Signs, Symptoms and Treatments of Gingivitis

Your good health means everything — and when it comes to staying on top of self-care and making sure your whole body is healthy, your mouth is one of the most important places to pay attention to, clean and check on a regular basis. Essential to your breathing, speaking, digestive health and more, your mouth is connected to so many systems in your body, and it’s also one of your most defining features.

If you love your smile, your teeth and your body in general, you’re probably aware of how important it is to avoid conditions like gum disease or periodontitis. They can lead to irreversible gum recession, dental infections, inflammation, tooth loss and even health issues in other areas of the body — but did you know that these serious oral afflictions start with gingivitis?

Affecting more than 30% of Canadian adults from ages 20 to 80, gingivitis is a common but often-overlooked condition that marks the early stages of more serious health issues like periodontitis — also known as gum disease. Gum disease is an oral condition that affects roughly half the American population and 70% of Canadians at some point throughout their lives. Although it’s entirely preventable and treatable, most people aren’t even aware they have gingivitis, let alone the risks it could pose if left untreated.

If you want to preserve your smile, prevent gum disease and promote better health all around, gingivitis awareness is key. From gingivitis causes, signs and symptoms to gingivitis treatments, here’s everything you need to know about the condition.

What Is Gingivitis?

Your teeth and gums are made up of various connected parts that support a healthy mouth. The periodontium is the part of your mouth composing the teeth and all their supporting structures, while the gums — also called gingivae — are pink, smooth tissues covered in mucous membranes, which are attached to the teeth, holding them in place and protecting them. Between the gums and each tooth is a small pocket, fold or gap called a sulcus, where bacteria and plaque accumulate when left uncleaned or unattended.

Every mouth is a breeding environment for bacteria — and when your mouth is healthy, it’s a balanced ecosystem of the right bacteria functioning with your gums, teeth and mouth in a healthy state that keeps you in equilibrium. When you allow too much bacteria or harmful bacteria to build up in your mouth, however, it manifests in plaque accumulation on your teeth and in the sulcus.

As a precursor to gum disease or periodontitis — which occur when so much bacteria builds up in the mouth that your periodontium and gums become inflamed — gingivitis is a condition in which your gums experience mild inflammation due to the overgrowth of harmful bacteria in the sulcus between the teeth and the gums. The bacteria buildup irritates the gums, causing swelling, redness, tenderness and sometimes even lesions.

The buildup of bacteria that most commonly leads to gingivitis and gum disease is known as tartar. Tartar buildup occurs when plaque is not removed quickly, giving it the opportunity to collect and harden over time. When enough tartar builds up under the gums, the tartar can begin to push the gums away from the teeth, resulting in gingivitis.

It is important to recognize plaque and remove it early before the minerals in your saliva start to deposit in the plaque, causing it to calcify and harden into tartar. Tartar, or calculus, takes an average of only 48 hours to form after plaque deposits on the teeth, so it is important to clean your teeth regularly. Sticking with a good oral hygiene routine of brushing and flossing your teeth can help you keep tartar from building up and gingivitis from occurring.

On rare occasions, plaque is not the cause of gingivitis. Instead, the condition can be traced back to a specific bacterium, virus or fungus. Other factors that can contribute to gingivitis include genetics, malnutrition, certain medications, wounds, systemic conditions like allergic reactions or illnesses and reactions to foreign bodies, such as dentures. In some cases, there is no clear cause for gingivitis.

Regardless of the cause of a case of gingivitis, the condition should be taken seriously and treated immediately. Even mild cases of gingivitis should be treated as soon as possible before they can develop into a more serious health issue, such as periodontal disease. Fortunately, there are many effective treatments for gingivitis.

Symptoms and Signs of Gingivitis

When your gums are healthy, they’re pale pink, smooth, strong and tight around your teeth. Gingivitis disrupts your gum health, making gums swollen and sensitive, though it’s possible for the signs of gingivitis to be somewhat subtle. To help you determine whether you might be in the early, reversible stages of gingivitis and assist you in preventing it from progressing to gum disease, we’ve listed the most common and noticeable symptoms of gingivitis in adults and children.

Here’s how to tell if you have gingivitis:

Look for swollen, tender, red or purple gums: Those with gingivitis typically have bright red or purple inflamed gums that are tender to the touch. Gums that are consistently in pain or extremely sensitive to touch or when eating certain foods are often diagnosed with gingivitis. Your gums may also be soft or puffy if you have gingivitis.
Pay attention to whether your gums bleed easily and regularly: If your gums bleed during and after flossing or brushing your teeth, you may have gingivitis.
Notice if your gums are receding: Chronic gingivitis can cause gum recession. Gums that have pulled away from the teeth often create a small pocket between the teeth. If your gums are receding, your teeth might appear longer as well.
Check for loose or shifted teeth: A receding gumline may result in teeth loosening or shifting. These changes may also affect the way your teeth fit together.
Be aware of pus: Any pus coming from between the gums or teeth is one of the clearest gum disease signs.
Don’t ignore bad breath: Persistent bad breath, also known as halitosis, or a chronic bad taste in your mouth are common gum disease symptoms.

