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Gum Disease: Gingivitis, Periodontitis and What to Do

Bleeding gums are the most common early sign of gum disease. Caught early it can be reversed; left alone it can damage the bone that holds your teeth. Here is how to spot it, treat it and prevent it.

Updated September 2026·By the OHA editorial team·7 min read·How we write
Key takeaways
  • Gum disease is caused by plaque building up along the gumline. The early stage, gingivitis, can be reversed with good cleaning and a professional clean.
  • The advanced stage, periodontitis, damages the bone that holds teeth in place. It cannot be reversed, but treatment can stop or slow it.
  • Bleeding, red or swollen gums are the usual first signs. Gum disease is often painless, so regular check-ups matter.
  • Smoking is a major risk factor, and people with diabetes are at higher risk.
  • Brush twice a day, clean between your teeth every day, do not smoke and see a dentist regularly.

Gum disease is where the gums become red, swollen and sore, and bleed. The NHS describes it as very common but says it is important to get it checked by a dentist. The good news is that the early stage can be reversed, and advanced gum disease can be controlled with treatment and good daily care.

What is gum disease?

Gum disease (also called periodontal disease) is inflammation of the tissues that surround and support your teeth. It is caused by plaque, a sticky layer of bacteria that builds up on the teeth and along the gumline. healthdirect Australia explains that if plaque is not brushed off it can harden into tartar (also called calculus), which can only be removed by a dental professional.

Gingivitis: the early stage

Gingivitis is the mildest and most common form. The gums become red and swollen and may bleed easily when you brush. healthdirect and the US Centers for Disease Control and Prevention (CDC) both describe it as reversible, and the American Dental Association says it can usually be eliminated by a professional clean followed by daily brushing and cleaning between the teeth.

Periodontitis: the advanced stage

If gingivitis is not controlled, the inflammation can progress to periodontitis. The Australian Dental Association explains that bacteria damage the gums and the bone that support the teeth, creating pockets (spaces) under the gums around the teeth. Over time teeth can become loose, move, or be lost. The American Dental Association describes gum disease as a major cause of tooth loss in adults.

Periodontitis cannot be reversed, but it can be controlled. healthdirect says that with treatment the bone loss may become very slow or stop, and the CDC says it can be slowed down and managed.

How common is it?

Very common, though the figures vary. In Australia, healthdirect says 3 in every 10 adults have moderate to severe periodontitis, while the Australian Dental Association says periodontitis affects around 1 in 4 adults; the two do not agree exactly. In the US, the American Dental Association says chronic periodontitis affects 47.2% of adults over 30.

What are the signs of gum disease?

Signs listed by the NHS, healthdirect, the American Dental Association and the US National Institute of Dental and Craniofacial Research (NIDCR) include:

  • gums that bleed when you brush, floss or eat hard foods such as apples
  • red, swollen or tender gums
  • bad breath or a bad taste in your mouth that will not go away
  • gums shrinking back from the teeth, making the teeth look longer
  • sensitive teeth
  • loose teeth, or teeth that move or separate
  • pain when chewing
  • a change in the way your teeth fit together when you bite, or in the fit of a partial denture

Gum disease is often painless. The American Dental Association notes that you may not know you have it, and the Australian Dental Association says periodontitis does not usually cause pain. This is one reason regular check-ups matter.

What increases the risk?

Plaque is the cause, but the health bodies list several things that make gum disease more likely or more severe.

  • Smoking. The NIDCR says smoking or using tobacco is the most significant risk factor, and that tobacco can delay healing and make treatment less successful.
  • Diabetes. See the section below.
  • Family history and genetics.
  • Hormonal changes, such as puberty, pregnancy or menopause.
  • Stress, poor nutrition and drinking alcohol.
  • Some medicines, including those that cause a dry mouth. The American Dental Association lists steroids, some anti-epilepsy drugs, some cancer treatments, some calcium channel blockers and oral contraceptives.
  • Crooked teeth that are hard to keep clean, and grinding or clenching.
  • Older age. The NIDCR also says gum disease is more common and more severe in men.

Gum disease and diabetes

The link with diabetes runs both ways. The Australian Dental Association says people with diabetes have a greater risk of periodontitis, particularly when blood glucose levels are not within the recommended range, and that people whose diabetes is well managed have the same risk as people without diabetes. It also says there is scientific evidence that periodontitis may make blood glucose levels worse. The CDC says untreated periodontitis can make chronic conditions such as diabetes worse. The NHS advises regular dental check-ups, especially if you have type 2 diabetes.

