Recognizing Signs of Gum Disease
- Ashlyn Darling
- 13 minutes ago
- 3 min read
Here's an un-fun fact: gum disease, also known as periodontal disease, remains as one of the most common oral health issues worldwide. Here's another one: Recents studies show that more than half of adults over 30 in America may have it.
Early detection can improve overall health outcomes such as prevent tooth loss, but also relieving chronic pains and resolving many other compounding issues that stem from a dental disease. Here is a brief guide for identifying the symptoms early.
The Basics: What is Gum Disease?
Periodontal disease is progressive. The diagnosis changes as damage is prolonged, and therefore, more severe.
Gingivitis is the early, reversible stage—gum inflammation without bone loss.
Periodontitis is more advanced: connective tissue damage, bone loss, formation of deep periodontal “pockets,” and potential tooth loosening.
New classification systems (post-2017) categorize periodontitis by extent, severity (stage), and grade (rate of progression). Recent studies increasingly use these categories.
Early and Reliable Indicators
Don't panic: There's literature that can tell us what to look for so that we can remain vigilant about our oral health. Here are signs, both clinical and molecular, that recent research identifies as important for detecting gum disease early or tracking its progression.
Marker | How it Presents | Science Behind the Symptoms |
Elevated Inflammation Proteins in Saliva | Increased levels of cytokines and other inflammatory markers in saliva (e.g. IL-1β, MMP-8) correspond with disease progression. | A 2025 study: Uzar et al. found serum and salivary interleukin-1β and matrix metalloproteinase-8 are strong determinants of periodontitis grading (distinguishing mild vs. more severe disease). Also, a large longitudinal study tracked >400 patients for ~18 months: those whose periodontitis worsened had significantly higher levels of nine inflammatory signaling proteins in saliva vs. stable patients. |
Microbiome Biomarkers | Presence and abundance of particular bacterial species in saliva or sub-gingival plaque. | A 2025 meta-analysis showed these bacteria in saliva had sensitivities up to ~89% and specificities up to ~95% for detecting periodontitis; subgingival samples performed even better in some cases. |
Elevated IL-18 Markers | Higher concentration of interleukin-18 (in saliva, plasma etc.). | A 2024 meta-analysis: Alarcón-Sánchez et al. found IL-18 levels are significantly higher in persons with periodontitis vs. controls. This suggests IL-18 may serve as a useful biomarker. |
Physical Symptoms | • Gums that bleed during brushing or flossing • Red, swollen, tender gums • Receding gum line, exposing more tooth or root • Deep periodontal pockets (measured by probe) or clinical attachment loss • Accumulation of plaque / tartar | These remain core diagnostic criteria. Recent works confirm that plaque index and clinical attachment level correlate with systemic effects. Also, studies of younger individuals highlight that even in early stages, these signs correlate with risk factors and can be found in those < 40 years old. |
Systemic Health Indicators | • Changes beyond the mouth (e.g. brain imaging, white matter integrity) • Increased risk of systemic inflammation • Association with prediabetes, cardiovascular conditions etc. | Example: A 2024 study found that higher plaque index, higher clinical attachment loss, and greater numbers of decayed/missing/filled teeth (DMFT index) are associated with subtle white matter brain changes—even before visible lesions in MRI. Another large population-based study showed that periodontitis is more common (or more severe) in patients with prediabetes; and that worse disease correlates with poorer outcomes in glucose regulation. |
What Readers Should Do if They Notice Warning Signs
If you notice bleeding when brushing or flossing, red or swollen gums, bad breath that won’t go away, or even shifting teeth, don’t brush it off. Gum disease isn’t always painful in the early stages. A dentist can check for signs you can’t see, like deep gum pockets, attachment loss, or bone changes on X-rays, which are key to catching problems before they become serious.
Science is also opening the door to newer tools, like saliva tests that look for inflammatory proteins or certain bacteria linked to gum disease. While these aren’t widely available yet, they’re showing promise in research. In the meantime, the basics still matter most: brush twice a day, floss daily, and see your dental professional for cleanings on schedule. If you smoke, have diabetes, or deal with other health risks, managing those factors can make a big difference in keeping your gums—and the rest of your body—healthier in the long run.
You can use the simple steps below to begin building a healthy set of gums.
Conclusion
Healthy gums should be pink, firm, and never bleed during brushing or flossing. If you notice bleeding, swelling, persistent bad breath, loosening teeth, or changes in bite, see a dental professional. Early detection and intervention can preserve your teeth, and could protect your overall health.
References
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