Gum disease, also known as periodontitis, is an infection that affects the soft tissues surrounding the teeth and gums. Since gum disease is progressive, it can destroy the jawbone and lead to tooth loss if left untreated.
Periodontal disease is more common than you might think and is usually caused by poor oral hygiene.
“Periodontal disease is the leading cause of tooth loss in adults and is associated with systemic conditions such as diabetes and heart disease. Early diagnosis and treatment are essential.”
American Academy of Periodontology (AAP)
What are the different types of gum disease?
Gum disease isn’t always painful, so you might have it without realizing it, which allows it to progress. Understanding the mild to severe types of the condition can help prevent this.
Gum disease can be categorized into two main types and stages:
Gingivitis
Mild inflammation of the gums, characterized by redness, swelling, and bleeding. Gingivitis is the earliest stage of gum disease and is considered the mildest and most common form of periodontal disease.
It is often referred to as gingivitis rather than gum disease. This condition affects the superficial layers of the gums, particularly where the gum tissue meets the teeth.
At this stage, the deeper parts of the gums, teeth, and bones remain unaffected. The most important symptoms of gingivitis are bleeding gums (especially when brushing or eating), redness, and swelling.
This type of gum disease usually targets the following people:
- Women who are pregnant.
- Women who take birth control pills.
- People with uncontrolled diabetes.
- People who take steroids.
- People who take medication to control seizures and blood pressure.
If your gums are red and swollen, it is natural to be concerned, but do not stop brushing your teeth unless you plan to see a dentist immediately. Instead, use a soft-bristled toothbrush to remove the bacteria and plaque that cause gum disease.
See your dentist if your gums don’t improve after a few days and continue to bleed. Fortunately, gingivitis is not life-threatening, so it’s easily treatable.
Simple home remedies and professional cleaning at your dentist’s office can significantly improve the condition. Antibiotics or mouthwashes may also be prescribed to kill any remaining bacteria and help heal decay.
Periodontitis
Advanced inflammation of the gums and bone can lead to loosening and loss of teeth. Periodontitis is an advanced stage of various gum diseases that can occur if gingivitis is not treated.
The periodontium refers to the structures surrounding and supporting the teeth, including the gums and bone. The gums form a protective covering around the roots of the teeth and safeguard the periodontium.
In this way, periodontitis is an inflammation of the periodontium caused by plaque bacteria and the body’s immune system’s response to it. The structures affected by this gum disease are:
- The upper part of the tooth root, or cementum
- The periodontal ligament (the bone and fibers that attach the tooth root to the bone)
When the seal created by the gums is damaged, a space is made between the tooth root and this soft tissue. These spaces are called periodontal pockets.
Bacteria become trapped in these pockets, further damaging the periodontium. Over time, the bone is damaged and lost, creating a larger space between the tooth and the gum.
These gaps may appear as black triangles between the teeth, which can be challenging even for a specialist to restore.
If this gum disease is left untreated, the structures that hold the teeth firmly in the gums may be damaged to the point that the teeth become loose and painful, leaving them to be extracted.
“Advanced periodontitis can destroy the bone and tissues that support the teeth, leading to tooth loss if left untreated. Professional intervention is crucial.”
Centers for Disease Control and Prevention (CDC)
Other Types of Gum Disease
We have explained this soft tissue’s most important groupings and stages of diseases. However, when introducing the types of gum disease, other conditions are also mentioned:
Chronic Periodontitis
Chronic periodontitis is another common form of this disease, which primarily affects middle-aged people.
Among the signs of this disease are inflammation below the gum line and progressive destruction of the gum and bone tissue, which makes it seem that the teeth are growing while the gums are receding.
Unfortunately, unlike gingivitis, chronic periodontitis cannot be completely reversed, but its progression can be managed with proper treatment.
The destroyed supporting and protective tissues of the gums cannot regenerate. However, the dentist can stop its progression with scaling, root planing (deep teeth cleaning), and antimicrobial treatments.
