Gum disease, or periodontal (“around the teeth”) disease, is a prevalent inflammatory disease affecting the mouth, gums, bone, and tissues supporting the teeth of about 46 percent of all adults over 30.

Two different types of gum disease can develop. Depending on symptom presentation, individuals are classified as having one type or the other. They are:

• Gingivitis: Gingivitis is the mildest form of gum disease in which gums become red, swollen, and tender. Gums may also bleed more easily. This is the predominant form of the disease.
• Periodontitis: A more moderate-to-advanced form of gum disease, mild periodontitis develops due to untreated gingivitis, causing pockets in the gums where the gums separate from the teeth. This milder form can also cause bone loss around the teeth. In more advanced cases, more significant bone loss can occur, with deeper pockets and gum recession coinciding with bone loss. In advanced periodontitis, teeth may require extraction.

The good news about gum disease is that it is pretty simple to catch early, as many symptoms are difficult to ignore. Early signs of gum disease typically include gums with a swollen, tender, and red or purplish hue.

As gum disease develops, the following symptoms are common:

• Bad breath.
• Changes in taste.
• Tender gums.
• Gums that bleed easily.
• Pain while chewing food.
• Loose teeth.
• Tooth sensitivity.
• Gums pulling away from the teeth.
• Changes in the fit of dentures.

Gum disease is caused by a biofilm of bacteria adhering to food particles and sugar on the teeth. This eventually forms plaque that causes inflammation, separating the tooth from the gum. The resulting pockets further trap bacteria. The film eventually hardens into tartar if not removed early. For this reason, staying on top of at-home dental hygiene and professional practices is recommended.

Gum disease is something that, for the most part, can be prevented. However, some health conditions, lifestyle conditions, and genetics may increase one’s risk of developing gum disease.

Some of the following factors can increase one’s risk of developing gum disease:

• Smoking or using tobacco.
• Having dry mouth (xerostomia).
• Not maintaining adequate oral hygiene practices.
• Having diabetes.
• Having certain autoimmune conditions like lupus, scleroderma, and Crohn’s disease.
• Hormonal changes, including puberty, pregnancy, and menopause.
• Stress.
• Genetics or family history of gum disease.
• Having heart disease. Although heart disease does not cause gum disease, the two conditions often co-occur.

If you are experiencing symptoms of gum disease, the following tests can confirm or rule out a diagnosis:

• Gum examination: A dentist will examine the gums for signs of inflammation. He or she will use a probe to measure any pockets that may have formed around the teeth. If pockets are deeper than 3 millimeters, this can indicate gum disease. This method is known as pocket probing depth (PPD).
• Medical history survey: A dentist will ask questions about your medical history to screen for any conditions that may increase your gum disease risk.
• X-ray: The dentist may need to take images of the teeth and mouth to screen for any bone loss. Bone loss can indicate gum disease.

If left untreated, gum disease can devolve into several potential complications and health risks for an individual.

Some of the most common complications include:

• Tooth loss: Because gum disease affects the tissues surrounding and holding the teeth, tooth loss could result from untreated gum disease. The gum tissue and bony socket weaken, causing teeth to loosen and fall out.
• Swollen or recessed gums: Gums become swollen and red with untreated gum disease due to plaque and tartar that build up. This can lead to tenderness and bleeding. Additionally, gums can begin to recede due to gum infection, causing root exposure, pain, and sensitivity.
• Bad breath: Chronic bad breath, or halitosis, can be caused by untreated gum disease due to bacteria buildup. Because bacteria can release sulfur compounds, this causes a bad smell to emanate from the mouth.

Having untreated gum disease also increases one’s risk of developing other health conditions and diseases. These conditions include:

• Diabetes: Untreated gum disease can make it more challenging to manage blood sugar levels.
• Heart disease: Gum disease can worsen heart inflammation.
• Cancer: Untreated gum disease may increase one’s risk of developing certain types of cancers such as kidney, pancreatic, and blood.
• Alzheimer’s disease: Gum disease can affect one’s brain health, worsening symptoms of cognitive decline associated with Alzheimer’s.

The treatments for gum disease vary based on symptom severity, disease stage, the individual’s overall and oral health, and his or her ability to follow posttreatment hygiene instructions, and ultimately, what a health care provider or periodontist deems necessary. Common treatments involve either surgical or nonsurgical options.

Nonsurgical

Nonsurgical treatment options are typically for those with early-stage gum disease and include:

• Dental prophylaxis: Routine dental cleaning removes plaque and tartar from the teeth. This treatment often reverses early-stage gum disease, and frequent teeth cleaning appointments may be needed.
• Scaling and root planing: These are deep dental cleanings that go beneath the gum line to remove the built-up plaque and tartar. The surfaces of the teeth are often also smoothed to prevent the buildup of bacteria and plaque. This process requires the administration of a local anesthetic to numb the gums.
• Antibiotics: Antibiotics may be needed to treat gum disease on their own or in combination with other treatment methods. Common antibiotics to help treat gum disease include minocycline HCl or chlorhexidine. These are administered in the pocket between the gums and teeth.
• Laser periodontal therapy: A small laser removes diseased gum tissue and kills any bacteria under the gums. This may be considered as a treatment option instead of gum surgery.

