Quick GuideThe Ugly Truth About Your Toothbrush & Germs

A person with gingivitis will typically have one or more of the following signs and symptoms:

• Bright red, swollen gums that bleed very easily, even during brushing or flossing
• A bad taste or mouth odor
• White spots or plaques on the gums
• Gums that look like they're pulling away from the teeth
• Pus between gums or teeth
• A change in the way the teeth fit together in the mouth or spaces opening up between teeth
• Change in the way partial dentures fit

As gingivitis progresses (chronic gingivitis), various complications may arise. The affected person may develop receding gums or areas where the root of the tooth becomes uncovered by the shrinking, diseased gums. Deep pockets may develop around the teeth that trap food, plaque, and debris. If gingivitis advances to periodontal disease, the person may lose gum tissue or bone around the teeth and the teeth may become loose or fall out. These changes can develop either very slowly or very rapidly and can affect either a few teeth or the entire mouth. If oral hygiene is almost never done or if the person becomes immune-compromised, acute necrotizing ulcerative gingivitis may develop (ANUG, formerly termed trench mouth). This is a painful condition where infected gums swell, ulcerate, and slough off dead tissue.

It is possible to have gingivitis and not notice any signs or symptoms, so regular visits to the dentist are vital in determining a patient's specific risk level. The dentist is the primary-care provider of the mouth and will be able to provide all of the facts and information necessary in diagnosing the disease and taking steps in curing or reversing gum disease.

The following methods and symptoms are very useful in the diagnosis of gum disease:

• Measuring the gums: A dentist or hygienist will use a periodontal probe to measure the depths of the pockets around all of the teeth in the mouth generally once per calendar year. Healthy gums will have pockets 1 mm-3 mm deep. Beyond that, the deeper the pockets, the more severe the disease.
• Taking X-rays: Dental bitewing X-rays will help show the level of the underlying bone and whether any bone has been lost to periodontal disease.
• Examining sensitive teeth: Teeth that have become sensitive around the gum line may indicate areas of receding gums.
• Checking the gums: A dentist or hygienist will look for red, swollen, or bleeding gums.