Gum disease: symptoms, treatment and long-term care
Originally published
Gums that bleed when you brush or clean between your teeth should be checked. Gum disease is common and can often be managed, but advanced disease needs continuing care. It is better to seek advice early than wait for pain or loose teeth.
What causes gum disease?
Plaque is a film of bacteria that forms on teeth. If it remains around the gum line, it can cause inflammation. Hardened deposits, called tartar, need professional removal. Daily cleaning remains important after treatment.
Smoking and diabetes can increase the risk or severity of gum disease. Hormonal changes in pregnancy can make gums react more strongly to plaque. Some medicines and health conditions also affect the gums, so tell the dentist about your medical history and prescriptions.
Bleeding does not, on its own, diagnose diabetes, liver disease or a vitamin deficiency. Nor does it mean you have failed to look after yourself. The cause needs assessment, including whether your cleaning technique needs support or adjustment.
Symptoms to look out for
Bleeding, redness, swelling, persistent bad breath or an unpleasant taste can be signs of gum disease. Receding gums may expose sensitive roots. More advanced disease can cause teeth to move or become loose, but it can also progress without much pain.
Book a dental appointment for bleeding or sore gums. Seek an urgent appointment for very painful or swollen gums, pus, or teeth becoming loose. If urgent dental care is unavailable, contact NHS 111. Swelling that affects breathing or swallowing, or heavy mouth bleeding that will not stop, needs emergency help through A&E or 999.
The NHS gum disease guide explains symptoms and when to seek help.
Gingivitis and periodontitis are different
Gingivitis is inflammation of the gums without the loss of supporting bone that occurs in periodontitis. It can usually be reversed with effective daily plaque removal and professional care where needed.
Periodontitis damages the tissues that support the teeth. Treatment aims to control the disease and reduce the risk of further loss. It does not automatically restore all lost bone or gum tissue, and not every tooth can be saved. Long-term cleaning and reviews remain necessary even when symptoms improve.
A dentist checks the gums, measures the spaces around teeth and may take X-rays to assess support. You cannot reliably judge the depth or activity of a gum pocket by how it feels.
What does treatment involve?
The dental team will help you improve cleaning and address risk factors, such as smoking or diabetes control. Treatment may include removing deposits above and below the gum line, with local anaesthetic when needed.
The gums are reassessed after initial treatment. Some people need further treatment or referral to a periodontist. Surgery may be considered for selected areas that need more care; it is not the automatic next step after every scale and polish.
Antibiotics are not routine treatment for simple gingivitis or a substitute for cleaning. They may be used for particular conditions when the clinician finds an indication. Likewise, a medicated mouthwash should be used for the reason and duration advised.
Equipment such as Vector Paro can be used for professional cleaning, but the brand of instrument does not determine whether disease is cured. Ask what the treatment is intended to achieve and how the response will be monitored.
Keeping the gums stable
Brush twice daily with fluoride toothpaste and clean between the teeth every day using the method recommended for your mouth. Do not stop cleaning altogether because the gums bleed; use a gentle technique and arrange an assessment. Attend maintenance visits at the interval advised for your risk.
The Guy’s and St Thomas’ guide to advanced gum disease explains why ongoing care matters after treatment.
Costs and getting help
Costs depend on the assessment, treatment and maintenance needed. A fee for cleaning one or two arches is not automatically the cost of a complete course of periodontal care. See our current fees and ask for a written plan.
If anxiety or cost is making you postpone care, tell us when you contact the practice. We can discuss the appointment and your concerns. For possible instalments, read the current finance information; an old monthly example or a short list of requirements does not establish eligibility.