What Is Gum Disease? Symptoms, Stages, and Treatment Options
Most people associate dental problems with cavities — the kind of thing that hurts, gets drilled, and gets filled. But the most common serious dental condition in adults isn't cavities at all. It's gum disease, and the majority of people who have it don't know it. At Nanarao Krothapalli DMD PLLC in Londonderry, NH, we see the effects of undiagnosed and untreated gum disease regularly — and we also see how dramatically outcomes improve when it's caught and treated early. Understanding what gum disease is, how it progresses, and what can be done about it is one of the most useful things any dental patient can know.
Gum disease — clinically known as periodontal disease — is a bacterial infection of the tissues that support your teeth. It begins at the gumline and, if untreated, progresses deeper into the bone and connective tissue that hold teeth in place. It is the leading cause of tooth loss in adults in the United States, and it has been linked to a range of serious systemic health conditions including heart disease, stroke, and diabetes. The good news is that it is both preventable and treatable — especially when caught early.
The Two Stages of Gum Disease
Gum disease exists on a spectrum, and where you fall on that spectrum determines both what symptoms you're likely to experience and what treatment looks like. The two primary stages are gingivitis and periodontitis, and the difference between them is significant.
Gingivitis is the earliest and most reversible stage. It occurs when plaque — the soft bacterial film that forms on teeth — accumulates at and below the gumline and triggers an inflammatory response in the surrounding gum tissue. Gums become red, swollen, and may bleed when you brush or floss. Crucially, gingivitis is entirely reversible: with a professional cleaning and improved home care, the inflammation resolves and the gums return to health. No permanent damage has occurred at this stage.
Periodontitis is what gingivitis becomes when left untreated. As bacteria work their way deeper below the gumline, the body's immune response begins destroying the very bone and connective tissue it's trying to protect. Gum pockets deepen, teeth may become loose or shift position, and bone loss occurs — damage that is permanent and cannot be reversed. Periodontitis requires more intensive treatment than gingivitis and, in advanced cases, surgical intervention. This is why early detection matters so much.
Warning Signs to Watch For
One of the most challenging aspects of gum disease is that it's largely silent in its early stages. Many patients have gingivitis or even early periodontitis without any pain. But there are signs that should prompt you to call your dentist. Bleeding gums when brushing or flossing is one of the most common early indicators — many people assume this is normal, but healthy gums do not bleed routinely. Persistent bad breath that doesn't resolve with brushing or mouthwash is another sign that bacteria may be accumulating below the gumline.
As gum disease progresses, symptoms become more noticeable. Gums that look like they're pulling away from the teeth — making teeth appear longer than they used to — indicate recession. Teeth that feel loose or have shifted position signal that supporting bone may be compromised. Pus between teeth and gums, or teeth that are sensitive to pressure, can also indicate advanced disease. If you're experiencing any of these symptoms in the Londonderry, Derry, or Manchester area, it's worth calling us promptly rather than waiting for your next scheduled visit.
What Causes Gum Disease?
The direct cause of gum disease is the bacteria in dental plaque. When plaque isn't thoroughly removed through daily brushing and flossing, it accumulates at the gumline and hardens into tartar — a calcified deposit that can only be removed by a dental professional. The longer tartar remains, the more opportunity bacteria have to migrate below the gumline and trigger the inflammatory cascade that leads to tissue and bone destruction.
Several factors increase the risk. Smoking is one of the most significant — tobacco use reduces blood flow to gum tissue, impairs healing, and masks some of the early bleeding symptoms that might otherwise prompt a patient to seek care. Diabetes is another major risk factor, with the relationship running in both directions: uncontrolled blood sugar increases gum disease risk, and gum disease makes blood sugar harder to manage. Hormonal changes during pregnancy can also make gums more susceptible to inflammation. Genetic predisposition, certain medications that cause dry mouth, and a family history of gum disease all contribute as well.
For patients in Londonderry, Litchfield, Hudson, and Windham who have any of these risk factors, more frequent monitoring and preventive care is often recommended — every three to four months rather than every six.
How Gum Disease Is Treated
Treatment depends entirely on the stage of the disease. Gingivitis, caught at a routine cleaning, often requires nothing more than a thorough professional cleaning and improved home care habits. The gums heal on their own once the bacterial irritant is removed and inflammation subsides. Your hygienist may spend more time scaling below the gumline than usual and will likely give you specific guidance on brushing technique, flossing, and possibly the use of an antimicrobial rinse.
For early to moderate periodontitis, the standard treatment is scaling and root planing — sometimes called a "deep cleaning." This procedure goes well below the gumline, removing tartar deposits from the root surfaces of the teeth and smoothing those surfaces to discourage bacterial reattachment. Scaling and root planing is typically done in quadrants, with local anesthetic for comfort, and is followed by a re-evaluation appointment several weeks later to assess how well the gum tissue has responded. Most patients see significant improvement with this treatment.
In advanced cases where bone loss is severe or pockets remain deep despite non-surgical treatment, a referral to a periodontist for surgical intervention may be recommended. Procedures like osseous surgery or bone grafting can address more severe damage and help stabilize the condition. After any active treatment, patients with a history of periodontitis typically move to a maintenance schedule of more frequent cleanings — usually every three to four months — to prevent recurrence.
The Connection to Your Overall Health
Gum disease is not just a dental problem. The chronic inflammation and bacterial load associated with untreated periodontitis have been linked to elevated risk of cardiovascular disease, stroke, respiratory infections, and complications in diabetes and pregnancy. The bacteria from an infected mouth can enter the bloodstream and trigger inflammatory responses that affect organ systems throughout the body. For patients already managing cardiovascular disease or diabetes, treating active gum disease is an important part of comprehensive health management — not a separate or lower-priority concern.
Nanarao Krothapalli DMD PLLC — Periodontal Care in Londonderry
Gum disease is common, but it doesn't have to become serious. With regular monitoring and prompt treatment when needed, most patients can maintain healthy gums for life. The most important thing is staying consistent with your dental care and communicating openly with your dental team about any symptoms you're noticing at home.
If you have concerns about your gum health — or if it's simply been a while since your last visit — contact Nanarao Krothapalli DMD PLLC today to schedule an evaluation. We serve patients from Londonderry, Derry, Manchester, Litchfield, Hudson, Windham, and Auburn. Call us at (603) 432-6430 or visit us at 25 Nashua Rd #3, Londonderry, NH 03053. Learn more about our preventive dentistry services and how we help patients stay ahead of gum disease year-round.
