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Can zyns cause gum disease?
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Can zyns cause gum disease?
I am sure it's not healthy in the long-term, but I would not be able to function without stimulants. Nicotine use increases gingivitis and periodontitis, which also leads to gum recession. There are, however, several effective ways to treat it's symptoms. Apr 3, 2024 · CNN — A relatively new nicotine product with a tobacco-free and smokeless design has drawn in a wave of new users in just the past year: oral nicotine pouches that sit at the gums and are nearly. Gum disease is a bacterial infection that damages the gums and can lead to tooth loss. When smoking, nicotine in cigarettes and e-cigarettes causes the gum tissue to recede by narrowing the blood vessels that supply oxygen to the gums This can cause dry mouth, and that can directly contribute to bad breath. Realistically, if you use them discreetly, it's unlikely to cause any problems. We would like to show you a description here but the site won't allow us. This article lists 10 supplements that may help improve gum health and treat periodontal disease. Learn more about nicotine hair loss in our blog. Other symptoms of RA include:. whether gum disease actually causes health problems beyond the mouth, and whether treating gum disease can keep other health conditions from developing. Some conservative holistic dental treatments exist such as dental ozone and PRF. [] At-home treatments and remedies to help slow hair loss can include:. These products are typically used by placing them between the People with sensitive or swollen gums are more likely to develop gum diseases. The pouches could cause gum disease. This has caused people to wonder whether or not they cause gum disease. If you have ADHD, you may have trouble sitting still, but there are ways to harn. Left untreated, gum disease can lead to receding gums and tooth loss. They reduce blood flow and oxygen levels and impair healing in the gums, leading to cell death. For many people, chewing gum is a relatively mindless activity — one you might do while working, driving or sitting in class. Expert Advice On Improving Your Home. What is known is that nicotine pouches like Zyn's can cause gum irritation, soreness, infections and eventually even cancer. Children should not use Zyn or any other nicotine product. Once your oral hygiene is in order, you can see if you think your gum disease symptoms are improving. Are nicotine pouches are safe? What are some nicotine Pouches side effects? Read our latest article for the answers to your nicotine pouch questions. Feb 10, 2023 · ONPs users placed the pouches between the lip and gum, similar to chewing tobacco, smokeless tobacco, and snus. You can prevent gum disease by gently brush your teeth and gums twice a day with a soft toothbrush and fluoride toothpaste. Gum is the subject of many urban legends with the largest being that it stays in your stomach for seven years. Say goodbye to sticky messes and enjoy a clean floor today. Unfortunately, what we have seen here and around the world, is that young people, many of whom have never smoked a cigarette, have started vaping Do Zyns cause oral cancer? Understanding gum disease causes and risk factors is the first step in protecting oral health. We would like to show you a description here but the site won't allow us. Feb 10, 2023 · ONPs users placed the pouches between the lip and gum, similar to chewing tobacco, smokeless tobacco, and snus. May 7, 2024 · While Zyn pouches offer a tobacco-free alternative for nicotine consumption, they may still pose risks to gum health. Feb 10, 2023 · ONPs users placed the pouches between the lip and gum, similar to chewing tobacco, smokeless tobacco, and snus. Apr 26, 2024 · Chewing tobacco is linked to mouth cancer, gum disease and tooth loss. Oral cancer, also called mouth cancer, forms in the oral cavity, which includes all parts of your mouth that you can see if you open wide and look in the mirror. Jan 25, 2024 · Some experts think nicotine deteriorates gum tissue, which could lead to periodontal disease, said Irfan Rahman, a researcher at the University of Rochester Medicine who has studied. Find out how to clean the finish and restore the shine to a wooden table using a mixture of gum turpentine, boiled linseed oil, and hot water. Advertisement For millions of us, sne. From 154 quotes ranging from $500 - $2,500 $800. Like other nicotine pouches, ZYN pouches are designed to be a safer alternative to smoking and other tobacco products. Apr 26, 2024 · Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and. Advertisement Chewing gum is one of the oldest candies known to man, and. Canker sores are painful, round ulcers that form inside the mouth, on the inside of cheeks or lips, and along the tongue and gums. Jan 19, 2024 · An essential facet of comprehending