Periodontal disease, a disorder involving bacterial infection of the gums, is very prevalent in the United States today.1 It is estimated that 35.7 million Americans are living with the disease.1 It is present when inflammation and infection destroy the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets. Gingivitis, the mildest form of periodontal disease, is an inflammatory process confined to the gums. It is caused by a nonspecific, long-term accumulation of plaque on the teeth and is usually reversible. Plaque-induced gingivitis is the most common form of the disease.2
Plaque is a sticky material that develops on the exposed portions of the teeth, consisting of bacteria, mucus, and food debris. If plaque accumulates on the teeth, it mineralizes into tartar, a hard white substance that forms around the base of the teeth. Tartar makes plaque more difficult to remove. The tartar and plaque inflame the gums, which can result in infection. The longer plaque and tartar remain on the teeth, the more they irritate the gingivae and thus gingivitis occurs.2
More than 75% of the population experiences gingivitis at some level3.
Inflammation of the gums also can occur from injury or trauma caused by overly vigorous brushing or flossing of the teeth. Systemic conditions, such as diabetes, pregnancy, and general illness, can place your gums at risk for gingivitis.2
More than 75% of the population experiences gingivitis at some level.3 It can be caused by a lack of effective oral hygiene or by the hormonal changes during puberty or early adulthood. Once it develops, gingivitis may persist or recur throughout life.2
Although it was once believed that untreated gingivitis would inevitably lead to periodontitis, a much more serious form of periodontal disease, that is no longer the scientific conclusion. Even though periodontitis results from some form of gingivitis, untreated gingivitis does not always result in periodontitis.4
What Is Gingivitis?
Gingivitis is an inflammation of the gums characterized by a change in color from normal pink to red, with swelling, bleeding, and often sensitivity and tenderness. These changes result when a layer of bacteria accumulates along the gum line and the body's immune system responds to the release of destructive bacterial products.5
- Swollen gums
- Bright red or red-purple appearance to gums
- Shiny appearance to gums
- Bleeding gums (blood on toothbrush or floss even with gentle brushing and flossing)
- Gums that are tender when touched, but otherwise painless
- Persistent bad breath or bad taste in mouth
- Poor oral hygiene
- Tobacco use
- Systemic diseases, such as diabetes and leukemia
- Certain medications, such as steroids, some antiepilepsy and cancer therapy drugs, some calcium channel blockers, and oral contraceptives
- Decreased immunity
- Poor nutrition
- Defective fillings
Diagnosed With Gingivitis?
Here's What You Can Do Gingivitis therapy aims to remove the irritating plaque and prevent its return. To help avoid the occurrence of gingivitis or to reverse gingivitis, you should:
- Brush twice a day for 2 minutes with a fluoride toothpaste that contains an antibacterial and anti-inflammatory ingredient.
- Brush with a soft-bristled toothbrush held at a 45° angle to the line where your teeth and gums meet. Move the brush in small circular movements along the gum line and chewing surfaces of your teeth. A power toothbrush may make brushing easier and more efficient.
- Floss daily. Hold the floss tight. Gently bring it down between the teeth. Do not pop the floss against the gum. Curve the floss around the tooth and gently rub up and down. Adjust the floss so you use a fresh section for each tooth, including the back side of the last teeth. Alternative flossing methods are available for patients who have difficulty flossing or who cannot floss.
- Rinse with an antiplaque, antigingivitis mouthwash that contains either cetylpyridinium chloride or essential oils.
- Visit your dentist or dental hygienist every 3 to 6 months, depending upon the severity of the gingivitis.
How Severe Is the Problem?
If you develop gingivitis, your dentist can use various methods to determine the extent and severity of your condition. These methods are normally based on the assessment of color, contour, and bleeding of your gums.
Perhaps the most widely used assessment is the Gingival Index of Loe and Silness,6 which categorizes the condition as:
- Mild gingivitis—slight change in color of gums (from pink to slight red), slight swelling of gums, no bleeding on probing
- Moderate gingivitis—gums are red in color, moderate swelling of gums, some bleeding on probing
- Severe gingivitis—marked redness of gums, swelling of gums, ulcerations, spontaneous bleeding on probing
"IF I GET GINGIVITIS, DOES THIS MEAN EVENTUALLY I'LL GET PERIODONTITIS AND NEED SURGERY?"
Not necessarily. Periodontitis results from some forms of gingivitis, but untreated gingivitis does not always result in periodontitis. Once developed, however, gingivitis may persist throughout life. Treating your gingivitis will reduce your risk of developing the more severe gum disease.
Practice good oral hygiene. Keeping a clean mouth by controlling plaque buildup is essential in reversing and controlling gingivitis. A complete cleaning with a toothbrush and floss should take at least 2 minutes. Flossing before you brush allows you to clean away the loosened food particles and bacteria.
See your dentist. Visit your dentist as often as recommended for routine cleanings and checkups.
Eat a healthy diet. Eat a well-balanced diet containing plenty of fresh fruits and vegetables. Vitamin C, an antioxidant, is essential for healthy gums. Foods that are good sources of vitamin C include citrus fruits, berries, cantaloupe, broccoli, and spinach. Also, calcium is essential for bone health (including tooth bone), and many experts recommend getting 1,200 mg to 1,500 mg of the mineral every day.
The content of this guide is for information purposes only. It does not substitute for the dentist's professional assessment based on the individual patient's case.