Gum Disease

What is gum (periodontal) disease?

It is an inflammatory reaction to the bacteria in the plaque and tartar, which leads to the loss of gum and bone around the tooth.


Not brushing or flossing causes a build-up of sticky plaque and eventually harden and becomes tartar.

Gum Disease (Periodontitis) Animation Video

Types of Gum Disease

If you have bad breath, bleeding gums, swollen gums and sensitive gums, you may have gum disease. Gum disease or gingivitis is an inflammation of the gums due to infection, inflammation increases gum swelling. If the infection spreads to the underlying bone, it’s called periodontitis. It is a disease of the tissue and bone. Gum disease is a major health problem affecting 64 million Americans

Signs and Symptoms of Gum Disease

  1. Bad breath
  2. Bleeding gum
  3. Swollen gum
  4. Gum recession     
  5. Spaces between your teeth.
  6. Loose teeth. 
  7. Cannot chew properly
  8. Sensitive teeth
  9. Bite changing, the teeth may not fit the same way as before
  10. Pus from the gums

Individuals have different susceptibility to gum disease. You have a higher risk of having gum disease if you are Asian, Hispanic or Black. Nicotine in tobacco with smoking or vaping produces inflammation, both cardiovascular disease and diabetes are inflammatory diseases that can lead to gum (periodontal) disease.

Risk Factors for Gum Disease

  1. Smoking/vaping.
  2. Hormonal changes as in pregnancy
  3. Genetics
  4. Diabetes
  5. Cardiovascular disease
  6. Autoimmune diseases
  7. Dry mouth from medications 
  8. Age 

Treatment for Gum Disease

The goal of the treatment is to control the inflammation to reduce infection. Plaque and tartar start above the gum line (supragingival) and move down the gum line in time (subgingival). Home care should be twice a day to control the plaque using a brush, floss and other aids. Mouth rinse should be mostly used for gingivitis on the supragingival surface, as the rinse cannot get down to the subgingival pocket.   

Home Remedies

  1. Regular brushing
  2. Regular flossing
  3. Use of Waterpik
  4. Proxabrush (if able to slide in between teeth)
  5. Low abrasive toothpaste
  6. Alkaline toothpaste

With proper regular home care, the dentist can concentrate on the areas that are difficult to reach to provide scaling and root planing. In areas where the pocket is deep, dentists may lift the gum and do the scaling and root planing in an open flap procedure. Lasers can reduce the pocket depth, however, if the tartar remains, the pocket will remain and get worse.     

Professional Treatment

  1. Cleaning with scaling and root planing.
  2. Surgical open flap 
  3. Antibiotics. In severe cases, where it is difficult to get in to clean, antibiotics may be the choice. Antibiotics, such as amoxicillin, tetracycline will be taken orally or locally small dosage may be delivered over a longer period such as doxycycline.
  4. Lasers can be used to control the infection.

Cost of Treatment

The pricing for gum disease depends on the type of treatment that your dentist selects so it ranges between $200-$5000.   

Dr. David Cheng

A practicing dentist with over 30 years of experience and more than 3500 hours of continuing studies. He lives in both Toronto, Canada and Seattle, WA. Besides writing for this website, he practices dentistry in different clinics in Canada and mentors other dentists in the USA and Canada.

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