Is Gingivitis Reversible?

Gingivitis is reversible with proper care, but if left untreated, it will progress to more serious conditions like periodontitis (Inflammation and loss of tissue and bone around teeth) and potential tooth loss. To prevent more severe and permanent dental issues, it is important to treat gingivitis as quickly as possible. Without treatment, gingivitis can develop into advanced periodontal disease.

Here are the four stages of periodontal disease to be aware of:

1. Gingivitis

In this first stage, the gum disease has not yet had time to attack the bones, which means gingivitis is the only reversible phase of periodontal disease. Because gingivitis is merely the buildup of plaque, there are few symptoms of gingivitis that are severe enough to notice. For this reason, it is imperative to practice good oral hygiene and routinely visit your dentist, who can recognize and help reverse any silent signs of gingivitis.

2. Slight Periodontal Disease

As one of the early stages of gum disease, slight periodontal disease is manageable despite being irreversible. At this point, the infection has reached the bone and begun the process of destroying the bones. The bacteria has also become increasingly aggressive, putting the patient at a greater risk of bone loss. Simply following good oral hygiene will not be enough to remedy slight periodontal disease.

3. Moderate Periodontal Disease

This phase is also irreversible. By this point, the bacteria can attack even deeper to target the bones and immune system via the bloodstream. Treatment for this phase of gum disease and slight periodontal disease involves scaling and root planing. Scaling and root planing are two types of deep cleaning that extract the deeply rooted deposits of bacteria from the gums.

4. Advanced Periodontal Disease

In this final phase of gum disease, the infection has deepened even further and the bacteria has developed into disease-causing bacteria. Anyone with advanced periodontal disease is significantly at risk of bone loss. In addition, advanced periodontal disease can lead to more serious symptoms, such as gum recession, gaps between the teeth, the need for dentures and overall health problems like diabetes and heart disease. Advanced periodontal disease requires periodontal surgery to clean the mouth’s deep pockets of bacteria.

To avoid the later stages of periodontal disease, you can practice effective daily hygiene habits and schedule routine dentist appointments. Having any plaque buildup removed regularly by a professional can help stop the progression of periodontal disease.

How Do You Get Gingivitis?

A certain balance of bacteria in your mouth is healthy. But when you experience an overgrowth of bacteria in your gums or a disruption of the bacterial balance in your gum pockets and surrounding areas, it builds up an excess of plaque on your teeth, in your sulcus and throughout your mouth. When left untouched for too long, plaque hardens and becomes tartar on the teeth while causing swelling and redness in the gums.

Inflammation is your body’s natural reaction to excessive bacterial buildup, which is why it’s one of the earliest gingivitis symptoms. If inflammation continues over time, however, it can lead to long-term tissue damage, loss of gum tissue, loss of bone structure and even tooth loss.

While poor dental hygiene or neglecting your dental health can contribute to the bacterial buildup that causes gingivitis, your mouth can also be influenced by a variety of other risk factors, including hormones, other diseases, preexisting conditions and family history. At its core, however, gingivitis occurs because of excessive plaque buildup. Here are the main causes of gingivitis related to plaque:

Harmful bacteria and plaque accumulate and increase in your mouth because of weak immunity or poor dental hygiene.
A bacterial imbalance occurs where harmful bacteria overtake positive bacteria by outnumbering them or overtaking them.

This imbalance or overgrowth of bacteria — which leads to the harmful, excessive presence of plaque and the development of gingivitis — can occur as a result of a variety of behaviors, habits, health factors and other influences.

Who’s at Risk of Getting Gingivitis?

When it comes to the factors that affect the accumulation of bacteria and the excessive presence of plaque that leads to gingivitis, multiple behavioral and physical circumstances can increase your risk of developing the condition — although gingivitis can occur in anyone.

