Gingivitis

Overview

What is gingivitis?

Gingivitis is a mild, early form of gum disease, also called periodontal disease. Gingivitis happens when bacteria infect the gums, often making them swollen, red and quick to bleed.

You can successfully manage gingivitis, especially with the help of a dentist. But left untreated, the condition can lead to periodontitis , a more severe type of gum disease.

Who gets gum disease?

Gingivitis is very common. Almost half of all adults older than 30 have some kind of gum disease.

Gum disease is more likely to occur in:

  • Men, though researchers aren’t sure why. It could have to do with hormones or that men are more likely to get related diseases. Men also tend not to go to the dentist as often.
  • People living in poverty and those with less than a high school education. These factors are tied to a number of diseases.
  • People who smoke, since smoking weakens the body’s ability to fight infection.

Symptoms and Causes

What causes gingivitis?

Everyone has bacteria in their mouths. Most bacteria are normal, natural and safe. But a few types of bacteria can create plaque, a sticky, almost invisible film on the teeth.

If you don’t clean your teeth regularly and thoroughly, the bacteria and plaque can cause an infection where your teeth meet your gums. That is gingivitis.

Plaque eventually hardens and becomes tartar, which is harder to remove. Tartar can trap more bacteria, worsening gingivitis.

Do certain things increase the chances of developing gingivitis?

You may face a higher risk of developing gingivitis if you:

  • Are pregnant or experience other hormonal changes tied to oral health.
  • Don’t take good care of your teeth or have crooked teeth that are hard to clean.
  • Have diabetes.
  • Have a family history of gum disease.
  • Smoke or chew tobacco.

Also, some prescription and over-the-counter medications can reduce the flow of saliva (spit). Saliva helps keep the mouth clean, so this change may contribute to gingivitis. Examples of such medications include:

  • Drugs to treat epilepsy.
  • Some cancer therapies.
  • Calcium channel blockers for blood pressure.
  • Oral contraceptives.

What are the symptoms of gingivitis?

Gingivitis often doesn’t cause any symptoms, so you may have it and not know it. As the condition worsens over time, you may develop:

  • Bad breath that doesn’t go away, even after brushing.
  • Gums that bleed easily, particularly when you brush your teeth.
  • Red, swollen gums.
  • Sensitivity to hot or cold foods.
  • Tenderness or pain when you chew food.

When should you call a dentist about your gums?

If you have one or more of the symptoms of gingivitis, call your dentist. Your dentist may examine you at your next checkup or make a special appointment. It depends on how long you’ve had symptoms and how severe they are.

Diagnosis and Tests

How does a dentist diagnose gingivitis?

If you have symptoms of gingivitis, you should see a dentist for a checkup. Your dentist will inspect your mouth for:

  • Bleeding.
  • Signs of infection such as redness and swelling.
  • Loose teeth.
  • Gums that are pulling away from the teeth.

If your dentist suspects gum disease, X-rays can show if it has affected the bones underneath. Your dentist may also refer you to a periodontist, a gum disease specialist.

Management and Treatment

How is gingivitis treated?

Treatment for gingivitis aims to control the infection and restore healthy teeth and gums. Your dentist or periodontist will thoroughly clean your teeth to remove harmful bacteria, plaque and tartar. Additional treatments include:

  • Perform scaling and root planing: Scaling removes tartar and bacteria from teeth and from underneath your gums. Planing smooths the surfaces of the roots of the teeth. This step helps prevent bacteria from sticking.
  • Offer dental restoration: Your dentist may fix or remove crowns, fillings or bridges that stick out or don’t fit right. Smoother surfaces are easier to keep clean.
  • Recommend an oral hygiene routine: A good dental cleaning usually clears up gingivitis. But you need to keep the cleanliness going once you return home. You’ll learn how to properly clean your teeth and get help scheduling checkups.
  • Write a prescription: An antimicrobial mouth rinse can help destroy bad bacteria.

Prevention

Can I prevent gingivitis?

You can prevent gingivitis with good oral hygiene:

  • Brush thoroughly twice a day: once when you wake up and once before you go to bed.
  • Control diabetes if you have it.
  • Don’t smoke or use other tobacco products.
  • Floss every day to remove bacteria between the teeth.
  • Limit food and drinks with lots of sugar, including alcohol.
  • See a dentist at least once a year for checkups, and more often if you have any symptoms.

If people in your family have gum disease, you may face a greater risk of developing it. You may need more checkups and cleanings to prevent gum disease.

Outlook / Prognosis

What is the outlook for gingivitis?

The earlier you catch gum disease, the more you can control it. Gingivitis is reversible if you have a checkup and cleaning, but it can come back. You must take good care of your teeth and gums between office visits.

If you don’t treat gingivitis, it can turn into more serious gum disease. Known as periodontitis, this gum disease damages the structures that keep teeth anchored.

Living With

What is good oral hygiene?

Good oral hygiene is the key to preventing gingivitis:

  • Brush teeth twice a day. Hit all the surfaces of each tooth, and don’t forget your gums, your tongue and the roof of your mouth.
  • Don’t use tobacco products.
  • Floss between the teeth once a day.
  • Limit food and drinks with lots of sugar, including alcohol.
  • Visit a dentist at least once a year, and more often if you have any problems with your teeth or gums.

What questions should I ask my dentist about gingivitis prevention?

Consider asking your dentist the following questions:

  • How should I brush my teeth?
  • How long should I brush my teeth?
  • Can you tell if I’m I missing any spots when I brush?
  • Will my insurance cover the dental cleaning and treatment I need?
  • Do you recommend a certain toothbrush, toothpaste, mouth rinse or floss?
  • When should I come in for another dental appointment?

A note from Cleveland Clinic

Everyone’s mouth is full of bacteria. Good oral hygiene can stop bacteria from causing gingivitis, the first stage of gum disease. If you find and treat gingivitis early, you can avoid permanent damage to your teeth and gums. See a dentist regularly for cleanings and checkups, not just when you have a toothache or other dental problem.

Last reviewed by a Cleveland Clinic medical professional on 11/17/2020.

References

  • American Dental Association. Gingivitis. (https://www.mouthhealthy.org/en/az-topics/g/gingivitis) Accessed 11/18/2020.
  • Centers for Disease Control and Prevention. Periodontal Disease. (https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html) Accessed 11/18/2020.
  • Institute for Quality and Efficiency in Health Care. Gingivitis and Periodontitis: Overview. (https://www.ncbi.nlm.nih.gov/books/NBK279593/) Accessed 11/18/2020.
  • National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease: Causes, Symptoms and Treatments. (https://www.nidcr.nih.gov/sites/default/files/2017-09/periodontal-disease_0.pdf) Accessed 11/18/2020.

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