Gingivitis is inflammation of the gums.
Gum disease; Periodontal disease
Gingivitis is a form of periodontal disease. Periodontal disease is inflammation and infection that destroys the tissues that support the teeth. This can include the gums, the periodontal ligaments, and the tooth sockets (alveolar bone).
Gingivitis is due to the long-term effects of plaque deposits on your teeth. Plaque is a sticky material made of bacteria, mucus, and food debris that builds up on the exposed parts of the teeth. It is also a major cause of tooth decay.
If you do not remove plaque, it turns into a hard deposit called tartar (or calculus) that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become infected, swollen, and tender.
The following raise your risk for gingivitis:
- Certain infections and body-wide (systemic) diseases
- Poor dental hygiene
- Pregnancy (hormonal changes increase the sensitivity of the gums)
- Uncontrolled diabetes
- Misaligned teeth, rough edges of fillings, and ill-fitting or unclean mouth appliances (such as braces, dentures, bridges, and crowns)
- Use of certain medications, including phenytoin, bismuth, and some birth control pills
Many people have some amount of gingivitis. It often develops during puberty or early adulthood due to hormonal changes. It may last or come back often, depending on the health of your teeth and gums.
- Bleeding gums (blood on toothbrush even with gentle brushing of the teeth)
- Bright red or red-purple appearance to gums
- Gums that are tender when touched, but otherwise painless
- Mouth sores
- Swollen gums
- Shiny appearance to gums
Exams and Tests
The dentist will examine your mouth and teeth and look for soft, swollen, red-purple gums.
The gums are most often painless or mildly tender.
Plaque and tartar may be seen at the base of the teeth.
The dentist will use a probe to closely examine your gums in order to determine if you have gingivitis or periodontitis.
Most of the time, more tests are not needed. However, dental x-rays may be done to see if the disease has spread to the supporting structures of the teeth.
The goal is to reduce inflammation.
The dentist or dental hygienist will clean your teeth. The may use different tools to loosen and remove deposits from the teeth.
Careful oral hygiene is necessary after professional tooth cleaning. The dentist or hygienist will show you how to brush and floss.
Your dentist may recommend:
- Having professional teeth cleaning in addition to brushing and flossing twice a year, or more often for worse cases of gum disease.
- Using antibacterial mouth rinses or other aids
- Getting misaligned teeth repaired
- Replacing dental and orthodontic appliances
Any other related illnesses or conditions should be treated.
Some people have discomfort when plaque and tartar are removed from the teeth.
Bleeding and tenderness of the gums should lessen within 1 or 2 weeks after professional cleaning and good oral care at home.
Warm salt water or antibacterial rinses can reduce gum swelling. Over-the-counter anti-inflammatory medicines may also be helpful.
You must maintain good oral care throughout your life or gum disease will return.
- Gingivitis returns
- Infection or abscess of the gums or the jaw bones
- Trench mouth
When to Contact a Medical Professional
Call your dentist if you have red, swollen gums, especially if you have not had a routine cleaning and exam in the last 6 months.
Good oral hygiene is the best way to prevent gingivitis.
You should brush your teeth at least twice a day. You should floss at least once a day.
Your dentist may recommend brushing and flossing after every meal and at bedtime. Ask your dentist or dental hygienist to show you how to properly brush and floss your teeth.
Your dentist may suggest devices to help remove plaque deposits. These include special toothpicks, toothbrushes, water irrigation, or other devices. You still must brush and floss your teeth regularly.
Antiplaque or antitartar toothpastes or mouth rinses may also be recommended.
Many dentists recommend having teeth professionally cleaned at least every 6 months. Some plaque can be missed, even with careful brushing and flossing at home.
Amsterdam JT. Oral medicine. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 70.
Kawar N, Gajendrareddy PK, Hart T. Periodontal disease for the primary care physician. Dis Mon. 2011;57(4):174-183.
Chow AW. Infections of the oral cavity, neck, and head. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 60.
Ilona Fotek, DMD, MS, Palm Beach Prosthodontics Dental Associates, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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