the oral health repercussions of ZYNs and nicotine pouches involves drawing parallels with the impact of traditional cigarettes on gum health. Topical antibiotics can include antibiotic mouth rinses or putting gel containing an antibiotic into gum pockets. Apr 26, 2024 · Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. The Journal of Endodontics October 2017 showed that individuals with periodontal disease had a 3. Nicotine pouches, including ZYN, are bad for gum tissue. More research is needed to clarify. carcinogenic, cloud of smoke inhaled into the lungs. Gum disease is extremely common, especially in adults, but if left untreated, it can cause gum recession and even the loss of teeth. At this stage of gum disease, bacteria destroys gum tissue and tooth/bone, causing a whole mess in your mouth. Topical antibiotics can include antibiotic mouth rinses or putting gel containing an antibiotic into gum pockets. This lowers your body's ability to fight infections. Left untreated, gingivitis can turn into periodontal disease (see "Signs of gum disease"). Zyns because I was unmedicated most of my life and it was a quick-fix without having to shell out money for a psychiatric evaluation. 1 As summarized in "The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General," the evidence is sufficient to infer a causal relationship between smoking and. If a tooth is loose, the best step is to have it extracted. High levels of blood glucose increase the risk that gum disease will progress from mild to severe Gum disease advances in stages, from inflamed gums. Jan 19, 2024 · An essential facet of comprehending the oral health repercussions of ZYNs and nicotine pouches involves drawing parallels with the impact of traditional cigarettes on gum health. If your gums are red, inflamed, swell. It comes in several flavors, including citrus, coffee, cinnamon and several mint varieties. It comes in several flavors, including citrus, coffee, cinnamon and several mint varieties. For example, nausea, tooth decay, hiccups, sore mouth, and local irritation. It comes in several flavors, including citrus, coffee, cinnamon and several mint varieties. Nicotine is a powerful vasoconstrictor, not to mention a toxin which will damage the diversity of your oral flora. Learn more about periodontal pockets, how they can lead to gum disease and when and how to treat them. Types of Gum Disease. Gingivitis: Following gingivitis, an infection of the gums comes with gum disease. CVS is famous for their ridiculously long receipts. However, recent studies have shown that the use of Zyn can have negative effects on sexual health, particularly in men. ZYNs are a type of smokeless tobacco product that falls under the category of nicotine pouches. Smoking is an important cause of severe gum disease in the United States. If left untreated, this can cause inflammation of the parts which connect our teeth to the underlying bone. They are painless and pose no complications, but regular use may result in severe gum disease, oral cancer, or leukoplakia. Oral Probiotics to Heal Gum Disease. Periodontal disease located in the upper jaw increased the likelihood of having chronic sinusitis, whereas if periodontal disease was in the lower jaw. The nicotine and other ingredients found in these pouches can contribute to gum irritation, inflammation, and other oral health issues. Mild and Moderate Gum Disease Treatment: deep cleanings Toothpaste, whilst not a magic solution can help prevent and cure gum disease. How Can I Prevent Gum Recession from Braces? There are a few things you can do to prevent gum recession from braces: Keep your teeth and gums clean: Brushing twice a day, flossing daily, and using an antibacterial mouthwash can help reduce your risk of gum. These side effects might differ. tiny houses in georgia It's caused by bacteria-filled plaque sticking to and building up around the gumline. The good news is, you can quit Zyn with similar strategies used to quit other nicotine products. I am sure it's not healthy in the long-term, but I would not be able to function without stimulants. These healthy dental habits will help prevent gum disease (including recession) and cavities Brushing too hard can cause inflammation and, down the line, gum recession. It comes in several flavors, including citrus, coffee, cinnamon and several mint varieties. Alum is a popular home remedy for treating bleeding or swollen gums and for use as a mouthwash. Gum is the subject of many urban legends with the largest being that it stays in your stomach for seven years. Apr 10, 2024 · Zyn is a nicotine pouch meant to be placed in the mouth between the upper lip and gum. Feb 8, 2024 · Does Zyn raise blood pressure or cause gum damage? While we don't know the long-term effects of Zyn yet, health experts say there are several health concerns to be aware of when it. Allergies and bleeding gums actually may be signal