Gum disease or periodontal disease, as dentists call it, is caused by plaque, the film of bacteria that collects on teeth.  Gum disease involves the inflammation of the gums followed by infection.  Periodontal disease is usually painless making it harder to detect.

In its early stages just the gum is affected, with the gums becoming inflamed and appearing red and swollen.  The gums will bleed easily and the bleeding can often be noticed on brushing.  You may also notice bad breath.  At this stage if you get rid of all the plaque and keep it away, by careful brushing, flossing and perhaps the use of mouthwashes as well, your gums should return to normal.

If the disease is not stopped it will spread down beneath the gum, at which point the gums may become more swollen and bleed more often.  The plaque may harden to form 'tartar' or calculus around the teeth.  The infection would then spread into the bone that holds the teeth in place and start to dissolve the bone away.  Once the bone goes it cannot be naturally replaced.

Once the bone is lost, the tooth may become gradually loose and eventually, if the disease is not stopped, the affected tooth or teeth will fall out.  In these later stages you will need the help of a dentist or dental hygienist to carry out cleaning under the gums to clean out the affected areas.  If the disease is severe then you may need to see a gum specialist or periodontist for treatment and sometimes gum surgery is required.

Gum disease can usually be prevented by good and careful teeth cleaning, and regular cleanings or scale and polishes with your dentist or hygienist.  Studies have also shown that smoking is a risk factor for gum disease and every effort should be to stop smoking as part of treatment for the condition.  Your dentist should assess your gums at every check-up by gently probing round your teeth to check for areas of bleeding or to look for areas where bone may be being lost.  Additionally routine x-rays will show the bone levels around your mouth.  Your dentist should be keeping a record of the condition of your gums as they are as important as your teeth.  If you go to the dentist regularly and keep your teeth and gums clean there is usually no reason why you should suffer from gum disease.