Does treating gum disease help diabetes? The sources differ on how long any benefit lasts. The Australian Dental Association says treatment has shown a mild improvement in blood glucose levels that lasted only three months, with longer-term studies under way. A 2022 Cochrane review of 35 trials found moderate-certainty evidence that deep cleaning below the gumline improved blood glucose control (measured by HbA1c) at 3 to 4 months and at 6 months, with a single study showing a benefit at 12 months. If you have diabetes, tell your dentist, and look after both your gums and your diabetes.

Is gum disease linked to other health problems?

The evidence here is less certain, and the sources describe it with different degrees of confidence. healthdirect says there is growing evidence that poor oral health is linked to heart disease, diabetes, stroke, lung conditions and mouth cancer. The American Dental Association is more cautious: it says research is ongoing and, while a link is not conclusive, some studies suggest severe gum disease may be associated with conditions such as diabetes or stroke. A 2022 Cochrane review looking at whether treating periodontitis prevents heart and blood vessel disease found only two small, unreliable studies and could not draw any conclusions.

In short: an association has been reported, but there is not yet good evidence that treating gum disease prevents heart disease or stroke.

How is gum disease treated?

Treatment depends on how severe it is. A dentist or hygienist will examine your gums and may measure the pockets around your teeth with a small probe. The NIDCR says healthy pockets are usually 1 to 3 millimetres deep, and deeper pockets can be a sign of periodontitis. X-rays can show bone loss.

In the early stages, the NHS says your dentist will:

  • give you advice on keeping your teeth clean, such as using interdental brushes
  • advise you to stop smoking, if you smoke
  • advise you to have your teeth cleaned by a hygienist

For more serious gum disease, the NHS says you may need:

  • a deep clean under the gums (sometimes called scaling and root planing)
  • antibiotics
  • some teeth removed
  • gum surgery

You may be referred to a periodontist, a dentist who specialises in gum disease. Whatever the treatment, the NIDCR says good daily care at home is essential, and the Australian Dental Association describes periodontitis as a chronic disease that needs lifelong care.

How can you prevent gum disease?

The NHS advises:

  1. Brush your teeth with fluoride toothpaste at least twice a day. Spit after brushing, do not rinse.
  2. Clean between your teeth every day with floss or interdental brushes.
  3. See a dentist and hygienist for regular check-ups.
  4. Do not use mouthwash straight after brushing.
  5. Do not smoke.
When to see a dentist
  • Your gums bleed when you brush your teeth or eat hard foods.
  • Your gums are painful, red or swollen.
  • You have bad breath that does not go away.
  • Your gums seem to be shrinking back, or your teeth feel loose.
  • Your child has sore, bleeding gums.
Get help urgently
  • Ask for an urgent dental appointment if you have gum disease with very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip (NHS advice).
  • Gum disease can lead to a dental abscess. Get emergency medical care straight away if you are finding it hard to breathe, speak or swallow, have a lot of swelling in your mouth, or a swollen or painful eye. In the UK the NHS says to call 999 or go to A&E.

Frequently asked questions

Can gum disease be cured?

Gingivitis can be reversed without lasting damage. Periodontitis cannot be cured, but healthdirect says it can be controlled and the bone loss may become very slow or stop.

Should I stop brushing if my gums bleed?

No. healthdirect explains that bacteria in plaque irritate the gums and make them bleed, and says to keep brushing gently twice a day even if brushing causes bleeding. Clean between your teeth as well, and see a dentist: the Australian Dental Association says it is important to visit a dentist if your gums bleed when cleaning your teeth or eating.

Can I have gum disease without knowing?

Yes. The American Dental Association says it is possible to have gum disease with no warning signs, which is one reason regular dental check-ups are important.

Sources

  1. Gum disease, NHS, accessed September 2026
  2. Dental abscess, NHS, accessed September 2026
  3. Gum disease, healthdirect Australia, accessed September 2026
  4. Gum diseases, Australian Dental Association, accessed September 2026
  5. Diabetes, Australian Dental Association, accessed September 2026
  6. Gum disease, American Dental Association (MouthHealthy), accessed September 2026
  7. Periodontal (gum) disease, NIH National Institute of Dental and Craniofacial Research, accessed September 2026
  8. Periodontal (gum) disease, Centers for Disease Control and Prevention, accessed September 2026
  9. Does treatment for gum disease help people with diabetes control blood sugar levels?, Cochrane (Simpson and others, 2022), accessed September 2026
  10. Treating chronic gum inflammation (periodontitis) to prevent heart and blood vessel (cardiovascular) disease, Cochrane (Ye and others, 2022), accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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