from your immune system. A few bad habits can lead to gum disease, which can have some serious repercussions for your overall health. Eventually, this buildup can cause tooth decay and gum disease Although less common, vaping can lead to mouth burns because the lithium batteries can overheat and explode Vaping causes cell damage. Gum disease is a bacterial infection that damages the gums and can lead to tooth loss. It can cause loss of bone around your teeth and gum recession over time. Jan 19, 2024 · An essential facet of comprehending the oral health repercussions of ZYNs and nicotine pouches involves drawing parallels with the impact of traditional cigarettes on gum health. Gingivitis is a common and mild form of gum disease, also called periodontal disease. Apr 26, 2024 · Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. Gum disease has also been linked to: diabetes; cancer; Alzheimer's; obesity; infertility; pre-term. Xanthan gum really doesn’t sound that appetizing: The food additive is excreted by a strain of bacteria, Xanthomonas campestris, that is also responsible for the black slime that f. The breakdown of tissues around your teeth happens gradually. Nicotine gum is sugar-free, and the chewing motion actually stimulates saliva production. There has been a lot of talk about an association between oral and cardiac health, but is there really a direct link? Here's what we know. Apr 10, 2024 · Zyn is a nicotine pouch meant to be placed in the mouth between the upper lip and gum. uber eats promo code for existing users They are painless and pose no complications, but regular use may result in severe gum disease, oral cancer, or leukoplakia. This product can expose you to chemicals including nicotine which is known to the State of California to cause birth defects or other reproductive harm. is it true that the saliva may. Make a paste with salt (makes it hard for bacteria to survive), ground turmeric (antimicrobial and anti-inflammatory) and mustard oil (or vitamin E oil) and apply. Speaking of, if you find yourself with sore, inflamed, red gums, you could have some form of periodontal disease (the leading cause of gum recession). Praying I can get through to the VP level and completely. The nicotine and other ingredients found in these pouches can contribute to gum irritation, inflammation, and other oral health issues. Apr 26, 2024 · Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. 1; Smokeless tobacco use during pregnancy increases the risk for early delivery and stillbirth. 1; F. Severe attachment loss and gum recession was found among tobacco chewers. Explore the top 5 ways to lower your financial stress. Periodontitis is the main cause, and it can even change the way your teeth fit together when you bite. Zyn can cause nicotine addiction, which can have serious health consequences for children. Although there isn't much research or evidence on whether ZYN products can cause heart problems, you can look at the evidence about nicotine. pedro 90 day fiance As long as you're thorough, gentle pressure is sufficient for food and plaque removal. Chewing tobacco is linked to mouth cancer, gum disease and tooth loss. Find the answers to questions that pique your curiosity in our series "The Short Answer. [] At-home treatments and remedies to help slow hair loss can include:. There may also be a relationship between having a history of calicivirus infection and severe gingivitis. Periodontal disease affects the health of your gums. Can you MacGyver car repairs using a wad of bubble gum, a paper clip and some shoestring? Take this quiz right now and test your level of preparedness. Oral cancer (mouth cancer) affects the tissues in your mouth and throat. Learn more about nicotine hair loss in our blog. Gum diseases: Another common concern is, can steroids cause gum problems? Research suggests that the long-term use of steroid therapy is associated with an increased risk of gum diseases, such as gingivitis (inflammation of gums) or periodontitis (inflammation of tissues surrounding gums). Smokeless tobacco is addictive. Flossing and brushing are both great ways to keep your teeth and gums healthy. Learn more about nicotine hair loss in our blog. 1 and Grizzly Pouches Wintergreen), and two pharmaceutical, nicotine replacement therapy products (NRTs, Nicorette ® lozenge and Nicotinell ® gum). So just brush your gums to stimulate blood flow and dilate those capillaries that get shrunk by the nicotine. It's caused by plaque, a sticky film that builds up on your teeth and can be removed by brushing and flossing. Gum disease is the main cause of gum recession Some people may be more susceptible to gum disease Certain symptoms of celiac disease can occur very quickly after eating gluten. Bubble Gum Day is an annual celebration that brings joy and nostalgia to people of all ages. We would like to show you a description here but the site won't allow us.
