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by Tim Mosher, DMD, Willow Valley Periodontics

Studies suggest that up to 80 percent of American adults suffer from gum disease. In its earliest phases, gum disease causes puffy red gums that bleed easily when you brush and floss. At its worst, gum disease can lead to tooth loss. In fact, this form of gum disease — also known as periodontal disease or periodontitis — is the leading cause of tooth loss in adults over 35 years old. In other words, if you want to keep your teeth, you must take care of your gums.

What is gum disease?

Gum disease — or periodontal disease — is an inflammatory disease of the gums and bone around the teeth caused by bacteria. Simply put, the bacteria on the teeth cause your body to respond in defense. The normal response to an insult like this is inflammation. However, if there is an exaggerated response, or chronic, long-lasting inflammation, this process becomes destructive.


In the early stage of gingivitis, this inflammation causes the gums to become red and swollen and bleed easily, often during tooth brushing. So far, the gums may be irritated, but the teeth are still firmly planted in their sockets. No bone or other tissue damage has occurred at this stage.


When gingivitis is left untreated, it can advance to periodontitis. At this point, the inner layer of the gum and bone detach from the teeth and start to form pockets. These small spaces between teeth and gums will collect debris and can become infected. The bacteria that initially sat above the gum line are now able to invade deep below the gum line —out of reach from your toothbrush and floss. Bacterial toxins and the body’s enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed.

At this point, because there is no longer an anchor for the teeth, they become progressively looser, and the ultimate outcome is tooth loss.

Signs and symptoms

Periodontal disease typically progresses painlessly. Unfortunately, this means the disease can progress to very advanced stages without us even knowing.

Signs we can look for:

  • Bleeding, red, swollen or tender gums
  • Persistent bad breath or bad taste
  • Receding gum line
  • Loose or shifting teeth
  • A change in how your teeth fit together

Risk factors:

The main cause of gum disease is dental plaque; however, other factors affect the health of your gums and your chance of getting gum disease.

  • Age
  • Smoking/tobacco use
  • Genetics
  • Stress
  • Medications
  • Clenching or grinding
  • Diabetes or heart disease
  • Poor nutrition


Despite the destructive effects of gum disease, treatment is available to manage its activity and maintain healthy gums and teeth for a lifetime. First and foremost, we must improve our hygiene by brushing morning and night and flossing daily. In addition, your dentist or periodontist may recommend additional treatment. A periodontist is a dental specialist that received an additional three years of training for the treatment of gum disease, gum grafting and dental implants. This makes them uniquely qualified to treat even the most advanced cases of periodontal disease. Treatment ranges from a deep cleaning called scaling and root planing, to a minor gum surgery and bone grafting called osseous surgery. Modern techniques allow us to regrow some of the bone that has been lost with minimal post operative discomfort.

If you have noticed any of the above signs and symptoms of gum disease, contact your local dentist or periodontist for a comprehensive periodontal evaluation.