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Module 5

Gum Disease

What is it?

Gum disease is an inflammation caused by bacteria that accumulate in the mouth when the teeth and gums are not properly cleaned. It affects the tissues that support the teeth (gums, ligaments and bone).

There are two main stages:

  • Gingivitis: the initial stage. The gums appear red, swollen, and bleed when brushed. The good news is that it is reversible with improved hygiene.
  • Periodontitis: if gingivitis is left untreated, it can progress to this more serious stage. The supporting bone is gradually destroyed, which can cause teeth to loosen or even fall out.

Gum disease becomes increasingly common with age — over 60% of people are affected as they grow older.

Why does it occur?

Gum disease is caused by a combination of factors:

  • Bacterial plaque and tartar: if not removed through proper brushing, bacteria can build up and, together with tartar, inflame the gums.
  • Smoking: increases the risk and accelerates disease progression.
  • Poorly controlled diabetes: raises the likelihood of developing periodontitis.
  • Unhealthy diet: lack of essential nutrients.
  • Medications that reduce saliva: lead to oral dryness, which favours inflammation.
  • Stress and low immunity: can also negatively affect gum health.

What are the symptoms?

Gum disease often gives warning signs that can be easy to overlook:

Gums that bleed when brushed or even spontaneously

Red, inflamed, or painful gums

Gum recession, making teeth look longer or feel more sensitive

Persistent bad breath

Formation of pockets between teeth and gums

Tooth mobility: teeth may become loose or shift out of place

It is not normal for gums to bleed. Although many people think otherwise, it is a clear sign of gum disease.

If you see yourself in several of these symptoms, it’s important to talk to your dentist or doctor.

What are its consequences?

If left untreated, gum disease can have serious effects:

  • In the mouth: tooth loss, difficulties chewing or speaking.
  • For general health: increased risk of heart disease, worsening diabetes, and links to neurodegenerative, respiratory, and kidney problems….
  • In daily life: dietary limitations, impact on appearance and self-esteem.

For older adults, this can mean poorer nutrition, reduced quality of life, and greater dependency.

How is it treated?

Treatment depends on the severity of the disease:

Professional cleaning: removal of plaque and tartar from below the gums at the dental office.

Improved oral hygiene at home: brushing at least twice a day and using dental floss or interdental brushes daily. Your dentist may recommend specialty toothpastes or mouthwashes which normally contain antiseptics such as chlorhexidine or cetylpyridinium chloride for a limited period.

Surgery: in advanced cases, procedures may be performed to deeply clean tooth roots or regenerate lost bone.

Regular maintenance: periodic check-ups with your dentist or hygienist several times a year.

¿Cómo se puede tratar?

El tratamiento depende de la causa, pero suele comenzar por mejorar la higiene oral. El dentista puede recomendar:
  • Limpiezas profesionales para eliminar sarro y placa acumulada.
  • Tratamiento de caries o enfermedad periodontal si están presentes.
  • Revisión y ajuste de prótesis dentales para que no acumulen restos de comida.
  • Enjuagues antibacterianos sin alcohol o pastas dentales específicas para reducir bacterias.
  • Productos para la boca seca, como geles o espray, si la sequedad es la causa principal.

When should you see a dentist or doctor?

  • If your gums bleed, hurt, recede or appear inflamed.
  • If you have bad breath that won’t go away.
  • If a tooth feels loose or has shifted.
  • If your dentures no longer fit properly or become damaged.
  • If you experience pain or difficulty when chewing.

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Remember

Bleeding, inflamed or painful gums are warning signs you shouldn’t ignore. Early diagnosis can help prevent tooth loss and improve your overall well-being.

Your gums speak of your health.
Listen to them!

Access tailored solutions

Access tailored solutions

Here
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  • European Federation of Periodontology (EFP). The Perio-Cardio Connection: How gum disease affects your heart [Internet]. 2020 [cited 2025 Apr 25]
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  • Global oral health status report: towards universal health coverage for oral health by 2030. Executive summary. Geneva: World Health Organization;2022. License: CC BY-NC-SA 3.0 IGO. 
  • Hajishengallis G. Periodontal Inflammation and Systemic Diseases: An Overview. Periodontology 2000 [Internet]. 2020 Oct [cited 2025 Apr 25];83(1):9-13
  • Holland C. 2021 Oral Health Awareness Survey. In: Sunstar Global Healthy Thinking Report. Suisse. Sunstar Foundation; 2021
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