Early Signs of Gum Disease: Gingivitis vs. Periodontitis

The early signs of gum disease are gums that bleed when you brush or floss, look red or puffy, or feel tender, often with no pain at all. At this stage, called gingivitis, the damage is usually reversible. If signs persist and gums start to pull back or teeth loosen, the disease may have progressed to periodontitis, which needs professional treatment.

Key Takeaways

• Bleeding when brushing or flossing is one of the most common early signs of gum disease, even when nothing hurts.
• Gingivitis is inflammation of the gums without bone loss; according to the Canadian Dental Association, it can be prevented and reversed.
• Periodontitis is gum disease that has damaged the attachment and bone supporting the teeth; it can be controlled but the lost bone does not grow back on its own.
• Smoking, diabetes, dry mouth, hormonal changes and inconsistent cleaning between teeth all raise risk.
• Only a periodontal evaluation, with measurements and sometimes X-rays, can tell gingivitis from periodontitis.

What are the early signs of gum disease?

Gum disease often starts quietly. The Canadian Dental Association notes that gingivitis may not cause pain and lists puffy gums, traces of blood on your toothbrush and a change in gum colour as warning signs.

Watch for these early signs of gum disease:

• Bleeding gums when you brush, floss or eat something crunchy.
• Red or darker gums instead of firm, pale pink (or your usual healthy shade).
• Swollen or puffy gums, especially in the triangles between teeth.
• Tender gums that feel sore when brushed.
• Bad breath or a bad taste that keeps coming back.

Signs that gum disease may be more advanced include:

• Receding gums, where teeth look longer or roots show.
• New spaces between teeth, or front teeth that seem to be drifting.
• Loose or sensitive teeth, or pain when chewing.
• Pus between the teeth and gums.
• A change in your bite or in how a partial denture fits.

The U.S. Centers for Disease Control and Prevention lists many of the same signs, including red, swollen or tender gums, bleeding, receding gums, loose or sensitive teeth, painful chewing and changes in bite or denture fit.

Occasional bleeding after flossing for the first time in weeks is common, because inflamed gums bleed easily. Bleeding that continues after a week or two of daily cleaning is a reason to book a checkup.

What is gum disease?

Gum disease, also called periodontal disease, is an infection and inflammation of the tissues that hold teeth in place. It begins with plaque, the soft, sticky film of bacteria that forms on teeth every day, especially where teeth meet the gums.

If plaque is not removed, it irritates the gum margin and the body responds with inflammation. Plaque that stays in place hardens into tartar (calculus), which cannot be brushed off and gives bacteria an even better place to settle. Over time, in some people, that inflammation spreads below the gumline and begins to break down the fibres and bone that anchor the teeth.

Gum disease matters beyond the mouth, too. Untreated periodontitis can lead to tooth loss, and the NIDCR lists conditions such as diabetes and cardiovascular disease among the health problems associated with it. An association is not proof that one causes the other, but it is one more reason to take bleeding gums seriously.

Gingivitis vs. periodontitis

Gingivitis and periodontitis are two stages on the same path, but they are not the same condition.

	Gingivitis	Periodontitis
What is affected	Gum tissue only	Gums, attachment fibres and bone
Common signs	Bleeding, redness, puffiness, tenderness	Those signs plus recession, pockets, loose teeth, bad breath, pus
Pain	Often none	Often none until advanced
Bone loss	No	Yes, seen on X-rays
Reversible?	Yes, with good home care and professional cleaning	Can be controlled; lost bone does not regrow on its own
Typical treatment	Improved brushing and flossing, routine teeth cleaning	Scaling and root planing, periodontal maintenance, sometimes specialist care

Gingivitis

Gingivitis is inflammation of the gums, and it is the earliest stage of gum disease. Because the bone and attachment are not yet damaged, gingivitis can be reversed. According to the Canadian Dental Association, gingivitis can be prevented and, if started, it can be reversed. Most people see improvement within a couple of weeks of thorough daily brushing and flossing, combined with a professional cleaning to remove tartar.

Periodontitis

Periodontitis is gum disease that has moved below the gumline and damaged the attachment between gum and tooth. The gum separates from the root, forming a periodontal pocket where bacteria and tartar collect out of reach of a toothbrush. The National Institute of Dental and Craniofacial Research notes that advanced gum disease can destroy the bone that supports the teeth, which may lead to tooth loss.

