When gingivitis is left untreated, the bacteria can invade and destroy the tissues under the gums, causing advanced gum disease, or periodontal disease. “The bone supporting the teeth starts to break down, leaving the roots of the teeth exposed and sensitive in some cases,” Dr. Foyle said. “Spaces develop between the teeth, and the teeth start to get loose.”
People who smoke, have diabetes or grind their teeth have an increased chance for developing gum disease, Dr. Jeong said. Some medications, such as steroids, and certain epilepsy and cancer drugs, can also increase the risk. Genetics can also make people more or less susceptible, she noted.
People who rarely get cavities may be more likely than other people to get gum disease, too, Dr. Neiva said. That’s because the bacteria that cause gum disease outcompete and suppress the bacteria that cause cavities.
“It’s very common to see patients with very, very advanced periodontal disease not having a single cavity,” he said.
The Warning Signs, and What to Do
Gingivitis often goes unnoticed because it doesn’t cause pain. But people with gingivitis may notice that their gums bleed when they brush or floss their teeth, Dr. Neiva said. The part of the gums adjacent to their teeth may also look red rather than pink.
That said, smokers with gingivitis may not experience any gum bleeding or other symptoms, Dr. Jeong said. “People tend to think, ‘OK, my gums never bleed, I should be just fine,’” she said — but that’s a misconception.
Regular brushing and flossing can help prevent gum disease, but once gingivitis has set in, good oral hygiene at home can’t always fix the problem. That’s because the bacteria may have started to accumulate below the gum level, Dr. Neiva said. In these cases, a professional cleaning and, sometimes, antibiotics, can treat — and cure — gingivitis.
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