Gum Disease; Causes, Diagnosis, and Treatment

Gum disease is a broad term that most people use when describing the inflammation of the gums. What most people do not know is that gum disease can actually be divided into two parts; Periodontal Disease (Periodontitis), and Gingivitis. Continue reading on more information on these two conditions, as well as their causes, diagnosis, and treatment.


Gingivitis is the most common form of gum disease; it is usually caused by a lack of brushing and flossing. The gums become swollen, red, and irritated, and may cause pain or sensitivity in the mouth. Gums will bleed easily when touched, especially when attempting to floss or brush. Gingivitis is common and completely reversible with proper professional dental cleanings and good home care. However, if left untreated, Gingivitis can turn into Periodontitis, or Periodontal Disease.

Periodontal Disease (Periodontitis)

Periodontitis, or Periodontal Disease, is an advanced form of Gingivitis. When Gingivitis is allowed to progress and the patient does not return for their routine cleanings and does not maintain proper home care, they develop Periodontal Disease, which is caused by bacteria in the mouth and under the gums. Patients with a large buildup of bacteria usually have large amounts of calculus in their mouth, which is essentially plaque that has hardened due to the excess amount of bacteria. In some cases, the Periodontitis escalates to such a point that the bone has recessed, and the teeth are held in place only by the calculus in the mouth.

Symptoms of Periodontal Disease:

  • Considerable bleeding of the gums, even when untouched.
  • Deep pockets between tooth and gum
  • An unpleasant smell
  • Looseness of teeth
  • Recession of gums
  • Discomfort and pain in teeth and gums
  • Large amounts of calculus buildup

When left untreated, the bacteria begin to eat away at the bone. The pockets, or spaces between the gum and the tooth, are measured by a Dental Hygienist in order to determine the severity and progression of the Periodontitis. This is often referred to as Perio Charting.

Depending on the diagnosis, a deep cleaning, or “scaling”, is recommended for the patient. Rather than returning for a cleaning every six months, patients with Periodontal Disease return for their scaling. During this deep cleaning, antibiotics are placed underneath the gums to stop the growth of bacteria. Due to the amount of time required for scalings and placement of antibiotics, scalings tend to be more expensive than normal cleanings. This deters many people from coming in and getting their scalings done. Many do not understand the difference between the two, and ask to have regular cleaning done. It is not uncommon for dentists or dental hygienists to refuse to do this, though do not be alarmed; this is not your dentist choosing not to help you. It is quite the opposite. In refusing to do anything but a scaling on someone, dentists and dental hygienists are looking out for the patient’s health. Normal cleaning will do nothing to prevent the progression of Periodontitis.

It is important to remember that while Periodontitis can be treated to prevent its progression, it cannot be reversed, unlike Gingivitis. It is important to maintain scalings and antibiotic placement. If the condition is allowed to worsen, tooth loss is imminent, as the weakened and recessed bone becomes unable to hold the teeth in place.

Causes of Periodontal Disease:

  • Failure to brush or floss adequately; improper home care
  • Progression of gingivitis
  • Smoking (and other use of tobacco products)
  • Genetic predispositions
  • Diabetes
  • Chemotherapy
  • Excessive use of prescription medications