Gum Disease, Explained
How to recognise gum disease early, what each phase of treatment involves, and the routine that stops it returning.
How Do I Know If I Have Gum Disease, and What's the Treatment?
The main signs are bleeding on brushing, gums that look red or swollen, persistent bad breath, gums pulling back from the teeth and teeth that feel loose. Plaque bacteria at the gum line cause it, and smoking and diabetes speed it up. Caught early, as gingivitis, a thorough professional clean plus improved cleaning at home will reverse it. Once it has reached the bone, it's treated by deep cleaning under the gums in stages, followed by regular maintenance. At Peninsula Dentists on Greenwich Peninsula, deep gum treatment costs £100 per stage and a Diamond Smile Clean with Airflow £134.
Signs to Look Out For
- Blood in the sink after brushing or interdental cleaning, or spots of blood on the pillow when you wake
- Gums that look red, puffy or glossy rather than firm and pale pink
- A bad taste or bad breath that brushing doesn't shift
- Gums receding from the teeth, making them look longer or feel sensitive near the gum
- Teeth that have loosened, drifted or developed new gaps
- Pus, or a small boil on the gum
For most people gum disease causes no pain until it's well advanced, so it often goes unnoticed until a tooth starts to move. Bleeding comes first, and it's the sign worth acting on.
What Causes Gum Disease?
The root cause is plaque, the sticky layer of bacteria that builds up on teeth every day, mostly along the gum margin and in the spaces between teeth. Left in place, it inflames the gum, and within a day or two it begins to mineralise into tartar. Tartar can't be brushed away, and its rough surface gives yet more bacteria a foothold. Several factors make the process worse or faster:
- Smoking, which also suppresses the bleeding that would otherwise warn you
- Diabetes, particularly if blood sugar is poorly controlled
- Stress, which weakens your ability to fight infection
- Certain medicines that cause a dry mouth or overgrown gums
- Pregnancy, as hormones exaggerate the gums' reaction to plaque
- Close relatives with gum disease
- Hard-to-clean areas, such as crowded teeth, bridges and braces
Do Your Gums Bleed When You Brush?
Book directly with Stefanie Goodall, our dental hygienist. No dentist referral needed.
Gingivitis and Periodontitis: The Difference
Gingivitis is gum disease at its earliest. The inflammation is confined to the gum, no support has been lost, and it clears up completely once plaque is removed and kept off. Left alone, it can progress to periodontitis. At that point the inflammation reaches the ligament and bone holding the tooth, the gum peels away to form a pocket, and bone is gradually lost. Lost bone doesn't regenerate, so stopping the disease at the gingivitis stage matters a great deal. Some people with gingivitis never develop periodontitis, but nobody gets periodontitis without having had gingivitis first. For more on the advanced form, read our periodontal disease guide.
How We Check for It
Your gums are assessed at every dental examination and hygiene appointment. We look for bleeding and swelling and use a slim probe to measure the groove where gum meets tooth. In healthy gums that groove is shallow; a deeper pocket tells us the gum has come away. Where pockets are deep, X-rays show how much bone remains around each tooth, and we classify the disease by stage and grade under the British Society of Periodontology framework, which tells you how far it has gone and how fast it is progressing. The whole assessment is quick and painless.
Treatment, Step by Step
Gingivitis usually settles with a professional clean to remove plaque and tartar, followed by better cleaning at home so it doesn't return. Stefanie will show you the spots you're missing and size interdental brushes for your gaps, and the bleeding typically stops within a fortnight or so.
Periodontitis is treated in phases. The first deals with tartar above the gum and with the things that drive the disease, such as your cleaning routine and smoking. Next comes deep cleaning under the gum line, normally in four stages, one for each quarter of the mouth, with local anaesthetic for comfort. Each stage costs £100.2 After two to three months, the pockets are measured again to confirm healing. From then on, maintenance appointments, often three-monthly, hold it steady. Bone that has gone can't be restored, but the disease can be halted and kept that way.
What Airflow Does
Airflow is the best-known name in air polishing. Rather than a gritty paste on a spinning cup, it directs a fine spray of warm water, air and a soft powder at the teeth, lifting plaque and stain from the surfaces and from just below the gum, including around implants, bridges and braces where a conventional polish can't get. It's faster and gentler, and many patients prefer the feel of it to scaling alone. Our Diamond Smile Clean with Airflow is £134, and Airflow is part of every hygiene visit on both dental plans. You can also add it to a Classic Smile Clean for £35.2
Gum Health and Dental Implants
Gum disease has to be under control before an implant goes in. The bacteria that break down bone around natural teeth can do the same around an implant, which has fewer natural defences. That's why we treat gum disease first and revisit implant plans once the gums are stable, and why our implant guarantee requires three-monthly hygiene visits. If you already have implants, Stefanie can set up a maintenance routine to keep the surrounding gum and bone healthy, with Airflow to clean around them gently.
Keeping Gum Disease in Check
Treatment clears what's there; what you do at home decides whether it returns. Brush twice a day with the bristles angled into the gum, clean between your teeth daily, avoid smoking and attend hygiene appointments at the interval you've been given. If you've had gum disease, expect that to be three-monthly. Plan B is built around that pattern: for £40.16 a month you get four Airflow hygiene visits a year, two dental examinations and two small X-rays. For healthy gums, Plan A at £24.10 a month covers two hygiene visits a year. Members on either plan save 10% on most private treatment, and that includes each stage of gum treatment.
Questions
This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.