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Gum Health Guide

Signs of gum disease: what to watch for

Gum disease often develops without pain. Knowing the early signs means catching it when it’s easiest to treat.

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Signs of gum disease: what to watch for
Early signs (gingivitis)

What early gum disease looks and feels like

Bleeding when you brush or floss

The most common early sign. Healthy gums don’t bleed. If yours do, they’re inflamed, typically from bacteria built up at or below the gumline.

Red, swollen or puffy gums

Healthy gum tissue is firm and pink. Inflammation changes both the color and texture.

Persistent bad breath

Bacteria below the gumline produce odor that brushing doesn’t fix. If it keeps returning despite good home care, get your gums checked.

Advanced signs (periodontitis)

Signs the disease has progressed

Gums pulling away from teeth

Recession exposes more of the root. Once gum tissue pulls back it doesn’t grow back, though the disease can still be stopped.

Loose or shifting teeth

Bone loss weakens the support structure. Looseness or a change in your bite is a later-stage sign.

Deep pockets or pus

Pockets deeper than 3mm mean the disease has moved below the gumline. Pus is a sign of active infection.

Sensitivity to hot and cold

Receding gums expose root surfaces, which are more sensitive than enamel.

Don’t ignore it

Bleeding when you brush is not normal

The most common reason people delay care is believing some bleeding is just part of brushing. It’s not. Bleeding means the tissue is inflamed, and the earlier it’s addressed, the simpler the treatment: gingivitis is still reversible before it becomes periodontitis.

The direct cause is bacterial plaque. When it isn’t fully removed, it hardens into tartar at and below the gumline, which only professional instruments can remove. See plaque vs. tartar for more.

Risk factors

  • Genetics Some people are more prone
  • Smoking and tobacco A top risk factor
  • Diabetes Raises inflammation
  • Dry mouth Less saliva, more bacteria
  • Hormonal changes Pregnancy, puberty, menopause
FAQ

Common questions

Are bleeding gums always a sign of gum disease?
Almost always they signal inflammation, the first stage of gum disease. Occasionally brushing too hard or starting to floss after a long break causes bleeding, but if it lasts beyond a week or two, it’s worth having your gums evaluated.
Can gum disease be reversed?
Gingivitis is fully reversible with professional treatment and consistent home care. Once it progresses to periodontitis and causes bone loss, the damage can’t be undone, but the disease can still be controlled and stopped from progressing.
Does gum disease hurt?
Often, no. That’s one reason it goes undetected. Early gum disease typically causes no pain, which is why regular exams are the most reliable way to catch it.
Can receding gums grow back?
Gum tissue doesn’t grow back naturally once it recedes. In some cases a gum graft can restore it, and we do gum grafting right here in our office. Either way, the first step is stopping the disease that caused the recession.
How is gum disease diagnosed?
Your hygienist or dentist uses a small probe to measure the pockets between your gums and teeth. Healthy pockets measure 1–3mm; 4mm or more indicates gum disease. X-rays also show bone levels to assess how far it has progressed.
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