Periodontitis cannot be undone the way gingivitis can, but it can be controlled. Treatment aims to stop the disease from progressing, reduce inflammation and pocket depth, and keep teeth for as long as possible.

Not every case follows the same timeline

Not everyone with gingivitis goes on to periodontitis, and some people progress faster than others. Genetics, smoking, diabetes and immune health all play a part. This is why the diagnosis depends on measurements rather than on how long the bleeding has been going on.

Who is at higher risk of gum disease?

Anyone can get gum disease, but some factors raise the risk. The NIDCR describes smoking as one of the most significant risk factors, and lists older age, diabetes, genetics, stress, some illnesses, hormonal changes and a weakened immune system among others.

Smoking and vaping. Tobacco use raises the risk of gum disease and makes treatment less successful. Smoking can also hide bleeding, so gums may look healthier than they are.

Diabetes. Diabetes and gum disease affect each other. Poorly controlled blood sugar raises the risk of periodontitis, and active gum inflammation can make blood sugar harder to manage.

Pregnancy and hormonal changes. Hormonal shifts during pregnancy, puberty and menopause can make gums more reactive to plaque. Many pregnant people notice more bleeding. Keep up with checkups, and tell the office you are pregnant.

Medications and dry mouth. Many common medications reduce saliva, and some cause gum overgrowth. Bring an up-to-date medication list to every visit.

Crowded teeth, braces and dental work. Tight spaces, brackets and the edges of old fillings or bridges make cleaning harder.

Age. The CDC reports that about 4 in 10 U.S. adults aged 30 and older had periodontitis in 2009 to 2014, and about 60% of adults 65 and older did. Those figures are American, but they show that gum disease is common and becomes more likely with age.

Grinding and clenching. The CDC lists grinding among factors associated with gum disease. A night guard protects teeth, but gum disease still needs its own treatment.

How a dentist checks for gum disease

A periodontal evaluation is how a dentist tells healthy gums, gingivitis and periodontitis apart. Landmark Dental Care includes periodontal evaluation in its checkups and offers it on its own when you have concerns.

A periodontal evaluation usually includes:

1. Health history. Smoking, diabetes, pregnancy, medications and family history are reviewed.
2. Visual exam. The dentist or hygienist looks at gum colour, swelling, recession and plaque or tartar.
3. Probing. A thin probe with millimetre markings measures the space between gum and tooth at several points around each tooth. Shallow readings are typical of health; deeper readings can mean pockets.
4. Bleeding and mobility. Bleeding points show active inflammation, and loose teeth or bone loss between molar roots change the plan.
5. X-rays when indicated. Digital X-rays show bone levels that cannot be seen by eye.

You can ask to see your charted numbers and have them explained. Tracking them from visit to visit is the clearest way to see whether gums are improving.

Gum disease treatment, from gingivitis to periodontitis

Gum disease treatment depends on the stage. The ADA's clinical guidance supports scaling and root planing as initial treatment for periodontitis, and the NIDCR describes a range from daily brushing and flossing for early disease to professional deep cleaning and, for advanced cases, surgery.

Treating gingivitis

For gingivitis, the plan is usually a professional teeth cleaning plus better daily habits. At Landmark Dental Care, hygienists use the Cavitron, an ultrasonic scaler that uses vibration and water to break up tartar along and just below the gumline, followed by hand instruments and polishing. Read more in what a Cavitron cleaning is or on the Cavitron service page.

Treating periodontitis

For periodontitis, the first step is usually scaling and root planing, often called a deep cleaning. Deposits are removed from root surfaces inside the pockets, usually with local anaesthetic and often over more than one visit. See teeth cleaning vs. deep cleaning for what to expect.

A re-evaluation follows after healing. Many patients then move to periodontal maintenance, cleanings at shorter intervals that include care below the gumline. Some patients with advanced disease are referred to a periodontist for further treatment.

Gum infection and swelling

A painful, swollen area of gum, sometimes with pus or a bad taste, can be a periodontal abscess and needs prompt dental care. See signs of a dental abscess. Spreading facial swelling, fever with swelling, or difficulty breathing or swallowing is a medical emergency: call 911 or go to the nearest emergency department.

