Infected gums usually announce themselves with a combination of color changes, swelling, and bleeding, especially when you brush or floss. Healthy gums are firm, pale pink, and fit snugly around each tooth. If yours look puffy, feel tender, or have shifted to a bright red or dark red color, an infection is likely already underway. About 42% of American adults over 30 have some form of gum disease, and nearly 60% of those over 65 do, so this is one of the most common health problems you can develop without realizing it.
The Earliest Signs You’ll Notice
The first stage of gum infection is gingivitis, and it often starts so gradually that people dismiss the signs. The most reliable early clue is bleeding. If your gums bleed when you brush, floss, or eat something crunchy, that’s not normal. Healthy gum tissue doesn’t bleed from routine contact.
Along with bleeding, look for these changes:
- Color shift. Gums move from pale pink to bright red, dark red, or darker than your usual shade.
- Puffiness. The tissue between your teeth (the little triangular points) looks swollen or rounded instead of firm and tight.
- Texture change. Healthy gums have a slightly stippled surface, like the skin of an orange. Infected gums often look smooth and shiny.
- Bad breath that won’t quit. Persistent bad breath or a bad taste in your mouth can signal bacteria building up below the gumline.
The good news about gingivitis is that it’s completely reversible. At this stage, there’s no permanent damage to the bone or tissue holding your teeth in place. Improving your brushing and flossing habits and getting a professional cleaning can resolve it entirely.
When Infection Gets More Serious
If gingivitis goes untreated, it can progress to periodontitis, which is a deeper infection that damages not just the gum tissue but also the bone supporting your teeth. This is where the situation becomes irreversible. The body mounts a chronic inflammatory response that actually breaks down the structures keeping teeth anchored in place.
As the gums deteriorate, they begin pulling away from the teeth and forming pockets. Bacteria settle into those gaps, which causes further tissue damage and makes the pockets deeper over time. If the pockets grow large enough, teeth loosen and can eventually fall out. Around 8% of adults over 30 have severe periodontitis, the stage where significant bone loss has already occurred.
Signs that gingivitis has progressed to periodontitis include:
- Gums pulling back from your teeth. Your teeth may look longer than they used to. You might feel a notch or ledge where the gum used to sit.
- Sensitivity to temperature and certain foods. When gum tissue recedes, it exposes the tooth root, which isn’t protected by enamel. Hot, cold, sweet, sour, or spicy foods can trigger sharp pain.
- Teeth that feel loose or shift position. If your bite feels different or gaps appear between teeth that weren’t there before, bone loss may be underway.
- Pain when chewing. Discomfort while eating, especially with firm foods, can point to weakened support around the teeth.
- Pus between your teeth and gums. Any visible discharge is a clear sign of active, advancing infection.
It’s worth noting that gum recession can sometimes happen with no pain at all. You might have exposed roots and not feel a thing, which is one reason gum disease often goes undetected until a dentist catches it.
Signs the Infection Has Spread
A gum infection can occasionally develop into an abscess, which is a pocket of pus that forms when bacteria penetrate deep into the tissue. When this happens, symptoms become harder to ignore. You may experience severe, throbbing pain that radiates into your jaw, neck, face, or ear. Swelling in the cheek or face is common, and the lymph nodes under your jaw or in your neck may become swollen and tender.
A fever signals that your body is fighting the infection systemically, not just locally. If an abscess ruptures on its own, you’ll notice a sudden rush of foul-tasting, salty liquid in your mouth, which is the pus draining. While that can temporarily relieve pressure, the infection still needs treatment. Difficulty breathing or swallowing alongside a dental infection is a medical emergency that requires immediate care.
What a Dentist Checks That You Can’t
You can spot many warning signs at home, but the definitive way to know if your gums are infected is through a professional periodontal exam. The key tool is a thin, graduated probe that your dentist or hygienist gently slides into the space between each tooth and the gum tissue. In healthy gums, that space measures 1 to 3 millimeters deep. Anything deeper than 3 millimeters raises concern and suggests infection has started breaking down the attachment between gum and tooth.
The probe is measured at six points around every single tooth, and the deepest reading at each tooth gets recorded. Your provider also checks whether the gums bleed when the probe touches them. Bleeding on contact, even with very light pressure, is one of the most reliable clinical indicators of active gum inflammation. You’ll sometimes hear the hygienist calling out numbers during a cleaning. Those are your pocket depths, and lower is better.
X-rays complete the picture by showing whether bone loss has occurred beneath the gumline, something that’s invisible from the surface. Together, pocket depth and bone level determine whether you have gingivitis, mild periodontitis, moderate periodontitis, or severe periodontitis.
Who Is Most at Risk
Gum disease becomes significantly more common with age. About 30% of adults between 30 and 44 have periodontitis. That number climbs to 46% for people between 45 and 64, and reaches nearly 60% for those 65 and older. But age alone doesn’t explain the risk.
Smoking is one of the strongest risk factors. It reduces blood flow to the gums, which impairs healing and makes it easier for infection to take hold. Diabetes also increases susceptibility because high blood sugar weakens the body’s ability to fight bacterial infections, including in the mouth. Hormonal shifts during pregnancy, menstruation, or menopause can make gum tissue more reactive to plaque. Certain medications that cause dry mouth remove one of your body’s natural defenses, since saliva helps wash bacteria away from the gumline. A family history of gum disease raises your risk as well.
A Simple Self-Check You Can Do Now
Stand in front of a well-lit mirror and pull your lip away from your teeth, both top and bottom. Compare what you see against what healthy gums look like: firm, pale pink, and hugging each tooth tightly with pointed triangular tips between teeth. If the tissue looks red, puffy, or smooth instead of slightly textured, that’s worth noting.
Run a piece of floss between each pair of teeth, curving it into a C-shape against the tooth and sliding it below the gumline. If you see blood on the floss or in the sink when you spit, that’s a signal. Press a finger gently along the outer gum tissue. Tenderness, a spongy feeling, or visible swelling are all signs of inflammation. Check whether any teeth appear longer than they used to, or whether you can see yellowish root surfaces near the gumline where gum tissue has pulled back.
None of this replaces a professional exam, but it gives you a meaningful snapshot. If you notice even one or two of these signs, the infection is easier and less expensive to treat the earlier it’s caught.