Periodontal disease begins as inflammation of the gums. This may manifest as bleeding gums during flossing, brushing, or even eating. Pain can, but usually does not accompany gum disease until it reaches an advanced stage. Recession of the gums is also a common presentation and may include sensitivity of the affected teeth to cold air, food, or liquids. Bad breath and loosening of teeth is another sign of periodontal disease and should be discussed with your dentist or periodontist as soon as possible.