Here are the most important and common risk factors of gingivitis:

Poor dental hygiene: In most cases, excessive plaque buildup is a result of poor oral hygiene habits. Not flossing and brushing on a regular basis is an easy, unfortunate way to disrupt the bacterial balance in your mouth, allow harmful bacteria and plaque to take over and jeopardize your oral health in general. Neglecting to go to your dentist for regular cleanings can also allow plaque to accumulate unchecked, resulting in gingivitis.
Overuse of mouthwash: Although many people mistakenly believe mouthwash can prevent gingivitis or serve as a substitute for flossing or brushing, excessive use of it can be a poor dental habit leading to gingivitis. It dries out the mouth and kills both good and bad bacteria, leaving your mouth in a vulnerable state — which can be especially harmful if you rinse instead of flossing or brushing. Non-alcoholic mouthwashes are a better alternative as they don’t produce the same drying effect and are gentler on the tissues.
Tobacco use: Bad habits like smoking cigarettes or chewing tobacco can be extremely damaging to your mouth. Not only do they introduce unpleasant chemicals to your mouth, but they also make it more difficult for your gum tissue to repair itself — meaning if your gums are irritated or inflamed by plaque, they’re less likely to be able to heal and more likely to progress into stages of gingivitis and irreversible gum disease.
Hormonal changes: During puberty, menopause and menstruation, people experience fluctuating or unusual hormone levels, which change the body’s store of bacteria and make the gums themselves more sensitive — meaning plaque buildup, inflammation and gingivitis are more likely to occur. In addition, other conditions or actions that interfere with hormones — like thyroid issues and some birth controls — can increase the likelihood of gingivitis setting in.
Pregnancy: Pregnant women are especially susceptible to gingivitis because of the hormonal changes that occur during pregnancy. The hormones estrogen and progesterone, in particular, fluctuate throughout pregnancy, which can alter the tissues in the body and change the body’s response to plaque. These changes can make a pregnant woman’s gums more sensitive to bacteria and plaque, which can lead to gingivitis. Typically, signs of gum disease show up any time between the second and eighth months of pregnancy.
Family history: When considering your chances of developing gingivitis, look at your family dental history. Even when you demonstrate good oral habits and are in generally good health, sometimes genetics come into play when it comes to developing a disease or condition. A family history of certain dental disorders can contribute to the probability of you getting gingivitis.
Medications: Like hormones, certain prescription drugs and medications can change your body’s natural state and make you more susceptible to gingivitis. Antihistamines, seizure medications and anticonvulsants, calcium channel blockers, immunosuppressants, anti-angina medications and blood pressure medications can either lessen saliva flow and affect the protective abilities of the gums or cause abnormal gum tissue growth — both of which could lead to gingivitis because they imbalance the mouth’s natural condition.
Mouth breathing: Excessively breathing through your mouth — either in your sleep or throughout the day — can do a lot of damage to your mouth’s bacterial state and the health of your gums. Keeping your mouth closed is important to maintaining bacterial equilibrium, while keeping it open for long periods of time and exposing it to too much air and outside components will dry it out, disrupt bacteria balances and cause even healthy gums to bleed or crack — making gingivitis a much stronger possibility.
Sleep-disordered breathing: Just like mouth breathing, sleep-disordered breathing can negatively affect your overall mouth health, increasing your likelihood of developing gingivitis. Sleep disorders — like upper airway resistance syndrome, sleep apnea and more — affect your quality of breathing and the quality of your mouth health, sometimes contributing to gingivitis and poor gum health.
Dry mouth: Caused either by mouth breathing, natural circumstances, illnesses or medications, a dry mouth is a mouth that has trouble maintaining the natural bacterial equilibrium necessary for adequate tooth and gum health, making it much more possible for gingivitis to develop, even with proper dental care.
Poor nutrition: If your body isn’t receiving the right amount of nutrients — either because you eat an unhealthy diet or because you experience gut issues that cause poor absorption of nutrients — your mouth will be unable to support gum health, tissue repair and bacterial equilibrium, leaving you more susceptible to gingivitis.
Illnesses: Diseases or conditions that affect your immune system, blood sugar, strength or ability to operate properly — like cancer, osteoporosis, HIV, diabetes and other conditions — make it difficult for your body to fight infections and ward off inflammation, making gingivitis and gum disease more possible.
Aging: Up to 70%of seniors ages 65 and older are suffering from gum disease. This issue could be due to the fact that overall health is bound to decline somewhat as we get older and that plaque buildup increases over the years, but it could also be because salivary glands produce less fluid with age, and certain medications many seniors take can cause their dental health to become compromised.
Aggressive dental care: You might think that being attentive to your flossing and brushing habits means you completely cut off your chance of developing gingivitis or gum disease, but being too aggressive with your brushing and flossing can actually have the opposite effect. When you brush or floss harder in an attempt to get your mouth cleaner, you wear down your tooth enamel and gums, making your mouth less healthy and stripping away your defenses for fighting plaque and gingivitis.
Autoimmune disorders: An autoimmune disorder is a condition in which your body misinterprets and attacks your healthy tissues rather than harmful components, causing inflammation and making it difficult for your body to repair itself. This kind of disorder makes gingivitis more likely — and research suggests that gingivitis itself might be classified as an autoimmune disorder because it produces inflammatory cytokines that cause extreme inflammation in both the gums and the rest of the body.
Weak immune system: If you have a poor immune system due to genetics, illness or poor health habits, your gums and mouth are less capable of regenerating tissue and fighting bad bacteria, making you more susceptible to developing gingivitis. Obesity can also compromise the immune system.

