and gums can be found and treated early.

Your dentist or hygiene therapist can examine your teeth and gums for problems. They'll tell you how to clean more effectively at home, and how to lower your risk of gum problems, for example by stopping smoking.

If your risk of developing gum problems is higher (if you smoke or have diabetes, for instance), you may be advised to see your dentist more often so your teeth and gums can be closely monitored.

If you've been diagnosed with gingivitis or periodontitis, the Scottish Dental Clinical Effectiveness Programme has more information about managing these conditions.

If you leave gum disease untreated and it develops into periodontitis, it can lead to further problems, including:

• gum abscesses (painful collections of pus)
• receding gums
• loose teeth
• loss of teeth