Surgical

Surgical treatment options are typically for those with later-stage gum disease and include:

• Pocket reduction surgery: Also known as “flap surgery,” this involves a periodontist making incisions along the gum line to move the gums away from the teeth. Then, the roots under the teeth are cleaned, and the bone may be reshaped. The gums are then repositioned and sutured.
• Bone grafting: Your own bone, donated bone, or synthetic bone is used to rebuild damaged areas. This is often done in combination with pocket reduction surgery.
• Gum grafting: Your own tissue, donated tissue, or synthetic tissue is used to help with recession, a common symptom of gum disease. Tissue is placed on areas where gum recession occurs, and the gums are sutured into place.
• Guided tissue regeneration: A membrane is placed on damaged gums to keep the gum tissue from growing where bone should be, allowing for bone regeneration.

While gum disease seems to be brought on by genetics, diet, poor hygiene, and/or lifestyle habits, some research indicates that mindset can affect gum disease development.

Increased stress levels tend to exacerbate disease progression. Because stress amplifies emotional reactions, higher stress levels are linked to worsened immune functioning and disruption of oral bacteria.

Part of this physiological response has to do with the fact that both stress and immune responses have physical ramifications. When the body is stressed, stress hormones are released, sending the body into a fight-or-flight mode. If this becomes chronic, it can take a toll on the immune system and, ultimately, a person’s desire to engage in adequate hygiene practices. People who are more stressed out may not pay as much attention to personal oral hygiene practices, smoke, or consume high-sugar or highly processed foods. This suggests that keeping a positive mindset and reducing stress may indirectly help reduce the progression of gum disease.

Several natural remedies can aid in gum disease prevention and treatment.

Diet

Because gum disease affects the mouth, what you eat directly affects the health and integrity of the gums. Generally, keeping your sugar consumption low to moderate is helpful, as too much sugar can cause cavities and/or worsen symptoms or the development of gum disease.

In addition, including omega-3 fatty acids helps prevent and treat periodontitis due to the anti-inflammatory nature of omega-3s. Research shows that dietary supplementation of omega-3s can aid in the reduction of inflammation and chronic periodontitis. Eating foods rich in these omega-3s, such as salmon, anchovies, and mackerel, could also be helpful.

Certain dietary additions high in antioxidants, such as green tea, have also been shown to help reduce periodontal pathogens, as in a paper published in the Journal of Intercultural Ethnopharmacology. Foods and beverages high in antioxidants help reduce overall inflammation in the body, suppressing bone resorption that can occur due to the progression of gum disease.

Botanical Supplements

The paper mentioned above also examines the powerful effects of herbs like triphala, a powder that provides the body with a good source of vitamin C and advantageous fatty acids. Due to its potent antimicrobial and antioxidant properties, triphala has been shown to help those with gum disease.

In addition to triphala, the study showed the following herbs have similarly helpful effects for mitigating inflammation and reducing the progression and/or development of gum disease:

• Rubia cordifolia.
• Piperine.
• Sumac.
• Ginkgo biloba.
• Psidium guajava.

Oral Hygiene Practices

Maintaining comprehensive oral hygiene practices is critical for preventing and aiding in gum disease treatment. Brushing teeth twice daily, flossing, and using mouthwash are good starting points.

Other natural alternatives include:

• Using eucalyptus, lemongrass, peppermint, or tea tree oil on the gums.
• Using an electric toothbrush.
• Placing Aloe vera into the pockets between the teeth and gums.
• Using a saltwater rinse.
• Using baking soda to brush your teeth.
• Oil pulling with coconut or sesame oil. Oil pulling is an Ayurvedic folk remedy involving swishing oil in the mouth to “pull” toxins and bacteria from the mouth and into the oil, which is then spit out.
• Chewing sugarless gum after meals.
• Rinsing with hydrogen peroxide.

Because gum disease can be prevented, regular oral hygiene practices, dental visits, and dental cleanings are recommended for all people to optimize prevention efforts.

Some of the top ways to reduce your risk of developing gum disease involve oral hygiene, diet, and lifestyle and include:

• Prioritization of oral hygiene: Regular brushing, flossing, cleaning, and sterilization is imperative for optimizing oral hygiene efforts.
• Healthy diet: Keeping a diet more moderate in sugar intake (especially if you are predisposed to and/or have diabetes) can help prevent the development of gum disease. In addition, including anti-inflammatory foods, beverages, and herbs helps reduce overall inflammation in the body, reducing gum disease development likelihood.
• Drinking water: Drinking water frequently aids in dislodging food coatings and particles and maintains a less acidic environment in the mouth.
• Stress management: Managing stress can help prevent gum disease by reducing inflammatory pathways upregulated under higher stress levels. Prioritizing a stress-reduction routine regularly is advised.
• Avoiding smoking or chewing tobacco: If you are predisposed to gum disease, you can help prevent it by quitting smoking or chewing tobacco if you do either. Smoking makes it more difficult for the gums to repair themselves and can lower the success rates of gum disease treatments.