What treatment does not do

Treatment does not usually rebuild lost bone or return receded gums to their original level. It does not end the need for home care. And it does not replace maintenance visits, because periodontitis can return if plaque is allowed to build up again.

Cost factors. Costs depend on the stage of disease, how many teeth need treatment, whether anaesthetic and X-rays are needed and how often maintenance is scheduled. Ask for a written estimate and check your plan's periodontal limits.

What you can do at home

Daily care is what keeps gingivitis from coming back and periodontitis under control. The Canadian Dental Association recommends brushing at least twice a day, flossing once a day, regular dental exams and cleanings, a healthy diet with limited sugar and not smoking.

Practical steps that help:

• Brush along the gumline. Angle a soft brush toward the gums and use small, gentle strokes for two minutes.
• Clean between teeth every day. Floss, interdental brushes or a water flosser all work; the best tool is the one you will use.
• Keep going if gums bleed. Bleeding usually decreases as inflammation settles. If it does not improve in a week or two, book a visit.
• Quit smoking. Ask your doctor, pharmacist or dental team about quit-smoking support; it is one of the most helpful changes for gum health.
• Manage diabetes and dry mouth. Work with your doctor on blood sugar, sip water and ask about saliva substitutes.
• Replace your toothbrush when the bristles splay.

Mouthwash can freshen breath and some products reduce plaque, but it does not replace brushing and cleaning between teeth. Ask your dental team whether a specific rinse makes sense for you.

Checking your gums in Truro and Colchester County

If you have noticed bleeding, puffy or receding gums, Landmark Dental Care provides periodontal evaluations, hygiene visits with Cavitron ultrasonic cleaning and ongoing gum care at 125 Queen St in downtown Truro. The office serves Truro, Bible Hill, Colchester County and Central Nova Scotia, Monday to Friday, 8:30am to 5:00pm.

As of 2026, the federal Canadian Dental Care Plan lists cleaning (scaling) as a preventive service and periodontal care, including cleaning under the gumline, as a basic service, according to canada.ca. Eligibility requires no access to dental insurance and an adjusted family net income under $90,000, with co-payments above $70,000. Please call the office to confirm current CDCP participation and billing, and see our CDCP page. For children 14 and younger, Nova Scotia's Children's Oral Health Program covers scaling within set annual limits, billed through MSI.

For a serious infection with spreading swelling, call 911 or go to the Emergency Department at the Colchester East Hants Health Centre in Truro. For nurse advice at any hour, call 811.

FAQ

Can gingivitis go away on its own?

Gingivitis rarely clears without a change in care, but it can reverse within weeks once plaque is removed every day. A professional cleaning helps by removing tartar that brushing cannot.

Why do my gums bleed when I floss?

Bleeding usually means the gums are inflamed from plaque, which is a common early sign of gum disease. If it continues after a week or two of daily flossing, have your gums checked.

Can periodontitis be cured?

Periodontitis can be controlled but not fully reversed, because lost bone does not grow back on its own. Treatment and regular maintenance can stop it from progressing and help keep your teeth.

Is gum disease contagious?

The bacteria involved can be shared through saliva, but gum disease depends mostly on plaque control and personal risk factors. Good daily care and regular checkups matter more than avoiding contact.

Does gum disease hurt?

Often it does not, which is why it can go unnoticed. Pain usually appears only with an abscess or advanced disease, so bleeding and swelling are the signs to act on.

Next step

If your gums bleed, look puffy or seem to be receding, book a periodontal evaluation through preventive dentistry at Landmark Dental Care. Call 902-893-2919 or contact us at 125 Queen St, Truro.

References

• Canadian Dental Association: Gingivitis
• National Institute of Dental and Craniofacial Research: Periodontal (Gum) Disease
• Centers for Disease Control and Prevention: About Periodontal (Gum) Disease
• American Dental Association: Nonsurgical Treatment of Chronic Periodontitis (chairside guide)
• MouthHealthy (ADA): Gum Disease
• Government of Canada: Canadian Dental Care Plan coverage

This article provides general educational information and is not a diagnosis or a substitute for care from a dentist or other qualified health professional.