Gum disease affects nearly half of all UK adults and is the leading cause of tooth loss. Learn what the warning signs are and how to keep your gums healthy.
Gum disease is an infection of the tissues that support your teeth. It is caused by a build-up of plaque — a sticky film of bacteria — on the teeth and along the gumline.
There are two main stages:
Gingivitis — the early stage. The gums become red, swollen, and bleed easily. At this stage, the damage is reversible with good cleaning.
Periodontitis — if gingivitis is not treated, it can progress to periodontitis. The infection spreads deeper, damaging the bone and fibres that hold your teeth in place. This stage is not fully reversible, but it can be controlled.
Gum disease is the most common cause of tooth loss in adults in the UK. Around 45% of UK adults have some degree of gum disease, though many are unaware of it.
What causes gum disease?
The main cause is plaque — the soft, sticky coating that forms on teeth every day. If plaque is not removed by brushing and cleaning between teeth, it hardens into tartar (also called calculus), which can only be removed by a dental professional.
Other factors that increase your risk include:
Smoking — one of the strongest risk factors. Smoking masks the bleeding signs of gum disease and slows healing.
Diabetes — poorly controlled blood sugar increases susceptibility to infection, including gum disease.
Hormonal changes — pregnancy, puberty, and the menopause can make gums more sensitive.
Certain medications — some drugs cause gum overgrowth or dry mouth.
Stress — weakens the immune system's ability to fight infection.
Family history — some people are genetically more susceptible.
Signs and symptoms
Gum disease is often called a "silent" condition because it can progress without pain. Warning signs to look out for include:
Bleeding gums — when brushing or flossing. This is not normal and should not be ignored.
Red, swollen, or tender gums
Bad breath (halitosis) that persists despite good oral hygiene
Gums that look like they are pulling away from the teeth (receding gums)
Teeth that feel loose or have shifted position
Gaps appearing between teeth that were not there before
A change in your bite — the way your teeth come together
Pus between teeth and gums
If you notice any of these signs, please book an appointment. Early treatment makes a significant difference.
How is gum disease treated?
Treatment depends on the stage of the disease:
Gingivitis — this can usually be reversed with a professional clean (scale and polish) combined with improved home care. Your dentist or hygienist will show you the most effective way to clean your teeth.
Periodontitis — deeper cleaning called root surface debridement (sometimes called scaling and root planing) is needed. This removes bacteria from below the gumline. It may require several appointments and may be done with a local anaesthetic to keep you comfortable.
Advanced cases — some patients may be referred to a periodontist (a gum specialist) for more intensive treatment, which can include surgery to clean deep pockets around teeth or bone grafting procedures.
Gingivitis is fully reversible with good treatment and home care. Periodontitis — the deeper stage — cannot be reversed, but it can be successfully controlled to stop further damage. After active treatment, regular maintenance appointments are essential to prevent the disease from progressing.
What you can do at home
Good home care is essential for keeping gum disease under control. Here is what to do every day:
Brush for two minutes, twice a day — use a soft-to-medium brush and fluoride toothpaste. An electric toothbrush is often more effective at removing plaque.
Clean between your teeth every day — use interdental brushes (the small bottle-brush shaped cleaners) in a size recommended by your dentist or hygienist. Floss is an alternative if gaps are too tight for interdental brushes.
Do not smoke — stopping smoking is one of the most effective things you can do for your gum health. Your GP or the free NHS Stop Smoking Service can help — call the Smokefree helpline on 0300 123 1044 or visit nhs.uk/smokefree.
Control your blood sugar if you have diabetes — there is a two-way relationship between diabetes and gum disease. Better gum health can help improve blood sugar control.
Use a mouthwash as an addition to brushing — not a replacement. Antibacterial mouthwashes (containing chlorhexidine) can be helpful in the short term during active disease; they are not recommended for long-term daily use as they can cause tooth staining and alter the oral microbiome.
When to see your dentist
Please book an appointment soon if you notice:
Bleeding gums when brushing — even if it seems mild
Persistent bad breath
Any looseness or movement in your teeth
Swelling or pain in your gums
Even if you have no symptoms, attending regular check-ups is important. Gum disease is often only detectable through a clinical examination with special measurements taken around each tooth.
The link between gum disease and general health
Research has established clear links between gum disease and other conditions in the body. Treating gum disease may have benefits beyond your mouth:
Heart disease and stroke — gum disease bacteria can enter the bloodstream and contribute to inflammation in blood vessels.
Diabetes — gum disease makes blood sugar harder to control. Treating gum disease has been shown to improve HbA1c levels.
Pregnancy — severe gum disease has been linked to premature birth and low birth weight. Pregnant women should have their gums checked.
Respiratory conditions — breathing in bacteria from the mouth can worsen lung conditions.
Looking after your gums is part of looking after your overall health.
This leaflet is for general information only and does not replace professional dental advice. Your dentist will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.
References
Aligned with guidance from: BSP, NICE, SDCEP, DBOH.