Signs of Gum Disease
Gum disease is one of the main reasons adults lose teeth, yet it rarely hurts until it is well advanced. Knowing what to look for, and what happens at each step of care, makes it far easier to stop early.
What Are the Signs of Gum Disease and How Is It Treated?
The early signs of gum disease are gums that bleed when you brush, look red or puffy, or feel tender; at this stage, called gingivitis, it is fully reversible with better cleaning and a professional clean. Left alone it can become periodontitis, which destroys the bone holding teeth in place and needs a course of deeper treatment. At Comely Bank Dental in Edinburgh, a 30-minute hygiene visit is £90, and Airflow polishing can be added for £30.
What Are the Early Signs of Gum Disease?
The earliest sign of gum disease is bleeding when you brush or clean between your teeth. Healthy gums don't bleed with ordinary cleaning, so a pink tinge in the sink is worth taking seriously even when nothing hurts. Other early signs include:
- gums that look red, puffy or shiny rather than pale pink and firm
- tenderness when you brush
- a bad taste, or breath that keeps coming back
- food catching more than it used to between certain teeth
As the disease progresses you may notice gums pulling back so teeth look longer, new gaps opening up, teeth that feel loose or have drifted, or pus around a tooth. Pain usually arrives late, if at all, which is why gum disease is so often found at a routine check.
If you smoke, take note. Smoking narrows the blood vessels in the gums, so they bleed less even when disease is active. Gums that never bleed are not proof of health in a smoker.
Gingivitis or Periodontitis: What's the Difference?
Gum disease comes in two main forms, and the difference matters because one is fully reversible and the other is not.
Gingivitis is inflammation of the gum edge caused by plaque, the sticky film of bacteria that builds up on teeth every day. The gums bleed and may look swollen, but the bone and fibres holding the teeth are untouched. With thorough daily cleaning and a professional clean, gingivitis usually settles within a couple of weeks and leaves no lasting damage.
Periodontitis develops when inflammation spreads below the gum line in someone who is susceptible. The fibres attaching gum to tooth break down, a gap called a pocket forms, and the bone around the root is gradually lost. That bone doesn't grow back on its own. Treatment can stop the disease and keep it stable, but it manages periodontitis rather than curing it.
| Feature | Gingivitis | Periodontitis |
|---|---|---|
| What's affected | Gum edge only | Gum, ligament and bone |
| Main signs | Bleeding, redness, swelling | Pockets, recession, loose or drifting teeth |
| Reversible? | Yes | Damage is permanent, but the disease can be stabilised |
| Typical care | Better home care and a hygiene visit | Deep cleaning, then regular maintenance |
Not everyone with gingivitis develops periodontitis, but everyone with periodontitis had gingivitis first.
Gums Bleeding When You Brush?
Book a hygiene visit with Katie. We'll check your gums properly, clean thoroughly and explain exactly what we find before suggesting anything further.
What Makes Gum Disease More Likely?
Plaque is the cause, but the way your body reacts to it varies enormously. Some people carry heavy plaque with little damage; others lose bone quickly despite reasonable cleaning. These factors tip the balance:
- Smoking is the biggest risk you can change. Smokers are considerably more likely to develop periodontitis, it tends to be more severe, and treatment works less well. Stopping improves the outlook, and your GP or pharmacist can help.
- Diabetes, particularly when blood sugar is poorly controlled, raises both the risk and the speed of gum disease. The relationship runs both ways: active gum disease can make blood sugar harder to control.
- Stress is linked to poorer gum health, partly through its effect on the immune system and partly because routines slip when life is busy.
- Genetics plays a real part. If your parents lost teeth to gum disease, tell us, because you may need closer monitoring.
- Pregnancy changes hormone levels, and many women notice puffier gums that bleed easily. This usually settles after the birth, but existing periodontitis can worsen during pregnancy, so a check early on is sensible.
Dry mouth from medication, crowded teeth and old fillings with ledges that trap plaque also add to the risk.
How Do We Check Your Gums?
A gum check is part of every examination and hygiene visit at Comely Bank Dental, and it takes only a few minutes.
Screening. We gently measure the space between gum and tooth with a thin probe marked in millimetres. A quick score for each part of the mouth tells us whether the gums are healthy, inflamed or showing signs of deeper pockets.
