• Gum disease affects most people at some stage in their life.
  • The two stages of gum disease are gingivitis and periodontitis.
  • Careful and regular cleaning can help prevent gum disease.
  • Getting treatment early can help save teeth that are at risk from gum disease and other conditions – see your dentist or oral health professional if you have swollen or bleeding gums or loose teeth.
Most people will have gum disease at some time in their life. Some of the common signs of gum disease are gums that are red, puffy or bleed.

Causes of gum disease

Gum disease is usually caused by a build-up of plaque on teeth and along the gum line. Plaque is a sticky coating containing bacteria. The immune system tries to get rid of plaque with an inflammation response. This is seen by the redness and swelling of the gum around the tooth.

Everybody has a range of bacteria in their mouth. Plaque is constantly being formed by some of these bacteria when they feed on the sugars in the foods and drinks you consume. Plaque provides the perfect environment for the bacteria that can cause gum disease to live and multiply.

Stages of gum disease

The two main stages of gum disease are:
  • gingivitis
  • periodontitis.


Gingivitis is early gum disease. It affects the surface layers of the gum, particularly where the gum meets the tooth. At this stage, there is no damage to the deeper parts of the gums, teeth or bone.

The signs of gingivitis are:
  • bleeding gums, especially when brushing or eating
  • redness and swelling of the gum.
The good news is that gingivitis can be reversed.

You might think it is best to stop brushing if your gums are red or puffy. Try to keep brushing, as this will get rid of the bacteria and plaque that is causing the problem. Soon the gums should look and feel better. If not, see your dentist or oral health professional.


Periodontitis is an advanced stage of gum disease that may occur if gingivitis is not treated.

The periodontium is the name given to a group of structures that surround and support the teeth, keeping the teeth in place. Periodontitis is the inflammation of the periodontium caused by the bacteria in plaque and the body’s immune response to it.

The structures affected by periodontitis include the covering of the tooth root (cementum), the bone and the fibres that connect the tooth root to the bone (periodontal ligament).

When the gum is weakened by gum disease, spaces can form between the tooth root and the gum. These spaces are called ‘periodontal pockets’. Bacteria get trapped in these pockets and cause even more damage to the periodontium. Over time, bone is damaged and lost, and larger spaces begin to form between the tooth and the gum.

If periodontitis is not treated, the structures that hold the tooth firmly into the gum can become so damaged that teeth become loose and may need to be removed.

Smoking and poorly managed diabetes are risk factors for periodontitis.

Signs of periodontitis include:
  • bleeding gums
  • swollen gums
  • receding gums (the gum line shrinks away from the tooth making teeth look longer)
  • bad breath
  • a bad taste in the mouth
  • tenderness when biting
  • loose teeth.
Make an appointment with your dentist or oral health professional if you think you have any of these signs. They can talk with you about how to care for your teeth. They can also professionally remove plaque and hardened plaque (calculus). Early treatment of periodontitis can save affected teeth.

Prevention of gum disease

Regular tooth brushing helps to prevent gum disease by removing the plaque that causes it. Remember:
  • Brush teeth and along the gum line twice a day, in the morning and before going to bed.
  • Use a toothbrush with a small head and soft bristles.
  • Over 18 months of age, use a fluoride toothpaste, low fluoride for children aged 18 months to six years of age and standard fluoride for people six years and older.
  • After brushing, spit out toothpaste, don’t swallow and don’t rinse with water. This leaves a small amount of fluoride in the mouth to protect teeth.
Eating well can also help prevent gum disease. Sugars provide the food for some types of mouth bacteria to multiply and form a plaque layer on the teeth and gums. A high-sugar diet can contribute to a thick layer of plaque. Avoiding sugary foods and drinks, especially between meals, can help to keep plaque levels under control.

Follow the Australian Dietary Guidelines and enjoy a wide variety of nutritious foods from the five food groups every day, including vegetables, fruit, grain foods, lean meats (or alternatives), dairy (or alternatives). Drink plenty of water.

Have a dental check-up

See your dentist or oral health professional if you have swollen or bleeding gums, or are worried about anything to do with your mouth. Getting treated early can help save teeth affected by gum disease and other problems. Ask them how often you should visit for a check-up.

Where to get help

  • Your public dental clinic:
    • Community dental clinics:
    • The Royal Dental Hospital of Melbourne:
      • General enquiries or to make an appointment Tel. (03) 9341 1000 or 1800 833 039 outside Melbourne metro 8.30 am to 5 pm, Monday to Friday
      • Dental emergencies Tel. 1300 360 054 8.30 am to 9.15 pm, Monday to Friday, 9 am to 9.15 pm, weekends and public holidays
  • Your private dental clinic:
    • Look in the Yellow Pages under ‘Dentists’ or search at
    • Visit the Australian Dental Association website,, and use the ‘Find a Dentist’ search tool
  • Your doctor

Things to remember

  • Gum disease affects most people at some time in their life.
  • Gum disease can get more serious over time, so it is best to get help early.
  • Cleaning your teeth and along the gum line twice a day helps to prevent gum disease. Keep brushing gently even if gums bleed. See your oral health professional if bleeding continues.
  • Getting treatment early can help save teeth affected by gum disease and other conditions..
  • National Oral Health Promotion Clearing House, 2011, ‘Oral health messages for the Australian public; Findings of a national consensus workshop’, Aust Dent J,vol. 56, pp. 331-335. More information here.
  • Australian Dietary Guidelines, 2013, National Health and Medical Research Council, Canberra. More information here.

More information

Mouth and teeth

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This page has been produced in consultation with and approved by: Dental Health Services Victoria

Last updated: April 2015

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Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.