Gum disease (periodontitis): signs, causes and treatment
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Gum disease starts when bacterial plaque on the teeth inflames the gums. Its early stage, gingivitis, can be reversed with good home care and professional cleaning; left untreated it can progress to periodontitis, which affects the bone that holds the teeth. The WHO estimates that severe periodontal disease affects more than 1 billion cases worldwide.
Gingivitis vs periodontitis
Gingivitis is inflammation of the gums only: redness, swelling and bleeding when brushing. There is no bone loss and it improves with good oral hygiene.
In periodontitis the inflammation spreads to the supporting tissues and jawbone. Gum pockets deepen, gums recede and in advanced stages teeth can become loose.
Signs to look out for
The NHS describes bleeding gums as the most common early sign and recommends regular dental check-ups even without symptoms.
- Bleeding when brushing or eating hard foods
- Red, swollen or sore gums
- Persistent bad breath
- Receding gums, teeth looking longer
- Loose teeth or a change in your bite
Causes and risk factors
The main cause is plaque that is not removed and hardens into tartar. Smoking, poorly controlled diabetes, stress, some medicines and genetic susceptibility increase the risk.
Links with general health
A joint consensus report of the European Federation of Periodontology and the International Diabetes Federation describes a two-way relationship between periodontitis and diabetes: uncontrolled diabetes worsens gum disease, while periodontal treatment can help blood-sugar control.
A 2020 consensus report summarises evidence of an independent association between periodontitis and cardiovascular disease – one more reason to treat gum health as part of general health.
How is it treated?
- Examination, pocket measurement and X-rays if needed
- Scaling and home-care instruction
- Root planing (deep cleaning) under local anaesthesia
- Re-evaluation after 4–8 weeks
- Gum surgery and regular maintenance in advanced cases
Prevention
- Brush at least twice a day with fluoride toothpaste
- Clean between your teeth every day
- Stop smoking
- Have check-ups and professional cleaning as advised by your dentist
Frequently asked questions
Are bleeding gums normal?
No. Bleeding is usually a sign of gum inflammation and should be checked by a dentist.
Can periodontitis be cured?
Lost bone does not grow back by itself, but treatment and regular maintenance can usually stop the disease from progressing.
Can I have gum treatment during a short trip to Istanbul?
Initial treatment usually takes 1–2 sessions; a review is needed a few weeks later, which can be planned with your dentist at home or on a later visit.
Sources
- Oral health – Fact sheet — World Health Organization (WHO), 2025
- Gum disease — NHS (UK National Health Service)
- Scientific evidence on the links between periodontal diseases and diabetes: Consensus report (IDF & EFP) — Sanz M. et al., Journal of Clinical Periodontology 45(2), 2018
- Periodontitis and cardiovascular diseases: Consensus report — Sanz M. et al., Journal of Clinical Periodontology 47(3), 2020
This article is for general information only; diagnosis and treatment require an examination by a dentist.
