Understanding Gum Disease: Signs, Stages, and Treatment

Gum disease is the leading cause of tooth loss in adults worldwide — and it is almost entirely preventable. The challenge is that early gum disease causes little to no pain, meaning most people do not realise they have it until significant damage has occurred.

Stage 1: Gingivitis

Gingivitis is the mildest form of gum disease, caused by plaque build-up along the gum line. Signs include red, swollen gums that bleed when you brush or floss. At this stage, there is no permanent damage and the condition is fully reversible with improved hygiene and a professional clean.

Stage 2: Mild Periodontitis

If gingivitis is left untreated, bacteria begin to attack the bone supporting the teeth. Pockets form between the gum and tooth root, becoming traps for more bacteria. X-rays may reveal early bone loss. Treatment requires a deep clean (scaling and root planing) under local anaesthetic.

Stage 3: Moderate Periodontitis

Bone loss is more significant and teeth may begin to feel loose or shift slightly. Sensitivity to temperature increases. Treatment involves multiple rounds of deep cleaning and possibly antibiotics.

Stage 4: Severe Periodontitis

Severe bone and tissue loss puts teeth at high risk of falling out. Surgical intervention — including flap surgery or bone grafts — may be required to save remaining teeth. Extractions may be unavoidable in some cases.

Risk Factors

Smoking is the single greatest modifiable risk factor, doubling the likelihood of gum disease. Diabetes, hormonal changes in pregnancy, certain medications that dry the mouth, and a genetic predisposition also significantly increase risk.

• Bleeding gums are never normal — they are always a sign of inflammation.
• Bad breath that persists despite brushing can indicate active gum disease.
• Receding gums expose root surfaces that are more vulnerable to decay.
• Gum disease is linked to heart disease, diabetes complications, and preterm birth.
• Once bone is lost to periodontitis, it does not regenerate without intervention.

Early detection is everything. If your gums bleed even occasionally, book a check-up — it takes minutes to assess and could save your teeth for life.