What Does Gum Disease Look Like?

You need the "before" picture before you can judge the "after". Healthy gums are:

• Pink and firm, not red and squashy. The MSD Manual also describes a slightly dimpled texture, a bit like orange peel.
• Snug to the tooth. The edge hugs each tooth neatly, and the little bits of gum between your teeth come to a point.
• Quiet when brushed. No bleeding with normal brushing.

One thing to know: "pink" covers a range. Plenty of people naturally have darker or brownish patches of pigment in their gums, and that's normal for them. What I'm looking for is change, and colour that's different from the rest of your own gums.

Gingivitis is the early, reversible stage. It tends to look like:

• Redness along the gum line, a darker band right where gum meets tooth.
• Puffiness. The pointed bits between the teeth go rounded and swollen, a bit like a tent that's been overinflated.
• A shiny, smooth look, because the swelling stretches out that orange-peel texture.
• Bleeding when you brush, floss or bite into something hard.

Here's the catch. Early gum disease usually doesn't hurt, and it can look pretty subtle, particularly on the back teeth you can't see without a mirror and a contortionist's neck. It can also sit under a layer of plaque or hard tartar, which looks like a creamy or yellowish crust near the gum line. Think of tartar as limescale for teeth: once it's set hard, your toothbrush can't shift it and it needs a professional clean.

If you're seeing the red, puffy, bleeding version, the good news is that this stage can be turned around. I explain why your gums bleed in why do my gums bleed when I brush? and the full list of early signs in gum disease symptoms.

When gum disease moves down to the bone and tissue holding your teeth in, it's called periodontitis. The NHS and the MSD Manual describe changes such as:

• Gums shrinking back, so teeth look longer and you may see the darker root surface. More in receding gums.
• Teeth drifting, with new gaps appearing, or teeth that feel loose.
• A gum abscess: a painful, swollen lump on the gum, sometimes with pus.
• Bad breath or a bad taste that brushing doesn't fix.

Some of this can look surprisingly mild from the outside. The real damage is under the gum line, around the roots, where no phone camera reaches. That's why I measure it rather than guess. There's more on how the two stages differ in gingivitis vs periodontitis.

A few things look like gum disease but aren't. A single swollen spot or pimple on the gum is often something local, like an infected tooth; see pimple or boil on your gum. And I'll say this plainly: the NHS advises an urgent dental appointment for ulcers or red patches in your mouth, or a lump in your mouth or on your lip, alongside gum problems. Those need checking in person.

You can do a decent first look. Good light, a clean mirror, and:

• Compare the colour at the gum edge with the gum higher up.
• Look at the bits between your teeth: pointed or puffed up?
• Notice whether you see pink when you spit after brushing.
• Check whether any teeth look longer than they used to, or have moved.

What you can't do at home is see below the gum line or check the bone. If you smoke, your gums may also look healthier than they are, because smoking can hide redness and bleeding. So a clean-looking mirror check isn't a clean bill of health. A photo is a good reason to book, not a reason to skip booking.

Book a check-up if you've noticed any of these:

• red, puffy or shiny gums, or gums that look different from how they used to
• bleeding when you brush or floss
• gums that seem to have shrunk back, or teeth that look longer
• bad breath or a bad taste that won't shift

At the appointment I'll look, gently measure the 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 what stage you're at and what happens next.

Call us today if:

• your gums are very swollen and sore
• a tooth has become loose
• there's a painful lump, pus or a bad taste from one spot
• your gums are bleeding heavily or won't stop
• 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. The NHS says easy or unexplained bleeding or bruising should be checked by a GP.

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

Meanwhile, the NHS advice is to brush twice a day with fluoride toothpaste and clean between your teeth every day with floss or interdental brushes.

If you're near Harlow or Enfield and your gums don't look the way they used to, I'd much rather take a look than have you keep squinting at photos of your own mouth. A quick look in the chair will tell us more than an evening of zooming in.

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