Gum Disease

Gum disease (periodontal disease) is inflammation and destruction of the tissues that support the teeth. It starts as gingivitis — reversible, painless, bleeding gums — and can progress to periodontitis — bone loss around teeth, loose teeth, eventual tooth loss. It is extremely common in Indian adults and strongly linked with diabetes and heart disease.

Early signs

• Gums that bleed when brushing or flossing. Healthy gums don't bleed.
• Red, swollen, tender gums.
• Bad breath that doesn't go away with brushing.
• Gums pulling away from teeth (looking "longer").
• New gaps between teeth, loose teeth, change in bite.

What drives it

• Plaque and calculus (tartar) buildup — bacterial biofilm around the gumline. Once hardened into calculus, only a dentist can remove it.
• Diabetes — a two-way relationship: diabetes worsens gum disease, and gum disease worsens sugar control. Good dental care is part of diabetes management.
• Tobacco — the second biggest risk; slows healing, masks bleeding (which makes it easier to miss), increases tooth loss.
• Pregnancy and hormonal changes.
• Some medicines (calcium-channel blocker class, anti-seizure drugs, immunosuppressants).
• Genetic susceptibility.
• Poor nutrition, chronic stress, poor sleep.

Treatment

• Professional scaling ("cleaning") — removes plaque and calculus above the gumline. Often enough for gingivitis.
• Root planing / deep scaling — below the gumline; needed for established periodontitis, sometimes under local anaesthesia.
• Periodontal surgery for deep pockets and bone loss.
• Adjunct antibiotic rinses or short courses in selected cases.
• Replace missing teeth — implants/bridges/dentures — only after gum disease is controlled.
• Myth to drop: "scaling weakens teeth" — false. Scaling removes the tartar that was hiding the tooth; teeth are not damaged.

Prevention and daily care

• Twice-daily fluoride brushing + daily flossing is the core.
• Dental check every 6–12 months — dentists clean off the calculus that brushing can't.
• Quit tobacco.
• Manage diabetes — HbA1c control visibly improves gum healing.
• Electric toothbrushes and interdental brushes are useful for people struggling with technique.