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Gingivitis is the most common type of gum disease. Like tooth decay , it can be reversed with early detection, proper oral hygiene , and appropriate treatment by your dentist.

A build-up of plaque along the gum line often causes gingivitis. However, some other conditions and personal habits can cause gingivitis as well.

It is important to learn how to detect and stop the progression of gingivitis. If left untreated, the bacteria and inflammation will destroy the fibers attaching your gums (gingiva) and teeth, allowing more bacteria to invade and destroy the underlying bone. Once the attachment fibers begin to break down, gingivitis becomes periodontal disease (periodontitis). At this point, It is not reversible or curable. If you have periodontal disease, you will need to manage it for the rest of your life.

The most common cause of gingivitis is poor oral hygiene, which leads to a build-up of plaque on your teeth. Plaque is full of bacteria. If it is not removed from your teeth daily, it hardens and turns into tartar (calculus). If plaque and tartar remain on your teeth, the bacteria will quickly irritate the gums (gingiva) around the base of your teeth.

Factors that can increase your risk of developing gingivitis include:

  • Poor oral hygiene
  • Crooked or crowded teeth that are more difficult to clean
  • Dental work such as fillings , crowns , or bridges (fixed partial denture)
  • Smoking or chewing tobacco
  • Dry mouth (xerostomia)
  • Medications for conditions such as high blood pressure and epilepsy.
  • Poor nutrition and diets high in sugar
  • Vitamin C deficiency
  • Hormonal changes in women such as puberty, changes in menstrual cycle, use of birth control, or pregnancy .
  • Diseases or conditions that lower your body's immunity such as HIV/AIDS, leukemia, and cancer treatments.
  • A family history of gingivitis or periodontal disease (periodontitis).
  • Additional risk factors arising from age.
    • As you age, healing and immune cells in the blood begin to decrease, prolonging recovery times and making it more difficult to prevent infections and disease.
    • Dexterity, while usually associated with age, is also associated with non-age-related factors, including arthritis . Poor dexterity can make it more challenging to clean your mouth properly.
    • While also associated with age, cognitive issues can be related to other non-age-related factors like head trauma, developmental disabilities, or psychiatric issues. These factors may lead to poor maintenance of regular oral hygiene practices.

Some signs and symptoms that indicate you may have or are prone to gingivitis include:

  • Bleeding gums (gingiva), especially when you brush and floss
  • Swollen gums
  • Gums that are tender or sore
  • Gums that are a darker shade than normal
  • Receding gums
  • Bad breath (halitosis)
  • Pockets between the gums and the teeth

To diagnose gingivitis, your dentist will:

  • Review your dental and medical history and ask you about your habits and lifestyle choices that may contribute to your symptoms.
  • Examine your mouth for plaque , tartar (calculus), and inflamed gums (redness, swelling , bleeding, or infectious drainage).
  • Measure your gum pockets with a probe. Pockets that measure between one and three millimeters are generally considered healthy and can be cleaned with a toothbrush and floss. Pockets around three to four millimeters deep with signs of inflammation may indicate gingivitis. Pockets deeper than four millimeters may indicate periodontal disease (periodontitis).
  • Take dental X-ray (radiograph) images to examine areas of deeper gum pockets for signs of bone loss .

Minimizing the factors that can contribute to gingivitis and maintaining good oral hygiene habits are the best steps you can take.

What you can do:

  • Avoid unhealthy habits that can contribute to gingivitis.
  • Use a soft-bristled manual, electric or sonic toothbrush, and brush gently at least twice per day.
  • Floss daily
  • Use additional tools to clean the plaque from between your teeth, like an interdental brush , a dental pick, a toothpick, a floss threader, or a water flosser.
  • Use an oral rinse designed to reduce plaque.
  • Make sure you stay up to date on your dental exams and cleanings.

If your dentist has diagnosed you with gingivitis, the sooner you get treated, the better your chances of reversing its effects. Treatment and continued oral hygiene will also prevent it from progressing to more serious conditions. Your dentist will help you by providing professional tooth cleanings and oral hygiene instructions .

Author: Symbyos staff, go2dental staff
Medical review: Thomas J. Greany DDS
Last medical review: January 18, 2021
Last updated: June 2, 2021