How to Prevent Gingivitis

While gingivitis can be painful and inconvenient and progress to more serious gum disease if left untreated, the good news is that it’s both curable and preventable with the proper degree of care. In fact, you can avoid gingivitis from occurring by practicing the right dental hygiene techniques.

To keep gingivitis from ruining your mouth before it ever occurs, follow these preventive habits:

Brush your teeth at least twice a day, making sure to be thorough but not scrubbing too hard to strip away gums or enamel.
Use an electric toothbrush to target those hard-to-reach areas and help eliminate harmful plaque more easily.
Replace your toothbrush regularly to make sure you’re not “cleaning” your teeth with a brush full of old bacteria and plaque.
Buy a toothbrush with extra soft bristles to go easy on your mouth while still keeping it clean.
Floss every day, making sure to thoroughly remove plaque and buildup between each tooth. Try not to be overly aggressive and hurt your gums.
Control your plaque and tartar buildup and overall mouth health by scheduling a professional dental cleaning at least once a year — preferably twice.
Maintain a well-balanced diet to give your body the proper nutrition it needs to fight against infections.
Alter your diet to include less sugar, which will eat away at your teeth and cause both cavities and plaque buildup.
Try to avoid stressful situations, as stress makes it more difficult for the body to remain healthy and ward off infection.
Avoid tobacco products that can be harmful to your teeth and gums.
Avoid medications known for contributing to gingivitis risk.
Avoid excessive use of mouth-drying mouthwashes.
Avoid clenching and grinding your teeth, both of which tend to place excess force on your teeth’s supporting tissue, potentially accelerating the rate at which those tissues are destroyed.

How to Treat Gingivitis

If you do develop gingivitis, it’s not too late, so don’t worry — you just have to focus on improving your dental care habits, diet and overall health to reverse the effects and ensure it doesn’t progress to gum disease. Here are some steps you can take for gingivitis treatment:

Maintain a better diet: When it comes to boosting your body’s immune reaction, ridding it of harmful bacteria and toxins, and repairing damaged tissue, the best way to start reversing gingivitis is to improve your diet. Because gingivitis is often caused by inflammation and a lack of nutrients as well as poor dental hygiene, focusing on a nutrient-rich diet that incorporates plenty of antioxidants, probiotics and vitamins is crucial to a gingivitis cure. In particular, make sure your diet includes plenty of vitamin E and vitamin C, both of which help your body repair its damaged tissues. Try to eat plenty of leafy greens, nuts, vegetable oils, citrus fruits, berries, vegetables, yogurt and spices to support better mouth health.
Stop smoking: Tobacco contributes to the development of gingivitis and gum disease and makes reversing the condition almost impossible by ensuring that your gums won’t heal. If you’re serious about stopping your gingivitis in its tracks, you need to avoid tobacco.
Reduce your stress: Too much stress can slow or prevent your body from being able to fight infection and heal in a normal way, so focus on de-stressing and relaxing in healthy ways to help treat your gingivitis.
Improve your oral care: Dental hygiene is crucial to maintaining a healthy mouth, so if you know your oral habits are partly to blame for developing gingivitis — or even if you already take good care of your teeth — be sure to make dental care a priority. Thoroughly brush your teeth twice a day, and make sure to floss at least once. Dedicate time to cleaning plaque and food particles out of your mouth, but make sure you’re not too hard on your tender gums.
Use a mouthwash: A quick rinse of mouthwash won’t completely remove dental plaque on its own because plaque is a sticky substance. However, if you use mouthwash in tandem with routine brushing and flossing, you can boost your body’s ability to fight off plaque buildup and gum disease. Look for a mouthwash that is specifically for plaque and tartar protection, which can help prevent plaque from regrowing so it does not accumulate as quickly throughout the day.
See a dentist: If you don’t think your gingivitis is improving despite incorporating these healthy habits — or you’d just like some professional care to make sure your mouth is healthier — visit a dentist to address the issue.

Make Dental Choice Your Choice for Gingivitis Treatment

If you’re concerned about your swollen, tender or bleeding gums or want to learn more about preventing and treating gingivitis, Dental Choice offers the information and services you need to keep your gums healthy. Our oral health care professionals strive to prevent gum disease complications by removing plaque buildup and providing other periodontal disease treatments, such as scaling and surgical procedures.

Offering free consultations, reliable technology and convenient availability for both general and restorative dental care, we’re committed to delivering high-quality dental care that combats gum disease. Contact us today to schedule your appointment at a Dental Choice office near you.