The Subtle Signs You Have Gum Disease + How to Know When It’s Serious

Meh, so your gums sometimes bleed a little after you floss. It doesn’t hurt, so that means it’s no biggie, right? While you may think nothing of a little blood during your teeth cleaning routine, it’s definitely not something to, uh, brush off.

Gum disease is a serious infection of the tissues that surround and support your teeth. If gum disease is left untreated and becomes more severe, it can lead to tooth loss.

“There are varying degrees of gum disease,” says Jennifer Jablow, DDS, a dentist in New York City. “Most people have some form of what’s called gingivitis, which is a low-level inflammation of the gums. Full-blown gum disease is called periodontal gum disease, which also involves the bone, and that is quite serious.”

Gum disease is caused by plaque and bacteria that get stuck on the teeth and become calcified. The body reacts to this calcified plaque as something that’s foreign or a disease, which triggers inflammation to fight back. “The vessels open up and try to bring cells there to get and fight the bacteria. That’s why your gums become puffy, red, and bleeding,” says Dr. Jablow.

The Signs and Severity of Different Types of Gum Disease

“When I examine a patient, [the gum disease] is quite apparent from the inflammation,” says Dr. Jablow. The gum tissue isn’t as taut as it should be and it has the texture similar to the outside of an orange. “It’s usually more jelly-like, red, and angry,” she says.

Gingivitis is early-stage gum disease that often causes:

• Puffy or swollen gums
• Red gums
• Bleeding after brushing or flossing

Gingivitis is usually reversible with an in-office dental cleaning, as well as good oral hygiene. That means brushing twice a day (especially at night!) and flossing every day.

Periodontitis is advanced gum disease—and it’s quite common. Chronic periodontitis affects 47 percent of adults over age 30 in the United States, according to the American Dental Association.

Periodontitis can lead to loss of tissue and bone that support the teeth and may become more severe over time. “If the gum disease is more advanced the teeth actually start to become loose, because the disease process has actually started to eat away at the bone and gums,” says Dr. Jablow. Other signs of periodontitis may include:

• Gums that have pulled away from the teeth
• Chronic bad breath
• Changes in the way your teeth fit together when you bite
• Changes in the fit of partial dentures

Aggressive periodontitis is a highly destructive form of periodontal disease. This usually means there’s a rapid loss of tissue and bone that may occur in some areas of the mouth or in the entire mouth.

Gum disease can lead to permanent tooth and bone loss, which is why it’s critical to get it treated by a dentist.

How Gum Disease Is Treated

The first step in treating gum disease is to get a deep cleaning by a dental hygienist.

If the gum disease is more advanced, you may have deep “pockets” around the teeth. Your dentist will measure these pockets to see if further treatment is needed. “If they’re more than five millimeters, there’s no way that your floss or anything can get down there to remove the bacteria, so it’s going to have to be mechanically removed with a deep scaling and root planing,” says Dr. Jablow.

Gum disease is serious, but may also show no warning signs, which is why it’s crucial to see your dentist regularly.

“I wish people understood how important it is to see your dentist twice a year and go for a mechanical cleaning,” says Dr. Jablow. “There’s absolutely no way your toothbrush or floss can reach some of the bacteria that’s deep inside your gum tissue, which is the predecessor to gum disease and possibly even tooth and bone loss.”