Gum disease is a common condition affecting the tissues around your teeth. It causes swelling, redness of the gums, and sometimes pain, and avoiding treatment can lead to gum recession and even tooth loss.

Most of adults in the world have some gum disease, even if only a small amount. Gum disease, however, can be prevented by maintaining a good oral hygiene routine, including regular brushing, check-ups with your dentist, and hygienist appointments.

Find out more about the main types of gum disease, treatments for gum disease and symptoms to look out for.

What are the main types of gum disease?

There are three main types of gum disease: gingivitis, periodontitis and acute necrotising ulcerative gingivitis (ANUG). Gingivitis is an inflammation of the tissues that surround your teeth. If gingivitis isn’t treated it can lead to other type of gum disease called periodontitis, which can affect the bones and ligaments that support your teeth. ANUG is a serious type of gum disease that develops suddenly.

Gum disease isn’t always painful, so you may not realise you have it. That’s why it’s important to visit your dentist for regular check-ups.

Gingivitis

Gingivitis is caused by a buildup of plaque, a soft, sticky substance caused by bacteria. If you don’t clean the plaque off your teeth by brushing and flossing regularly, it can cause your gums to become inflamed. Your gums may bleed when you brush them but aren’t usually painful.

If you remove the plaque and look after your teeth and gums well, your gingivitis is likely to get better. But if you don’t get the plaque off properly, you may develop a more serious type of gum disease called periodontitis.

The symptoms of gingivitis are:

• Bleeding after cleaning or flossing your teeth, or eating something hard like an apple
• Occasional cases of bad breath (halitosis)
• You might also notice red or swollen gums

If you have symptoms of gingivitis, you may be able to resolve this at home with brushing and flossing techniques. Or you can see a hygienist for a professional dental clean. This will involve removing any traces of tartar, plaque, or bacterial products.

Periodontitis

If your gingivitis isn’t treated, the inflammation may spread to the ligaments and bones that hold your teeth in place. This is a type of gum disease called periodontitis. Your gums may begin to pull away from your teeth, leaving pockets. These pockets trap plaque that you may not be able to reach with a toothbrush.

Over time, the plaque hardens to become tartar. This may irritate your gums even more by collecting more plaque. The pockets may then get deeper and even more difficult to clean, making the problem worse. Sometimes you may develop an infection in your gums. Pus may collect under your gums, causing an abscess.

Untreated periodontitis can cause your gums to shrink back from your teeth (called recession). This may then expose some of the roots of your teeth, making them sensitive. If you have any bone loss, your teeth may feel loose. If your periodontitis isn’t treated for a number of years, you may even lose some teeth.

If your gingivitis has developed into periodontitis, you may experience the following symptoms:

• Bad breath (halitosis)
• Gum recession and sensitive teeth
• A wobbly tooth
• A bad taste in your mouth
• Gum abscesses (pus that collects under your gum

If you have any of these symptoms, we recommend you to visit us.

Acute necrotising ulcerative gingivitis (ANUG)

ANUG is a serious type of gum disease that develops suddenly. It is a bacterial infection that causes swelling, ulcers, bad breath (halitosis) and pain. ANUG must be treated by a dentist as soon as possible.

The symptoms of ANUG include

• Very painful ulcers that bleed easily
• Bad breath (halitosis)
• A metallic taste in your mouth
• Difficulty swallowing or talking
• Having a lot of saliva in your mouth
• You may also have a high temperature and feel generally unwell

If you have any of these symptoms, you should see a dentist straight away.

How is gum disease treated?

The type of treatment you will have will depend on how serious your gum disease is. The aim of treatment is to control any existing gum disease and prevent further problems.

• You may be able to treat mild gum disease (gingivitis)with a daily brushing and flossing routine. Your dentist or hygienist will arrange regular check-ups with you to monitor the size of any pockets in your gums, as well as how easily your gums bleed, to make sure these get better over time.

If your dentist thinks you have periodontitis:

• Your clinician will use a periodontal probe to measure the depth of any gaps between your teeth and gums. They may check how easily your gums bleed and how much plaque and tartar you have on your teeth. You may also need X-rays to check the state of your teeth and jaw bone.
• Root-planning may be required to treat periodontitis or acute necrotising ulcerative gingivitis (ANUG). Root planning removes plaque, tartar, and damaged tooth covering. Your dentist or hygienist may use a local anaesthetic to make the root-planning more comfortable. This will completely block the feeling from your gums.
• Treatment with antibiotics may be recommended if you have a very serious infection. Antiseptic mouthwash may be recommended by a hygienist to help discourage the growth of bacteria. However, a mouthwash can’t remove plaque already built up on your teeth – this must be brushed off or removed by a hygienist.
• If you have more serious periodontitis, and other treatments haven’t worked, your dentist may refer you to a periodontist for gum surgery. This is a healthcare professional who specialises in treating periodontal diseases. We have many specialists through the Bupa Dental Care network. Gum surgery may help to remove bacteria and repair your gums and bone. It may also improve how your teeth look and reduce any sensitivity.