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There are mild forms of gum disease that may be reversed if caught early and more severe forms. Add to the mix the medications that further reduce our. Severe attachment loss and gum recession was found among tobacco chewers. However, some individuals have expressed concern about the potential effects of Zyns on testosterone levels in the body. Periodontitis is a serious infection characterized by inflammation of the gums, which can ultimately lead to tooth loss. Zinc is a vital element in maintaining the normal structure and physiology of cells. Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. Are nicotine pouches a safe approach to quitting nicotine dependence? There is no data to show nicotine pouches as a safe or effective way to quit. The screen at the front of the room showed a horribly disfigured man. Methods. Bone-in stress which is the response of the bony structure to the force that is utilized When excessive pressure is continually applied to bone, this can lead to the formation of dysfunctional bone tissue. According to AMS Cardiology, those at risk of heart disease, stroke, and diabetes shouldn't smoke but also avoid vaping. that controlling gum disease can save your teeth - a very good reason to take care of your teeth and gums. which bank opens at 8am It is a natural astringent and antiseptic that is also effective in pain relief and. This can affect the tissues that support the teeth and jawbone. Severe attachment loss and gum recession was found among tobacco chewers. Check if you have gum disease. Also, finding a comfortable position in the lower lip could be an issue, as it is less tight to the gum and naturally moister, meaning the snus can slide as you speak or move your mouth, which may cause gum irritation. Because pouches generally don’t contain tobacco, there’s no spitting, unlike older products like chew and snuff. The nicotine and other ingredients found in these pouches can contribute to gum irritation, inflammation, and other oral health issues. Left untreated, this infection can turn into gingivitis or. Jan 25, 2024 · Some experts think nicotine deteriorates gum tissue, which could lead to periodontal disease, said Irfan Rahman, a researcher at the University of Rochester Medicine who has studied. Hydrate your mouth and keep it lubricated. This section embarks on a comparative analysis, elucidating the distinctions and resemblances in how these products might influence the gums. Apr 26, 2024 · Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. Gum disease is caused by one group of bacteria in plaque that makes toxins that inflame the gums, known as gingivitis. causes health problems beyond the mouth, and whether treating gum disease can keep other health conditions from developing. You can avoid irritation and prevent gum recession by carefully following the aftercare instructions provided by our dentist. The nicotine and other ingredients found in these pouches can contribute to gum irritation, inflammation, and other oral health issues. Zyn nicotine pouches are basically tiny bags — not unlike a tiny teabag — designed to be placed underneath the lip and between the gum. As estrogen fluctuates during perimenopause, some of this anti-inflammatory protection disappears Hormonal changes may also cause dental symptoms at other points in a woman's life, including. The 32-year-old said he quickly became addicted to Zyn, using up to 20 pouches a day. 38 weeks pregnant 2cm dilated Your lips, gums, tongue, cheeks, roof or floor of the mouth. But in the last decade or so, researchers and health regulators have begun to acknowledge different levels of harm. Apr 3, 2024 · CNN — A relatively new nicotine product with a tobacco-free and smokeless design has drawn in a wave of new users in just the past year: oral nicotine pouches that sit at the gums and are nearly. Expert Advice On Improving Your Home. If you have swollen gums or bleeding while brushing or flossing, you may have gum disease. Severe attachment loss and gum recession was found among tobacco chewers. Various substances can trickle into concrete’s tiny pores and leave a Expert Advice On Improving Yo. "Cardiovascular disease is the leading cause of death worldwide. Gum disease can lead to tooth loss and has also been linked to an increased risk of developing heart or blood vessel problems. The Stages of Gum Disease. The acid causes irritation of your gums which can turn into periodontal disease. But in the last decade or so, researchers and health regulators have begun to acknowledge different levels of harm. Left untreated, gingivitis can turn into periodontal disease (see "Signs of gum disease"). Zyns because I was unmedicated most of my life and it was a quick-fix without having to shell out money for a psychiatric evaluation. It comes in several flavors, including citrus, coffee, cinnamon and several mint varieties. " But the nicotine in Zyn pouches is highly addictive and it may increase cardiovascular disease risk in people not already using nicotine products, Rees said An essential