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Gum Disease

Medically reviewed by: Larissa Hirsch, MD

What Is Gum Disease?

Gum disease isn’t something that only happens to older people. Teens can get it too. Gum disease, also known as periodontal (pronounced: pair-ee-oh-DON-tul) disease, can cause problems from bad breath to pain and tooth loss.

Periodontal disease is inflammation of the gums. Gums are part of the mouth’s soft tissue. They surround and support the teeth and, when healthy, look pink and firm. Untreated gum disease can become very serious, causing teeth to become loose or fall out.

What Causes Gum Disease?

Gum disease is usually caused by a buildup of plaque (pronounced: PLAK). This invisible sticky layer of germs forms naturally on the teeth and gums. Plaque contains bacteria, which make toxins that irritate and damage the gums.

Hundreds of types of live in the mouth, so keeping plaque under control is a constant battle. That's why brushing and flossing every day — and regular trips to the dentist — are so important.

Who Is at Risk for Gum Disease?

Certain things can make a person more likely to develop gum disease. For instance:

  • If your parents have gum disease, you may be more likely to get it too.
  • The snacks you eat also can put you at risk — especially if you grab fries and a soda after school and can’t brush right away after eating them. Most of us know that sugar is bad for our teeth. But starchy foods like fries and chips also feed the acids that eat into tooth enamel.
  • If you have braces, fighting plaque can be tougher. Plus, some medical conditions and some medicines increase the risk of gum disease.
  • An unhealthy diet, too little sleep, and too much stress can make you more vulnerable to infection anywhere in the body, including your gums.
  • Increases in hormones during puberty can make  gums more sensitive to irritation. Some girls may notice that their gums bleed a bit in the days before their periods.
  • For severe — and early — gum problems, though, the real bad guy is tobacco. Smoking or chewing tobacco not only lead to bad breath and stained, yellowed teeth. They also cause  gum disease and make mouth cancer more likely.

How Does Gum Disease Happen?

Gum disease happens in stages. Many teens have some form of gum disease.

Do your gums bleed when you floss or brush your teeth? Chances are you already have the mildest form of gum disease, called gingivitis (pronounced: jin-juh-VY-tus). Bleeding gums are usually a sign of gingivitis. Other warning signs include gum tenderness, redness, or puffiness.

If plaque from teeth and gums isn't removed by good daily dental care, over time it will harden into a crust called calculus or tartar. If tartar forms, it starts to destroy gum tissue, causing gums to bleed and pull away from the teeth. This is known as periodontitis (pronounced: pair-ee-oh-don-TY-tus), a more advanced form of gum disease.

What Problems Can Happen?

With periodontitis, gums get weak and form pockets around the base of teeth. Bacteria pool in these pockets, harming the gums even more. As periodontitis spreads, it damages deeper gum tissue. Over time, it can spread to areas of the jawbone that support the teeth. Then, teeth can get loose and fall out.

Periodontitis is not common in teens, but it can happen. If it's not treated, it can cause real trouble for your teeth.

What should you do to avoid worsening gum disease? See your dentist if you notice any of these signs of gum disease:

  • regular bleeding of the gums when brushing or flossing
  • discolored gums (healthy gums are pink and firm, not red, swollen, or tender)
  • any sign of gums pulling away from teeth
  • bad breath that won't go away
  • loose teeth

How Is Gum Disease Treated?

Gum disease can be sneaky, sometimes causing little or no pain or irritation before doing permanent damage to teeth. That's why regular dentist visits are a must. With X-rays and an exam, a dentist or dental hygienist can spot trouble before you know it's there.

The earlier gum disease is caught, the better. Good brushing and flossing habits usually can reverse gingivitis. Sometimes dentists also prescribe antibiotics or a special antibacterial mouth rinse to tackle the problem.

Gingivitis that turns into periodontitis is harder to control. Usually, there’s a widespread infection of the gums that needs treatment. This may take several special treatments either by a dentist or a periodontist, an expert in the care of gum disease.

Some ways dentists and periodontists may treat periodontitis are:

  • Scaling or root planing. These deep-cleaning measures involve scraping and removing plaque and tartar from teeth above and below the gum line.
  • Antibiotics. These and other medicines often are used with scaling and root planing to stop the spread of infection and inflammation. They come in different forms, like medicated mouthwashes or antibiotic-containing gels or fibers placed in gum pockets to slowly kill bacteria and help gums heal.
  • Surgery. In advanced cases of periodontitis, a dentist might need to open and clean badly diseased gum pockets, then stitch the gums back into place to fit more snugly around the teeth.
  • Gingival grafting. If gum tissue is too diseased to sew back together, a dentist removes healthy gum tissue from another part of the mouth and stitches it into place. The graft replaces the diseased tissue and helps to anchor the teeth, making them look better.

If you’re treated for periodontitis, it's very important to take special care of your teeth and gums to see lasting improvement. Floss and brush every day, and quit habits that are bad for your mouth, such as smoking or eating sugary snacks between meals.

How Can I Prevent Gum Disease?

The good news is that gum disease usually can be prevented. Just take care of your teeth, starting now. Don't wait!

  • Brush twice a day for at least 3 minutes each time (about the length of your favorite song) and floss daily. If you're not sure whether you're brushing or flossing properly, your dentist or dental hygienist can show you the best ways.
  • Always brush with a toothpaste that contains fluoride. Some dentists also recommend daily mouth rinses containing fluoride.
  • Use a toothbrush with soft, polished bristles, as these are less likely to irritate or injure gum tissue. Replace your toothbrush at least every 3 to 4 months — a worn-out toothbrush can injure your gums. (Some toothbrush brands use color indicators on the bristles to remind you to replace them when they become worn.)
  • Eat a healthy diet. Avoid snacks and junk foods packed with sugar that plaque-causing bacteria love to feed on.
  • Don't smoke. Cigarettes and chewing tobacco cause mouth irritation and are very unhealthy for gums and teeth.
  • Regular dental care is key to keeping your mouth healthy. Visit your dentist for routine care — especially cleaning — at least twice a year. Your dentist can remove hardened plaque and any tartar that you're not getting to with brushing or flossing.
Medically reviewed by: Larissa Hirsch, MD
Date reviewed: August 2020