Gingivitis is a treatable disease, most often caused by a buildup of dental plaque, that is characterized by inflammation in the gum tissue. If left untreated, gingivitis can progress to periodontitis, which may lead to the destruction of gum tissue and periodontal bone and may also lead to tooth loss. With thorough oral hygiene, including professional cleanings, gingivitis can be reversed and the gums, or gingiva, can return to a healthy state. The symptoms of gingivitis correspond to the symptoms of general types of inflammation, including swelling, bleeding, or redness of the gums, tender or painful gums, and bad breath.
While gingivitis is reversible, if poor oral hygiene habits continue following successful treatment, gingivitis is likely to recur. In addition to periodontitis, gingivitis can lead to infection or abscess of the gum tissue or of the bones in the jaw, swelling in the lymph nodes, or trench mouth, which is a painful bacterial infection characterized by ulceration of the gums. Gingivitis is associated with low birth weights and premature births, and recent studies suggest that bacteria that cause gingivitis may also correlate to Alzheimer’s disease, though more research is needed before this claim can be confirmed.
Plaque-induced gingivitis is caused when bacterial plaque, which is present in every human’s mouth, accumulates between the teeth and just under the edges of the gum tissue. Some types of bulky dental restorations are also prone to plaque buildup, and tartar that has built up on the teeth can also attract the accumulation of plaque. Chemicals produced by this plaque accumulation can cause inflammation and weakening of the gingival tissue that holds the gums tight to the teeth, allowing more plaque to enter the small spaces between the gums and the teeth, thereby worsening the gingivitis; gingivitis begets more gingivitis. Gingivitis is more common in aging people, people with poor oral hygiene, people who brush their teeth too aggressively, and people with certain pre-existing health conditions like osteoporosis, diabetes, and depression. Gingivitis may also be exacerbated by stress, cigarette smoking, certain medications, mouth breathing while sleeping, and some genetic factors. Gingivitis can be diagnosed by a dentist or dental hygienist during a dental examination. While the majority of gingivitis is caused by plaque, some gingivitis can be caused by viruses, fungi, systemic conditions, or trauma.
Preventing gingivitis requires regular, effective oral hygiene. Dentists recommend brushing twice daily with a soft-bristled toothbrush and fluoride toothpaste, as well as flossing daily. Research suggests that electric toothbrushes may work better than manual toothbrushes at reducing plaque-induced gingivitis. Dentists may also recommend using a specific type of mouthwash, containing either hydrogen peroxide or chlorhexidine, for people who are prone to gingivitis. Gingivitis may also be treated with topically applied antibiotics, applied either directly to the gums with an oral irrigator or as a prescription mouthwash. If allowed to progress to periodontitis, dentists may recommend a dental deep cleaning treatment called scaling and root planing, in which the plaque and tartar that have built up on the teeth and under the gums are scraped away with specialized dental instruments, allowing the gums to re-adhere to the teeth and return to health.