Gingivitis (gum inflammation)

Gingivitis is a common and mild form of gum disease causing redness and swelling of the gums around the base of your teeth.

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Gingivitis mostly occurs if you don’t look after your teeth properly, or if an area is often missed by your toothbrush by mistake, when cleaning your teeth. If your teeth aren’t cleaned well at home and checked regularly by a dentist, plaque can build up where your gums meet your teeth. If it’s not managed, gingivitis can lead to periodontal disease.

Gingivitis is a sign that there is excess bacteria and plaque in your mouth, which your body is fighting back against through inflammation. As your gums get inflamed, they can become puffy and bleed when you brush.

This happens because your mouth is full of all sorts of bacteria – some good for us, some bad. The bad bacteria, along with mucus and other particles, can form a sticky ‘plaque’ on your teeth. If you don’t brush and floss regularly, the plaque may harden from the calcium in your saliva and form ‘tartar’ (also known as ‘calculus’). Calculus increases the rate at which plaque forms, as it provides a base for the bacteria to live on. This causes inflammation of your gums, or gingivitis. It can't be removed at home, it needs a dentist or dental hygienist to carefully scrape it off – called scaling

It can be easy to overlook mild gingivitis. You may be unaware of it until your dentist or hygienist checks for it. Look out for the following symptoms:

• swollen red gums
• bleeding when brushing, flossing or eating
• tenderness or pain
• bad breath (halitosis)
• sensitivity to cold or hot foods and drinks.

Gingivitis can affect anybody but you're at increased risk if you: 

• have poor brushing habits, which leads to plaque and tartar building up
• smoke
• have diabetes (especially if it's poorly controlled)
• are obese
• have a weakened immune system
• have a dry mouth (saliva is protective) – this can be caused by some medications and by getting older
• have poorly fitting dentures
• brush your teeth too hard
• are pregnant
• have a diet lacking in vitamins and minerals. 

In most cases, you can treat gingivitis at home by following good oral hygiene practices. These include:

• gently brushing your teeth twice a day (first thing in the morning and before bed) with a fluoride toothpaste
• using a soft or ultra-soft toothbrush – medium and hard toothbrushes can damage your gums and can be less effective at removing plaque
• flossing regularly to remove plaque from between your teeth – if you have larger gaps between your teeth a dental professional might recommend you use an interdental brush
• considering using an electric toothbrush rather than a manual one
• using mouthwash daily after brushing to further reduce bacteria in your mouth.

For acute gingivitis, use a mouth rinse such as Colgate Savacol for up to 2 weeks (longer-term use may stain your teeth and it's the wrong type of mouthwash for long-term use). If your gingivitis is ongoing, use any supermarket type of mouthwash daily. If your gingivitis persists, see a dentist.

You should also:

• visit your dentist routinely for a check-up and professional cleaning
• avoid smoking and limit alcohol intake
• avoid cannabis use as this is associated with severe gingivitis and periodontitis
• avoid eating sugary foods between meals. 

If it's not treated, gingivitis may develop into more deep-seated inflammation and infections in your mouth, such as periodontitis (periodontal or gum disease), although this doesn’t always happen. Periodontal or gum disease can destroy the ligaments and bone holding your teeth securely in place so that they become loose and teeth may eventually fall out.

Gingivitis can also lead to acute necrotising ulcerative gingivitis, which is a condition that causes pain, tissue loss and foul breath.

Prevention is the same as treatment. If you follow the steps outlined under treatment, you have much less risk of developing gingivitis.

Avoiding smoking is a key step in keeping your gums healthy. People who smoke have a higher risk of gum problems (and oral cancer), such as complications after tooth extractions and surgery in your mouth. You have lower resistance to infections and your healing is impaired. 

Gum conditions in smokers are also often not noticed. This is because people who smoke typically don't have bleeding gums as they have poor blood supply to their gums. If you're a smoker and you stop smoking, your gums are likely to start to bleed. This is because the blood supply is returning to your gums and they're starting to fight the plaque.

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