Pocket charting. If screening suggests periodontitis, we record six measurements around every tooth. Healthy gums usually measure between one and three millimetres. We also note bleeding points, recession, loose teeth and any bone loss between the roots of back teeth. This chart becomes the baseline we compare against at every later visit.
X-rays. Gum disease destroys bone you can't see from the surface, so X-rays show how much support each tooth has left and whether the loss is even or concentrated in certain areas. We take them only when they will change what we do.
What Does Treatment Involve?
Treatment follows the same logic whether your gums need a simple clean or a full course of care. It happens in steps, and each builds on the one before.
- Understanding the problem and improving home care. We show you where plaque is being missed and which tools fit your mouth, and talk through anything that raises your risk, such as smoking or diabetes. Nothing done in the chair lasts without this step.
- A professional clean. We remove plaque and hardened tartar from above and just below the gum line. For gingivitis, this plus good home care is often all that's needed. A 30-minute hygiene visit is £90, or £135 when a longer appointment is needed.
- Deep cleaning, if you have periodontitis. Root surfaces inside the pockets are cleaned thoroughly, usually under local anaesthetic, over a planned course of visits. Each stage is £167, and our gum disease treatment page explains the course in more detail.
- Re-checking and maintenance. A few months later we chart the gums again to see how they've responded, then agree how often you need ongoing hygiene visits to keep them stable.
Fees are guide prices and are confirmed in a written treatment plan before anything starts.
What Is Airflow Polishing?
Airflow is a way of cleaning and polishing teeth with a fine jet of water, air and a very fine powder. Rather than scraping, it lifts the soft bacterial film and surface staining from teeth, gum edges, fillings, crowns, braces and implants.
What it's good for. It is gentle on gums and reaches well into grooves and between teeth, which makes it useful for clearing the biofilm that drives gum disease and for lifting tea, coffee, red wine and tobacco stains. Many people find it more comfortable than traditional polishing with a rotating cup and gritty paste.
What it isn't. Airflow doesn't remove hard, established tartar on its own. Where tartar is present we still remove it with ultrasonic and hand instruments; Airflow complements that rather than replacing it. Nor is it whitening. It brings back your teeth's natural shade by removing surface stain, but won't make them any lighter than that.
Tell us first if you have asthma or another breathing condition, or follow a low-salt diet, so we can check it suits you.
Airflow polishing can be added to any hygiene visit for £30.
Why Do Healthy Gums Matter for Dental Implants?
Implants are held in bone much as natural teeth are, and the tissue around them can become inflamed in a similar way. Inflammation limited to the soft tissue is called peri-implant mucositis. When it spreads and bone is lost around the implant it becomes peri-implantitis, a common reason implants run into trouble years after placement.
People with a history of periodontitis are at higher risk of these problems. That doesn't rule implants out, but it does mean:
- active gum disease should be treated and stable before an implant is placed
- daily cleaning around an implant needs to be every bit as thorough as around natural teeth
- regular hygiene visits matter just as much after treatment as before it
If you're considering dental implants, getting your gums healthy first is one of the most useful things you can do to help the result last.
Is Gum Disease Linked to Your General Health?
Research has found links between periodontitis and several wider health conditions, but it's important not to overstate them.
Diabetes has the strongest evidence. People with diabetes are more prone to gum disease, and treating periodontitis has been shown to give a modest improvement in blood sugar control for some people.
Heart and circulatory disease is more common in people with periodontitis. The two share risk factors such as smoking, and although ongoing inflammation may play a part, gum disease has not been shown to cause heart disease.
Pregnancy. Some studies have associated severe gum disease with premature birth, but treating the gums during pregnancy hasn't consistently changed that outcome.
The sensible conclusion is that healthy gums are part of being healthy overall. If you have diabetes or a heart condition, let us know.
Getting Your Gums Checked in Edinburgh
At Comely Bank Dental, gum care is led by Katie Ventisei, our dental hygienist and therapist, working alongside our dentists in Comely Bank, a few minutes' walk from Stockbridge. Every examination includes a gum check, and if anything needs attention we'll explain what we've found and agree a plan with you before treatment starts.
Adults are seen privately, and the children of our dental plan members under the NHS. Our hygiene page explains what a visit involves, and if you're new to us, the new patients page shows how to join. You can book online or call 0131 332 3971.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.