Gum Disease Symptoms | What Are the Early Signs?

The NHS lists the early signs as:

• Bleeding when you brush, floss, or eat something hard.
• Gums that are red, swollen or sore.
• Bad breath or a bad taste in your mouth.

For comparison, healthy gums are pink and firm, and sit snugly around each tooth like a well-fitted collar. Inflamed gums look redder, a bit puffy and shiny, especially along the edge next to the tooth. For more on what gum disease looks like, see the signs in my gum disease guide.

Bleeding is the one people notice first, usually as pink in the sink after brushing. It isn't normal for healthy gums to bleed with ordinary brushing, so please don't take it as just "one of those things". My guide explains why gums bleed when you brush.

Here's the annoying bit. Most dental problems announce themselves with pain. Gum disease mostly doesn't. The MSD Manual notes that people with gingivitis usually have no pain, and that even the more advanced stage usually doesn't hurt unless an abscess forms.

Think of pain as your mouth's burglar alarm. Decay trips it. A cracked tooth trips it. Gum disease is the burglar who's found a way in through the side window and is quietly rearranging the furniture. Nothing goes off. That's why the quiet signs, the bleeding, the redness, the breath, are worth taking seriously even when everything feels fine.

It's also why I check gums at every check-up, whether or not you've noticed anything. A lot of gum disease is found by the dentist rather than the patient, and that's no failing on your part. It's just hard to see your own gum line in a bathroom mirror.

Left alone, gingivitis can progress to periodontitis, where the inflammation moves down to the bone and tissue holding the teeth in. The damage at that stage can't be undone, though it can be stabilised. The NHS and the MSD Manual describe signs such as:

• gums shrinking back so teeth look longer (receding gums)
• teeth that feel loose, or have shifted and started to gap
• pain when chewing
• a gum abscess, a painful swelling with pus
• bad breath that doesn't go away with brushing

If you've spotted any of these, I don't want you to panic, but I do want you seen sooner rather than later. The difference between the two stages is explained plainly in gingivitis vs periodontitis, and what's possible once it's established is in can gum disease be cured?

Usually, sore or bleeding gums are down to plaque building up at the gum line. But a few other things can make gums more likely to bleed or swell. The MSD Manual lists pregnancy and hormone changes, diabetes, some medicines, and, less often, vitamin C deficiency or blood conditions such as leukaemia. Blood-thinning medicines can also make any bleeding last longer.

Two things I'd flag in particular:

• If it's just one spot, it may be something local, like food trapped next to a tooth or an old filling edge. See one small area of gum keeps bleeding or one gum suddenly swollen around one tooth.
• If you smoke, your gums may bleed less even when gum disease is there, because smoking can mask the usual warning signs. So "my gums don't bleed" isn't the reassurance it sounds like. No lecture from me, just a reason to keep your check-ups.

I'll keep this bit straight. The NHS says bleeding or bruising easily or for no reason should be checked by a GP. If your gums are bleeding and you've also got bruises you can't explain, or you feel tired, weak or unwell, see your GP promptly as well as your dentist.

Book a check-up if:

• your gums bleed when you brush or floss, even a little
• your gums look red or puffy, or feel sore
• you've had bad breath or a bad taste that doesn't shift
• your gums look like they've shrunk back

The visit itself is simple. I'll look at your gums, gently measure the little gap between gum and tooth with a thin probe, and take X-rays if I need to see the bone. Then I'll tell you plainly what stage you're at and what happens next, which may be a clean with my hygiene team and some tips on cleaning between your teeth.

Call us today if:

• your gums are very sore and swollen
• a tooth has become loose
• you have a painful swelling on the gum, a bad taste or pus
• your gums are bleeding heavily or it won't stop (see my gum won't stop bleeding)
• you have swelling with a fever or feel unwell

See your GP promptly, or call NHS 111, if: your gums are bleeding and you're also bruising easily for no reason, or feeling unusually tired, weak or unwell.

Call 999 or go to A&E, not a dentist, if:

• it's hard to breathe, swallow or speak
• swelling is spreading towards your eye or into your neck
• your eye is swollen or painful, or your eyesight suddenly changes
• you can't open your mouth properly because of swelling

In the meantime, the NHS advice is to brush twice a day with fluoride toothpaste, clean between your teeth every day with floss or interdental brushes, and spit rather than rinse after brushing. Keep brushing even if your gums bleed. It's the plaque that's causing the trouble, not the toothbrush.

If you're near Harlow or Enfield and your gums have been bleeding for a while, I'd much rather take a look than have you spend another month rinsing pink and hoping. Early gum disease is one of the most fixable things I see, and the sooner it's caught, the easier it is.

This article is general information, not a diagnosis. Gum problems need examining in person to find the cause.