By the time people reach adulthood, their teeth and gingivae, or gums, have had quite a workout. When gums are healthy, they continue to fit snugly around the teeth. Many adults, however, develop some type of periodontal, or gum, disease—an infection of the tissues that support their teeth.

Some researchers suggest that there may be a link between gum disease and other health concerns such as cardiovascular problems, stroke, bacterial pneumonia and increased risk during pregnancy. More studies are needed to determine if the bacteria or the inflammatory response associated with gum diseases play a role in these systemic problems.
Gum disease is usually caused by plaque, a sticky film of bacteria that constantly forms on teeth. If plaque is not removed with thorough daily brushing and cleaning between teeth, gums become irritated and inflamed. The irritated gum tissue can separate from the teeth and form spaces called pockets. Bacteria move into the pockets, where they continue to promote irritation. Left untreated, the process can continue until the bone and other tooth-supporting tissues are destroyed.

The early stage of periodontal disease is called gingivitis. It often results in gums that are red and swollen and may bleed easily. The good news is that this early stage is usually reversible. Sometimes, all it takes are more regular professional cleanings and better home care.


Regular checkups are important. During an examination, your gums are evaluated for periodontal disease. The dentist looks at many things, including the color and firmness of the gums. A very small instrument called a periodontal probe is used to gently measure the space between the teeth and gums. This determines whether periodontal pockets are present. The normal space between teeth and healthy gums should be three millimeters or less. Generally, the more advanced the gum disease, the greater the pocket size.

Except in unusual cases, you can help prevent gum disease by brushing twice a day and cleaning between your teeth with floss or an interdental cleaner once a day. Choose products that display the ADA Seal of Acceptance, your assurance that they meet the ADA’s criteria for safety and effectiveness. Your dentist may provide additional instructions on cleaning methods or products you can use at home. Avoiding tobacco use and other healthy measures, such as eating a balanced diet, are important in preventing periodontal disease.

Even if you brush and floss regularly, you may not remove all the plaque, especially around the gumline. Plaque can harden into a rough, porous deposit called calculus or tartar. Once hardened, it can be removed only in the dental office during your regular cleaning.
You may not even be aware that you have gum disease because often there is no pain. There are warning signs, however, and you should call your dentist if you experience any of the following:
  • gums that bleed during brushing;
  • red, swollen or tender gums;
  • gums that have pulled away from the teeth;
  • persistent bad breath;
  • pus between the teeth and gums;
  • loose or separating teeth;
  • a change in the way your teeth fit together when you bite;
  • a change in the fit of partial dentures.

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