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Gum disease is one of the most common conditions there is, and one of the easiest to miss. It is usually painless in its early stages. By the time it becomes uncomfortable, it has often been progressing for years.
The useful thing to know is that the first stage is reversible. The later one is not.
The signs that come first
Bleeding when you brush or clean between your teeth. This is the earliest and most reliable sign, and it is the one most people explain away. Healthy gums do not bleed when cleaned. Bleeding is not a reason to clean that area less.
Red or puffy gum margins. Healthy gum is firm and sits in a neat point between the teeth. Its colour varies between people — many people naturally have evenly brown or darker gums, and that is normal. What matters is a change from your own normal: inflamed gum looks redder, rounder and slightly swollen, and loses that neat point.
Persistent bad breath or a bad taste that comes back soon after brushing.
Tenderness along the gum line, particularly when brushing.
The signs that come later
These suggest it has moved beyond the reversible stage:
- Gums receding, so teeth look longer
- Gaps opening between teeth that were not there before
- Teeth feeling loose or shifting position
- A change in how your teeth meet when you bite
- Discomfort or discharge around the gum
Gingivitis and periodontitis
Gingivitis is inflammation of the gum alone. Plaque sits at the gum margin, the gum reacts, it bleeds. Nothing has been lost. With consistent cleaning it typically settles within one to two weeks and the gum returns to normal.
Periodontitis is what can follow if that inflammation continues. It affects the bone and fibres that hold the tooth in place, and that loss is permanent. Treatment can halt it and keep the teeth stable for decades, but it does not grow the support back — in a few specific kinds of deep, narrow defect a specialist can regain some of it surgically, and that is the exception rather than the thing to plan for.
The line between the two is the reason the early signs are worth taking seriously.
What raises the risk
- Smoking, which is the single biggest modifiable factor — and which also masks bleeding, so the condition advances with fewer warning signs
- Diabetes, particularly when poorly controlled
- Certain medicines, especially those that cause a dry mouth
- Hormonal changes, including pregnancy
Weaker, but worth knowing: a family history of gum disease or early tooth loss, and stress. The evidence on both is thin, so treat them as a reason to be thorough rather than a verdict.
- Certain medications, especially those causing a dry mouth
- Hormonal changes, including pregnancy
What to do about it
For early gum inflammation, the answer is unglamorous and effective:
- Clean between the teeth once a day, every day
- Brush for two minutes twice a day, angled into the gum line
- Expect bleeding to increase slightly for a few days, then settle
- Give it two weeks
If bleeding continues past that, or if any of the later signs are present, have it assessed. Gum inflammation on its own makes the gum swell, which deepens the space around the tooth without anything having been lost — so the measurement by itself does not settle it. Telling gingivitis from early periodontitis means measuring whether the attachment has moved down the root, usually with an X-ray to see the bone level.
The exception, which does not wait two weeks
Everything above is the picture for ordinary gum inflammation, which is usually painless. Two gum problems are not, and neither of them is a two-week problem.
Bleeding gums are not normal, and they are not a reason to stop cleaning. They are the earliest warning you get, at the stage where it can still be undone.
