If you develop gingivitis and do not have the plaque or tartar (hardened plaque) removed from your teeth, the condition may get worse and lead to periodontitis.

You may develop further complications if you do not treat periodontitis (where the tissue that supports teeth is affected), including:

• recurrent gum abscesses (painful collections of pus)
• increasing damage to the periodontal ligament (the tissue that connects the tooth to the socket)
• increasing damage to and loss of the alveolar bone (the bone in the jaw that contains the sockets of the teeth)
• receding gums
• loose teeth
• loss of teeth

Acute necrotising ulcerative gingivitis

If you have acute necrotising ulcerative gingivitis (ANUG) and it is not treated, it can cause more severe complications.

The infection can spread to all areas of your gums and the alveolar bone surrounding your teeth. This can lead to:

• the gums between your teeth being completely destroyed
• large ulcers (open sores) leaving permanent holes in your gums
• loose and unstable teeth

If ANUG is not properly treated the first time you have it, you are more likely to have recurring cases in the future. This can cause persistent bad breath (halitosis) and bleeding gums, as well as gradually receding gums.

In very rare cases, ANUG can lead to a condition called gangrene affecting the lips and cheeks. This occurs when tissue starts to die and waste away. If you develop gangrene, you may need to have the dead tissue removed.

Other complications

Gum disease has also been associated with an increased risk for a number of other health conditions, including:

• cardiovascular disease
• lung infections
• if affected during pregnancy, premature labour and having a baby with a low birth weight

However, while people with gum disease may have an increased risk of these problems, there is not currently any clear evidence that gum disease directly causes them.