Understanding Gum Disease
Learn the warning signs of gum disease, how it is treated, how to keep your gums healthy at home and when to see your dental team.
What is gum disease?
Gum disease is an infection of the tissues that hold your teeth in place. It is caused by plaque building up on your teeth and along the gum line. Plaque is a sticky film of germs (bacteria).
There are two main stages:
- Gingivitis is the early stage. Your gums become red and swollen, and bleed easily. At this stage, good cleaning can undo the damage.
- Periodontitis can follow if gingivitis is not treated. The infection spreads deeper. It damages the bone and fibres that hold your teeth in place. This stage cannot be fully undone, but it can be controlled.
Gum disease is the most common cause of tooth loss in UK adults. Around 45% of UK adults have some gum disease, but many do not know it.
What causes gum disease?
The main cause is plaque. This soft, sticky coating forms on your teeth every day. If you do not remove it by brushing and cleaning between your teeth, it hardens into tartar (also called calculus). Only a dental professional can remove tartar.
Other things that raise your risk:
- Smoking. This is one of the biggest risks. Smoking hides the bleeding signs of gum disease and slows healing.
- Diabetes. Poorly controlled blood sugar makes you more likely to get infections, including gum disease.
- Hormone changes. Pregnancy, puberty and the menopause can make gums more sensitive.
- Some medicines. Some drugs make the gums overgrow or cause a dry mouth.
- Stress. It weakens your body's ability to fight infection.
- Family history. Some people are more likely to get it because of their genes.
Signs and symptoms
Gum disease is often called "silent" because it can get worse without pain. Look out for:
- Bleeding gums when you brush or floss. This is not normal. Do not ignore it.
- Red, swollen or sore gums
- Bad breath (halitosis) that does not go away, even with good cleaning
- Gums that seem to be pulling away from your teeth (receding gums)
- Teeth that feel loose or have moved
- New gaps between your teeth
- A change in your bite (the way your teeth meet)
- Pus between your teeth and gums
If you notice any of these signs, book an appointment. Early treatment makes a big difference.
How is gum disease treated?
Treatment depends on the stage:
- Gingivitis. This can usually be reversed with a professional clean (scale and polish) and better cleaning at home. Your dental team or hygienist will show you the best way to clean your teeth.
- Periodontitis. You need a deeper clean below the gum line. This is called root surface debridement (or scaling and root planing). It removes bacteria from under the gums. It may take several visits. You may have a numbing injection (local anaesthetic) to keep you comfortable.
- Advanced gum disease. Some people are referred to a gum specialist (periodontist) for more treatment. This can include surgery to clean deep pockets around the teeth, or bone grafts.
Gingivitis can be fully reversed with good treatment and home care. Periodontitis, the deeper stage, cannot be reversed. But it can be well controlled to stop more damage.
After treatment, regular follow-up (maintenance) visits are essential. They stop the disease getting worse.
What you can do at home
Good home care is essential to keep gum disease under control. Do this every day:
- Brush for two minutes, twice a day. Use a soft to medium brush and fluoride toothpaste. An electric toothbrush often removes more plaque.
- Clean between your teeth every day. Use small bottle-shaped brushes (interdental brushes) in the size your dental team suggests. If the gaps are too tight for these brushes, you can use floss instead.
- Do not smoke. Stopping smoking is one of the best things you can do for your gums. 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. Diabetes and gum disease affect each other. Healthier gums can help you control your blood sugar better.
- Use a mouthwash as well as brushing, not instead of it.
- A germ-killing mouthwash with chlorhexidine can help for a short time while the disease is active. It is not advised for long-term daily use. It can stain your teeth and change the natural balance of germs in your mouth.
When to see your dental team
Book an appointment soon if you notice:
- Bleeding gums when you brush, even if it seems mild
- Bad breath that does not go away
- Any looseness or movement in your teeth
- Swelling or pain in your gums
Even with no symptoms, regular check-ups are important. Often gum disease can only be found at a check-up, where your dental team takes special measurements around each tooth.
Gum disease and your general health
Research has found clear links between gum disease and other health problems. Treating gum disease may help more than just your mouth:
- Heart disease and stroke. Germs from gum disease can get into your blood. They can add to swelling (inflammation) in your blood vessels.
- Diabetes. Gum disease makes blood sugar harder to control. Treating gum disease has been shown to improve HbA1c (a measure of long-term blood sugar).
- Pregnancy. Severe gum disease has been linked to babies born early or at a low weight. If you are pregnant, have your gums checked.
- Lung conditions. Breathing in germs from the mouth can make lung conditions worse.
Looking after your gums is part of looking after your whole health.
This leaflet is for general information only and does not replace professional dental advice. Your dental team will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.
Sources
- BSP implementation of European S3-level evidence-based treatment guidelines for stage I–III periodontitis in UK clinical practice (Journal of Dentistry 106:103562). British Society of Periodontology (BSP), 2021.
- Prevention and Treatment of Periodontal Diseases in Primary Care, 2nd edition. Scottish Dental Clinical Effectiveness Programme (SDCEP), 2024.
- Delivering better oral health: an evidence-based toolkit for prevention, 4th edition. Department of Health and Social Care and NHS England, 2021, updated September 2025.
- Gum disease. NHS website (nhs.uk), reviewed April 2026.
Links checked 18 October 2026.
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