Gum disease occurs due to inflammation or infection in the gum and the bone surrounding and supporting the teeth. In its initial stage (gingivitis), the gums are red and swollen and may bleed. However, in its aggravated form (periodontitis), the bone is lost, and the gums pull away from the tooth. Consequently, the teeth fall or loosen. Tooth decay and gum disease are the two most significant threats to oral health.

Causes
Typically, gum disease commences with plaque development, a sticky film composed of bacteria. If not treated, plaque aggravates and causes periodontitis in the following manner:

• Plaque develops
  Plaque develops on the teeth when sugars or starches in the food interact with the bacteria in the mouth. Brushing twice daily and flossing once daily can help remove plaque, but it usually returns.
• Plaque hardens
  If it continues to stay on the teeth, plaque hardens under the gumline, turning into tartar. Tartar is tricky to remove. In most cases, it cannot be eliminated with flossing and brushing, and the patient needs professional dental assistance. Since tartar and plaque contain bacteria, the longer they cling to the teeth, the more damage they do.
• Plaque leads to gingivitis
  Plaque leads to gingivitis, a mild form of gum disease. Gingivitis is a swelling and irritation of the gum tissue around the teeth’s base. Fortunately, it can be reversed with good at-home dental care and professional treatment. However, reversal is possible only if individuals treat it before experiencing bone loss.
• Gingivitis aggravates into periodontitis
  If gingivitis is not treated, it can lead to a severe form of gum disease, periodontitis. It occurs when plaque, bacteria, and tartar-filled pockets deepen over time. If not treated, these deep infections cause bone and tissue loss, and individuals may lose one or more teeth. Further, ongoing inflammation can strain the immune system, resulting in other health problems. Periodontal disease is typically seen in adults.

Some factors can aggravate one’s risk of developing gum disease. These include:

• Gingivitis
• Hormonal changes like those related to menopause or pregnancy
• Poor dental care habits
• Nutrition plans low in vitamin C
• Genetics
• Diseases like Crohn’s disease, rheumatoid arthritis, and diabetes
• Conditions that lower immunity, such as cancer, HIV/AIDS, or leukemia
• Using treatments that cause gum changes or dry mouth

Symptoms
Typically, the symptoms vary depending on the stage of gum disease. The general indicators include the following:

• Receding gums
• Bad breath
• Gums that bleed during flossing or brushing
• Tender, red, or swollen gums
• Changes in teeth position
• Tooth loss
• Foul taste in the mouth
• Tartar or plaque build-up on the teeth
• An inflammatory response across the body
• Pain when chewing

The symptoms are not very apparent in the early stage, and only a dentist can point them out.

Diagnosis
Usually, dentists diagnose gum diseases during routine examinations. They look for plaque build-up on the teeth and inquire about the patient’s symptoms. If a problem is detected, they refer the individual to a gum specialist or periodontist for further checks.

The periodontist assesses the pockets around the teeth with a periodontal probe. The tool helps examine how much bone a person has lost around the teeth. Naturally, the deeper the pockets, the more severe the gum disease. Further, the periodontist evaluates the patient’s bite, how much their gums pull away from the teeth, and how loose their teeth are. Following this, they perform dental X-rays to confirm the diagnosis. X-rays produce detailed images of the areas where bone loss has occurred.

Treatment options
Treatment helps eliminate the bacteria from the teeth pockets and prevent further bone and tissue destruction. Here are some of the best treatment options for gum disease:

• Cleaning and scaling
  Removing plaque helps restore periodontal health. The expert may first clean the area with fluoride and then perform debridement and scaling of teeth surfaces above the gum line and in the pockets. They may then polish and smoothen rough areas on the teeth to prevent further plaque build-up. The frequency of cleaning typically depends on how much tartar and plaque accumulate.
• Surgery
  The dentist may advise periodontal surgery if other treatment options do not work. It helps remove root bacteria (the bacteria on the roots of the teeth) and eliminate plaque bacteria in pockets. Surgery may also involve restoring lost bone and gum tissue. Dentists perform these procedures after administering a treatment to numb the affected region of the mouth.

Besides these treatments, gum disease can be managed with special mouthwashes, gels, and rinses. They help maintain oral hygiene and relieve pain and discomfort.