In episode 16 of the Abbey House Dental Podcast, Dr Mumta Jilka speaks with Dr Lyndzi Seadon, a senior hygiene therapist at Abbey House Dental, about gums, gum disease, and the confusion many people face when trying to understand bleeding gums, bad breath, and oral hygiene.
This episode explains what gum disease is, how it starts, the stages it can progress through, and the practical daily habits that help reduce risk and support long-term gum health.
Gum disease is an inflammatory condition started by your body’s immune response to bacteria in your mouth. Dr Lyndzi describes it as a “silent disease” because it often doesn’t hurt, so many people do not realise they have it until later.
A helpful way to imagine it is like a seesaw: on one side is the bacteria biofilm (plaque), and on the other side is your body’s immune response. When the balance tips, gum disease can develop.
Plaque is a sticky bacterial film (a biofilm). It is what you are brushing off with your toothbrush. It can sometimes look yellow, and if your teeth feel a bit “furry” when you run your tongue over them, that can be plaque.
When plaque is left in place, the bacteria grows into a biofilm and can trigger the immune response that leads to inflammation in the gums.
1) Gingivitis
Gingivitis is inflammation of the gums. Signs can include red, puffy, and bleeding gums, but it usually does not hurt. Gingivitis is preventable and reversible.
2) Periodontitis
If gingivitis is left untreated, it can progress to periodontitis. Periodontitis involves inflammation of the supporting tissues around the teeth (the gums, ligaments, and supporting bone). This can lead to bone loss, loose teeth, and tooth loss. Dr Lyndzi highlights that periodontitis is the number one cause of tooth loss in adults.
Unlike gingivitis, periodontitis is not reversible once the bone support has been lost. This is why early detection matters.
The most common sign patients notice is bleeding gums – bleeding when brushing, cleaning between teeth, or when spitting into the sink.
A key message from the episode is: bleeding gums are common, but they are not normal.
Other signs include puffy or red gums and bad breath.
The goal of brushing and cleaning between teeth is to disrupt the bacterial biofilm. If plaque is left to mature, harmful bacteria can settle under the gums, contribute to bad breath, and cause damage.
Disrupting plaque regularly helps prevent the harmful biofilm from forming.
Bleeding gums in pregnancy is common, but not something to ignore. Dr Lyndzi explains this is linked to hormonal shifts that increase systemic inflammation, which can show up in the mouth as red, bleeding gums.
She also notes gum changes can occur at other times when hormones and inflammation change – during parts of the menstrual cycle, postpartum (especially with stress and disrupted routines), and during menopause.
The balance still matters: keeping plaque under control and seeing the hygiene team can help reduce the chance of bleeding gums.
Several factors discussed in the episode can worsen gum health:
– Inconsistent oral hygiene: not brushing twice a day and not cleaning between teeth.
– Diabetes: described as a bi-directional relationship. Uncontrolled diabetes can worsen gum disease, and uncontrolled gum disease can worsen diabetes.
– Smoking: one of the number one causes of advanced gum disease. Nicotine constricts blood vessels, which can reduce bleeding and mask symptoms while disease progresses.
– Vaping: discussed as still concerning, particularly due to nicotine and inflammation.
– Dry mouth: saliva protects teeth, helps buffer acids, and supports a healthier mouth. With dry mouth, gum issues and tooth decay can be more likely.
When bleeding is not obvious, other signs may include gum recession, black triangles (spaces between teeth), sensitivity, teeth drifting, seeing more of the roots, and eventually mobile teeth.
They also mention tongue changes such as a furry tongue and staining associated with nicotine.
Brushing twice a day
Dr Lyndzi recommends brushing twice daily and prefers an electric toothbrush. Manual toothbrushes can work but are technique-sensitive, and many people brush too hard. Electric brushes are more user-friendly and often include pressure sensors.
Cleaning between teeth (daily)
Gum disease often starts between teeth. If you do not clean between your teeth, you can miss a significant portion of tooth surfaces. Interdental brushes (such as TePe brushes) are recommended – using the biggest size that fits without forcing. Different gaps may need different sizes, and the hygiene team can help size you correctly. For tighter gaps, floss tape may be used.
Water flossers
Water flossers can be helpful for removing food debris and cleaning around implants or bridges, but plaque is sticky and often needs mechanical disruption from bristles.
Tongue scraper
Both speakers recommend tongue scraping to reduce bacterial load and help with bad breath and bad taste.
Mouthwash
Mouthwash is optional and can be used to freshen up during the day. If used, it should be at a separate time from brushing. After brushing, the recommendation is to spit out the excess toothpaste rather than rinsing, so the fluoride stays on the teeth longer. Alcohol-free daily mouthwash is preferred.
Dr Lyndzi suggests everyone can benefit from seeing the hygiene team because gum disease is often not picked up early. Hygiene visits include screening for gum disease, tailored advice (oral hygiene is not one-size-fits-all), and professional cleaning.
They also remove hardened calculus (tartar) that cannot be removed at home. Once removed, it gives a “blank slate” and makes home cleaning more effective.
A key theme is that most of the progress comes from what you do at home daily – hygiene appointments support you with education, tools, and maintenance.
Scale and polish
A basic scale and polish uses an ultrasonic scaler to remove plaque and hardened buildup, followed by polishing paste for a smooth finish.
Airflow
Airflow is described like a jet wash – warm water mixed with air and powder. Dr Lyndzi highlights that it can feel more comfortable for sensitive teeth. The powder mentioned is erythritol, described as helping when it comes into contact with bacteria and supporting prevention and treatment by keeping bacteria at bay.
Airflow is also described as gentle and effective for stain removal and safe for use around crowns, bridges, implants, and across the whole mouth.
As gum disease progresses, gums can move away from the teeth and form pockets. When pockets become deeper (past around 2 to 3 mm), you cannot physically clean them properly at home. Harmful bacteria can settle deeper, the bone can move away, and pockets deepen further.
With periodontitis, the aim is not to reverse damage but to stabilise the condition, stop progression, and maintain what remains.
Periodontitis is described as a chronic condition that needs long-term management. Treatment involves regular appointments to clean deeper pockets you cannot reach at home and to disrupt bacteria repeatedly over time.
Improvement is gradual. The goal is to reduce pocket depths and reach a stable maintenance stage where pockets are easier to manage at home.
In the episode, maintenance is discussed as typically every three months once stable, with more intensive early appointments for very active disease.
A recurring message in the episode is that gum health is your foundation. They compare it to building a house: you would not build a house on sand. If you get gum maintenance right from the beginning, you support healthy teeth and smiles long term.
They close with a simple reminder: aim to see the hygiene team regularly – at least every six months, and in many cases every three months – and keep up consistent daily home care.
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