facet of comprehending the oral health repercussions of ZYNs and nicotine pouches involves drawing parallels with the impact of traditional cigarettes on gum health. What it can cause: Dry mouth that can increase risk for cavities, gum disease and canker sores. Can ZYNs cause gum disease? Nicotine pouches in general will negatively impact your health over time. faux hawk mullet fade Xanthan gum really doesn’t sound that appetizing: The food additive is excreted by a strain of bacteria, Xanthomonas campestris, that is also responsible for the black slime that f. Smokeless tobacco is addictive. Alternate sides when using nicotine pouches consistently to avoid. Over time, gum disease can move to stages two or three. Symptoms of gum disease are often silent, meaning they may not appear until the advanced stages. However, dental treatments can help restore the gums around the teeth. Nicotine-induced endothelial dysfunction substantially contributes to the development of arteriosclerotic cardiovascular disease. Zyn Pouches, Your Health and Nicotine. They also release VSCs - Volatile. They reduce blood flow and oxygen levels and impair healing in the gums, leading to cell death. Key Takeaways: Zyns and vaping products both contain nicotine but differ in delivery and potential health risks. Jan 25, 2024 · Some experts think nicotine deteriorates gum tissue, which could lead to periodontal disease, said Irfan Rahman, a researcher at the University of Rochester Medicine who has studied. Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. In such cases, the pH level and nicotine in pouches would be much more likely to cause irritation or burning. it's certainly not a 'risk-free' product having been linked to gum disease, heart disease and strokes. Mild and Moderate Gum Disease Treatment: deep cleanings Toothpaste, whilst not a magic solution can help prevent and cure gum disease. if a girl had gum diseases or bleeding gums, and i received oral sex from her, what are the chances of me getting hiv, and is this worth getting tested.
May 7, 2024 · While Zyn pouches offer a tobacco-free alternative for nicotine consumption, they may still pose risks to gum health. Nicotine plays a significant role in the development and progression of this disease. Smokeless Tobacco is not a safe alternative to cigarettes. But before I introduce you to the incredible solutions that could help you cure your gum disease without the help of a dentist, I want to list the top signs and symptoms of gum disease quickly. There are two potential dental risks associated with nicotine gum. Medical History Survey: The dentist will ask questions about your medical history. free xfinity rewards list When nicotine enters the bloodstream, it can increase blood pressure and heart rate. Not to mention the terrible artificial sweeteners, which in great use can have lasting detrimental health risks. Apr 26, 2024 · Users stick them between their lip and gums, where they slowly release low levels of nicotine that are absorbed into the bloodstream. Feb 8, 2024 · Does Zyn raise blood pressure or cause gum damage? While we don't know the long-term effects of Zyn yet, health experts say there are several health concerns to be aware of when it. Yes, severe gum disease can put you at a higher risk of a fatal heart attack or stroke Good oral hygiene habits and regular professional dental cleaning are also super important in preventing gum disease. Say goodbye to sticky messes and enjoy a clean floor today. craigslist fort wayne farm and garden Zyn, a type nicotine pouch, is gaining popularity with some workers looking to get a boost. All of these can cause teeth to loosen and fall out. Does Zyn raise blood pressure or cause gum damage? While we don't know the long-term effects of Zyn yet, health experts say there are several health concerns to be aware of when it. Feb 8, 2024 · Does Zyn raise blood pressure or cause gum damage? While we don't know the long-term effects of Zyn yet, health experts say there are several health concerns to be aware of when it. Nicotine gum is sugar-free, and the chewing motion actually stimulates saliva production. Lack of routine dental cleanings with your vet can also cause gum disease in cats. Most children with gum disease have the mildest form, called gingivitis. Apr 26, 2024 · Chewing tobacco is linked to mouth cancer, gum disease and tooth loss. brevard county dmv appointment Feb 8, 2024 · Does Zyn raise blood pressure or cause gum damage? While we don't know the long-term effects of Zyn yet, health experts say there are several health concerns to be aware of when it. Nicotine is a powerful vasoconstrictor, not to mention a toxin which will damage the diversity of your oral flora. Are Zyns better than vaping?. You can read more about this in our do nicotine pouches cause gum disease guide No, ZYNs do not cause oral health problems when you follow good dental practices. This can lead to gum abscesses, and pus may. However, if you don't treat the disease, your disease will worsen. Chewing tobacco is linked to mouth cancer, gum disease and tooth loss.
