Have you seen a bit of blood in your sink when you brush your teeth lately? That bleeding can be one of the first warning signs that you’ve got gum disease.

The mild variety is called gingivitis. When you have that, only your gums are infected. If you don’t treat it, the infection can travel below your gum line and into your bone. Then it becomes a more serious form of gum disease called periodontitis.

Both gingivitis and periodontitis have been shown to raise your risk of things like diabetes, heart disease, osteoporosis, pneumonia, and cancer. Early detection is your best bet.

Symptoms

You can find and treat the problem before it gets serious if you know what to look for. Take note if you notice:

 

Red, swollen gums: That’s one of the first signs your gums need attention. “Gum diseases typically start with inflammation along the gum line,” says Erik Sahl, DDS, assistant professor of periodontics at Loma Linda University. They may also feel tender or painful and bleed easily when you floss or brush.

 

Bad breath: Your mouth is a nice, warm, and wet home for millions of bacteria. They feed on plaque, so the more of that you have, the bigger the buffet. “Bacteria release toxins that can irritate the gums and teeth and have a foul smell,” Sahl says.

It can also be a symptom of serious gum disease. Your breath usually doesn’t change much if you’ve got gingivitis.

Gums that get smaller: If your teeth look longer than they used to, chances are they’re not growing -- your gums are shrinking.

“[When] bone starts to break down, the gums start separating from the tooth, creating a pocket,” Sahl says. This pulling away is called receding gums.

Sensitive teeth: If a sip of a cold drink makes you wince, your teeth may be telling you something. That’s a symptom of gum disease that often goes hand in hand with shrinking gums. “With receding gums, the sensitive part of the tooth is exposed -- called the dentin -- causing sensitive teeth when exposed to cold water and air,” Sahl says.

Wiggly or shifting teeth: Does your smile look a little different lately? Gum disease can attack the bones that hold your teeth in place, making them loosen or move. Periodontitis is the main cause, and it can even change the way your teeth fit together when you bite.

Treatment

The goal is to control your infection. Your dentist will look at what’s affected to figure out where to start.

Deep cleaning: The first line of treatment for gum disease is a careful, in-depth cleaning.

Unlike a regular cleaning, which is usually only done above the gum line, deep cleaning goes under the gum line. The dentist will also use special instruments, Sahl says.

Your dentist can do something called scaling. That’s scraping off tartar both above and below your gum line. She may also do something called root planing. That’s when the rough surfaces of the roots of your teeth are smoothed out. It helps the gums reattach to your tooth.

Both methods may take more than one visit to the dentist.

Medication: There’s no magic pill or cream that can cure gum disease, Sahl says. Still, your dentist may prescribe medication as part of your treatment.

Options include:

Antiseptic chip or antibiotic microspheres: You insert these tiny gels or particles into pockets in your gum, and they release medication slowly over time to help reduce the size of the pocket and get rid of bacteria.

Antibiotic gel: You spread this on gum pockets after a deep cleaning to help control infection.

Enzyme suppressant: You take this tablet after a deep cleaning to block certain enzymes in your mouth from breaking down gum tissue.

Oral antibiotics: For more serious infections, you can swallow these capsules or tablets.

Surgery: If deep cleaning can’t take care of the whole problem, you may need to go deeper to fix it. Your dentist may recommend:

Gum graft surgery: A surgeon takes tissue from another part of your mouth (like your palate) and covers any exposed tooth roots to prevent bone loss or decay and help sensitive teeth.

Flap surgery: Your gums are lifted up so the surgeon can get at tartar deep underneath your gum line. Then she stitches your gum back in place so it’s tight around the tooth to help prevent more tartar from forming.

Your dentist may also recommend antimicrobial mouthwash You swish this in your mouth as part of your daily brushing routine to help control bacteria. It’s available both by prescription and over-the-counter.

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