Depending on the patient’s condition, a series of surgeries to reduce periodontal pockets and bone grafting may also be necessary to treat chronic gum disease.
Aggressive Periodontitis
The rapid loss of gum attachment and bone tissue is the primary symptom of this condition. In other words, this disease is chronic periodontitis that progresses much faster.
Smokers and those with a family history of aggressive periodontitis are at higher risk of developing the condition. Treating aggressive gum disease is similar to treating a chronic condition, but surgery is likely required.
It is challenging to stop and treat the disease. However, your dentist may use scaling, root planing, and other procedures to preserve gum tissue and bone.
Periodontitis Due to Systemic Diseases
Gum disease is a symptom of a disease or condition that affects the rest of the body. Depending on the underlying condition, it can behave like aggressive periodontitis, rapidly destroying gum tissue and even bone.
Heart disease, diabetes, and respiratory diseases are the most common systemic diseases affecting the gums (although there are many others). Even in cases where plaque on the teeth is very light, many diseases can worsen gum disease.
In this case, the underlying problem must first be controlled before aggressive and chronic periodontitis treatments can be used to stop and improve the disease.
Necrotizing Periodontitis
This type of gum disease gets worse quickly. It is more common in people with HIV, immunosuppression, malnutrition, chronic stress, and smokers. Tissue death (necrosis) usually affects the periodontal ligament, gum tissue, and alveolar bone.
Necrotizing periodontitis is rare, and its treatment requires a multidisciplinary approach. Because it may be associated with other serious conditions (as mentioned), your dentist will likely consult with your doctor before starting treatment.
Scaling, root planing, antibiotics, medicated mouthwashes, and antifungal medications are the options for this condition.
Symptoms of Gum Disease
How Do You Know If You Have Gum Disease?
The most common symptoms of gum disease include:
- Red or purple, swollen, and tender gums that may cause mouth sores
- Bleeding and pain when brushing, flossing, or eating hard foods
- Gum recession (when the gums pull away from the teeth)
- Loose or shifting teeth
- Persistent bad breath (halitosis)
- A bad taste in the mouth
- Pus between the teeth and gums
- Recently worn dentures
- Changes in the alignment of the bite and jaw
If you notice any of these symptoms, visit your dentist immediately for diagnosis and treatment.
Preventing Gum Disease
Regular brushing (by removing plaque) goes a long way toward preventing gum disease. Remember to:
“The most effective way to prevent gum disease is through daily brushing and flossing, along with regular visits to a dentist for check-ups and cleanings.”
Source: American Dental Association (ADA)
- Brush your teeth thoroughly along the gum line at least twice daily.
- Replace your toothbrush every three to four months.
- Use dental floss, an interdental brush, or another tool recommended by your dentist.
- Visit a specialist twice a year for a complete dental check-up.
- Use antibacterial mouthwash.
- If you wear dentures or false teeth, clean them every day. Plaque can quickly build up on dentures, increasing your risk of gum disease around your natural teeth.
- Quit smoking (and using other tobacco products)
- If you have diabetes, controlling your blood sugar levels can help reduce the risk of periodontal disease.
- Be more careful with your diet. For example, avoid sugary foods and drinks, especially between meals.
- Drink plenty of water (fluoridated if possible).
- And finally, visit a specialist twice a year for a complete dental check-up.
Conclusion
In this article, we learned about the types of gum disease. Note that gum disease treatment includes scaling, root planing, antibiotics use, and gum surgery in advanced cases.
Maintaining oral hygiene and visiting the dentist regularly are the most important ways to prevent this disease.
It is best to consult a dentist whenever your gums are bleeding, sensitive, or severely swollen. See your dentist as soon as possible to find the cause of your gum disease and treat it.
Sources:
https://www.perio.org/consumer/periodontal-disease-fact-sheet
https://www.mouthhealthy.org/en/az-topics/g/gum-disease
https://www.mouthhealthy.org/en/az-topics/g/gum-disease