Gum disease is incredibly common in cats; in fact, up to 90% of cats over the age of 4 may have gum disease 1. Plaque bacteria irritate your gums and cause inflammation. The early stages of RA can cause joint pain or tenderness. This section embarks on a comparative analysis, elucidating the distinctions and resemblances in how these products might influence the gums. Are nicotine pouches are safe? What are some nicotine Pouches side effects? Read our latest article for the answers to your nicotine pouch questions. Some medical conditions, such as hormonal changes, diabetes, and certain autoimmune diseases, can impact the color of the gums. Gum disease is common, and the early stages are very treatable. Severe attachment loss and gum recession was found among tobacco chewers. Side effects of use can include irritation of the gums, sore mouth, hiccups, nausea and most importantly, nicotine addiction which increases relapse risk with other tobacco products. Mild cases of gum disease, in early stages called gingivitis, can progress into a more serious condition called periodontitis. Let's also throw on this list that it can cause cells to stop responding to insulin, which can lead to higher blood sugar levels. Gum Disease. Given that half of adults over age 30 in the U have some form of gum disease, I don't recommend that anyone share saliva — even amongst family members, and especially not from parent to child. A new study links chronic inflammatory gum infections with a particular bacterium to rheumatoid arthritis via a process called "hypercitrullination". In this article, we'll provide you with information about gum disease, its causes, how to prevent it, and its treatment options. Without long-term data, we cannot be certain if or how reduced exposure will prevent harm to one's health. Medical History Survey: The dentist will ask questions about your medical history. matrixcare.pruitthealth A dentist gives the best and worst foods for sore gums, based on what is causing the soreness. These side effects might differ. Compare top pet insurance plans. Cause of Gum Sensitivity : Potential Remedies: Gum disease: Gingivitis, periodontitis, and other types of gum disease require professional medical attention and improved dental hygiene: Smoking: Since cigarette smoking can contribute to gum disease, switching to a smoke- and tobacco-free nicotine product is advisable: Oral infections Gum disease is where the gums become red, swollen and sore, and bleed. Zinc is a vital element in maintaining the normal structure and physiology of cells. Periodontal disease, a serious condition affecting gums and the supporting structures of the teeth, can be exacerbated by the use of oral nicotine pouches. Because pouches generally don’t contain tobacco, there’s no spitting, unlike older products like chew and snuff. About 9% of adults have severe gum disease. Learn the pros and cons of deep dental cleaning. It also raises your risk of developing oral, esophageal, and pancreatic cancer This can cause. It can vary from not noticeable, to irritating, to painful and bleeding throughout the mouth. For a week or two after you leave the dentist you do it every day, but you'. michael grimes net worth This can help reduce your. Apr 10, 2024 · Zyn is a nicotine pouch meant to be placed in the mouth between the upper lip and gum. Periodontal disease in dogs, commonly referred to as dog gum disease, causes progressive damage to the supporting structures of the teeth as a result of oral bacteria. How to blow a bubble with our gum and. The nicotine and other ingredients found in these pouches can contribute to gum irritation, inflammation, and other oral health issues. Apr 10, 2024 · Zyn is a nicotine pouch meant to be placed in the mouth between the upper lip and gum. CVS is famous for their ridiculously long receipts. When patients grind their teeth, two key forces are at work: Axial stress, which is a huge force applied vertically to the teeth and periodontium. The nicotine and other ingredients found in these pouches can contribute to gum irritation, inflammation, and other oral health issues. There has been a lot of talk about an association between oral and cardiac health, but is there really a direct link? Here's what we know. We would like to show you a description here but the site won't allow us. If left unchecked, gingivitis can cause the gums to separate from the teeth However, the following can be symptoms of gum disease: gums that are red, tender, or swollen; The only way to truly know whether your gum health condition is hormonal related or clinical periodontal disease is to meet with your dentist or gum specialist.