Gum disease: bleeding gums, plaque, tartar and what to do about them

What gum disease is

Gum disease is an infection and inflammation of the tissues that hold your teeth in place, and it comes in two stages. Gingivitis is the early, mild stage: plaque sitting along the gum line irritates the gums so they become red, puffy and bleed when you brush. It is common, it does not damage the bone, and it is fully reversible with better cleaning. Periodontitis is what gingivitis can turn into if it is left: the gums pull away from the teeth, pockets form where bacteria collect, the bone supporting the teeth slowly erodes, and eventually teeth loosen. Periodontitis cannot be reversed, but it can be stopped and controlled.

It is far more common than most people think. Healthdirect reports that about three in ten Australian adults have moderate to severe periodontitis, and it is the leading reason adults lose teeth. Because it is usually painless until it is advanced, many people do not know they have it until a dentist measures their gum pockets.

Signs: bleeding gums and beyond

Bleeding gums are the sign most people notice first, usually a pink tinge on the toothbrush or when flossing. Healthy gums do not bleed with normal brushing. Bleeding means the gum is inflamed, and the answer is to clean the area more, gently, not to avoid it.

Other signs to look for: red or swollen gums rather than pale pink and firm; persistent bad breath or a bad taste; gums that have receded so teeth look longer; new sensitivity to hot and cold where roots are exposed; teeth that feel loose or have shifted; and gaps opening between teeth. If you notice gums swelling or bleeding regularly, or a tooth feels loose, see a registered dentist as soon as you can rather than waiting for your next check-up.

Plaque vs tartar: how to remove each

Plaque is the soft, sticky film of bacteria that forms on teeth every day. You can and should remove it yourself: that is what brushing and flossing are for. If plaque is left on the teeth, minerals in saliva harden it within days into tartar (calculus), a rough, chalky deposit that bonds to the tooth. Tartar cannot be brushed off. It has to be scraped away by a dentist or hygienist with hand instruments or an ultrasonic scaler.

So the honest answer to “how to remove tartar from teeth without a dentist” is that you cannot, safely. Home scraping tools sold online can gouge enamel and gums and push bacteria deeper, and acidic “home remedies” like vinegar or lemon juice erode enamel. What you can do at home is remove plaque thoroughly every day so that new tartar does not form, and have the existing tartar removed professionally.

How to remove plaque from teeth at home

1. Brush twice a day for two minutes with a soft-bristled brush and fluoride toothpaste. Angle the bristles at 45 degrees towards the gum line and use small circular or short back-and-forth strokes; the gum line is where plaque does the damage.
2. Clean between your teeth once a day with floss or interdental brushes. A toothbrush cannot reach the surfaces between teeth, which is where gum disease usually starts.
3. Consider an electric toothbrush. Oscillating-rotating and sonic brushes remove plaque more consistently than most people manage by hand, and their timers help you reach two minutes.
4. Use disclosing tablets occasionally. They stain plaque pink so you can see what you are missing.
5. Drink water, limit sugary snacks and do not smoke. Smoking is the biggest avoidable risk factor for periodontitis and it also masks bleeding, so smokers often miss the warning sign.

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How dentists treat gum disease

For gingivitis, treatment is a professional scale and clean to remove plaque and tartar, plus advice on cleaning technique at home. Gums usually stop bleeding within a week or two of thorough daily cleaning. The ADA fee survey data reported by CHOICE puts an average scale and clean at about $123 (item 114, 2022 survey), and a standard check-up with scale and fluoride at around $219, which most extras policies cover under general dental after a two-month wait.

For periodontitis, the dentist or a periodontist (a specialist in gum disease) measures the pockets around each tooth and takes x-rays to see bone loss. Treatment starts with deep cleaning of the root surfaces below the gum line, sometimes called root planing or periodontal debridement, usually done in two to four visits with local anaesthetic. Costs vary with how many teeth are involved; ask for a quote by item number and check what your extras cover returns, as some funds treat periodontal items as major dental with a 12-month wait. Advanced cases may need gum surgery or referral to a periodontist, and a small number of teeth may be too damaged to save.

After treatment, periodontitis needs maintenance for life: cleaning appointments every three to six months rather than yearly, and meticulous home care. Stop the maintenance and the disease returns.

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Who is at higher risk

Plaque is the cause, but some things make the gums more vulnerable to it. Healthdirect lists smoking and alcohol use, diabetes (especially if poorly controlled), stress, some medicines that dry the mouth, poor nutrition, hormonal changes in pregnancy and puberty, and a family history of gum disease. Gum disease and diabetes affect each other in both directions: periodontitis makes blood sugar harder to control, and high blood sugar makes gum infection worse.

Research links poor oral health with heart disease, stroke, lung conditions and complications in pregnancy, though Healthdirect notes the evidence on cause and effect is still developing. The practical point stands: if you have diabetes, are pregnant or smoke, tell your dentist and have your gums checked more often.

Preventing gum disease

Prevention is cheap and mostly boring. Brush twice a day with fluoride toothpaste, clean between your teeth daily, see a dentist for a check-up and clean every six to twelve months (more often if you have had periodontitis), do not smoke, keep diabetes well controlled and drink water rather than sugary or acidic drinks. If your gums bleed, that is your cue to clean more thoroughly for two weeks; if they are still bleeding after that, book a dental visit.

A note on mouthwash: it can help freshen breath and some antibacterial rinses reduce plaque, but no mouthwash replaces mechanical cleaning. If a dentist prescribes a chlorhexidine rinse after treatment, use it for the period advised, because long-term use stains teeth.

For the tools that make daily cleaning easier, see our reviews of the best electric toothbrushes in Australia and the best water flossers. If gum recession has left your teeth sensitive, our guide to sensitive teeth covers what helps. And remember: this page is general information. For diagnosis and a treatment plan, see a registered dentist; you can check any practitioner’s registration on the AHPRA public register.

Common questions