Gingivitis

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Gingivitis is a common and mild form of gum disease (periodontal disease) that causes irritation, redness and swelling (inflammation) of your gums. Because gingivitis can be mild, you may not be aware that you have the condition.But it’s important to take gingivitis seriously and treat it promptly. Gingivitis can lead to much more serious gum disease (periodontitis) and eventual tooth loss.

Symptoms

Signs and symptoms of gingivitis include:

  • Swollen gums
  • Soft, puffy gums
  • Receding gums
  • Occasionally, tender gums
  • Gums that bleed easily when you brush or floss, sometimes seen as redness or pinkness on your brush or floss
  • A change in the color of your gums from a healthy pink to dusky red
  • Bad breath

When to see a dentist

Most dentists recommend regular checkups to identify gingivitis, cavities (caries) and other dental conditions before they cause troubling symptoms and lead to more serious problems. If you notice any signs and symptoms of gingivitis, schedule an appointment with your dentist. The sooner you seek care, the better your chances of reversing damage from gingivitis and preventing its progression to periodontitis.

Causes

The most common cause of gingivitis is poor oral hygiene that encourages plaque to form. Plaque is an invisible, sticky film composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth at least twice a day and flossing each day removes plaque. Plaque requires daily removal because it re-forms quickly, usually within 24 hours.

Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar can also develop resulting from the mineral content in your saliva. Tartar makes plaque more difficult to remove and creates a protective shield for bacteria. You usually can’t get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.

The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily. Tooth decay (dental caries) also may result.

Risk factors

Factors that can increase your risk of gingivitis include:

  • Poor oral health habits
  • Tobacco use
  • Diabetes
  • Older age
  • Decreased immunity as a result of leukemia, HIV/AIDS or other conditions
  • Certain medications
  • Certain viral and fungal infections
  • Dry mouth
  • Hormonal changes, such as those related to pregnancy, your menstrual cycle or use of birth control pills
  • Poor nutrition
  • Substance abuse
  • Ill-fitting dental restorations

Complications

Untreated gingivitis can progress to gum disease that spreads to underlying tissue and bone (periodontitis), a much more serious condition that can lead to tooth loss.

Periodontitis and poor oral health in general may also affect your overall health. It’s not completely understood — and researchers haven’t established whether periodontal disease actually causes any of these conditions — but having periodontitis may be associated with:

  • Heart attack
  • Stroke
  • Lung disease
  • Premature birth or having a baby with low birth weight, in women

Tests and diagnosis

Dentists usually diagnose gingivitis based on symptoms and an examination of your teeth, gums, mouth and tongue. Your dentist will look for plaque and tartar buildup on your teeth and check your gums for redness, puffiness and easy bleeding.

Treatments and drugs

Prompt treatment usually reverses symptoms of gingivitis and prevents its progression to more serious gum disease and tooth loss. Effective treatment requires professional care followed by stepped up oral hygiene at home.

Professional gingivitis care includes:

  • An initial evaluation and thorough dental cleaning to remove all traces of plaque and tartar
  • Instruction on effective home brushing and flossing techniques
  • Regular professional checkups and cleaning
  • Possibly fixing crowns or fillings (dental restorations) that make good hygiene difficult

Your initial professional cleaning will include use of dental instruments to remove all traces of plaque and tartar — a procedure known as scaling. Scaling may be uncomfortable, especially if your gums are already sensitive or you have extensive plaque and tartar buildup.

Misaligned teeth or poorly fitting crowns, bridges or other dental restorations may irritate your gums and make it harder to remove plaque during daily home care. If problems with your teeth or dental restorations contribute to your gingivitis, your dentist may recommend fixing these problems.

Gingivitis usually clears up after a thorough professional cleaning — as long as you continue good oral hygiene at home. Your dentist will help you plan an effective at-home program.

Lifestyle and home remedies

Steps you can take at home to prevent and reverse gingivitis include:

  • Get regular professional dental cleanings, on a schedule recommended by your dentist.
  • Use a soft toothbrush and replace it at least every three to four months.
  • Consider using an electric toothbrush, which may be more effective at removing plaque and tartar.
  • Brush your teeth twice a day, or better yet, after every meal or snack.
  • Floss at least once a day.
  • Use an antiseptic mouthwash, if recommended by your dentist.
  • Use an interdental cleaner, such as a dental pick or dental stick specially designed to clean between your teeth.

If you’re consistent with your home hygiene, you should see the return of pink, healthy gum tissue within days or weeks. You’ll need to practice good oral hygiene for life, however, so your gum problems don’t return.

Prevention

The best way to prevent gingivitis is a program of good dental hygiene, one that you begin early and practice consistently throughout life. A complete cleaning with a toothbrush and floss should take three to five minutes. Flossing before you brush allows you to clean away the loosened food particles and bacteria.

See your dentist or dental hygienist regularly for professional cleanings, usually every six to 12 months. If you have risk factors that increase your chance of developing gingivitis, you may need professional dental cleanings more often.

 

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