Gingivitis (gum inflammation)

Key points about gingivitis

  • Gingivitis is a common mild inflammation (redness and swelling) of your gums. It's a sign of poor oral hygiene.
  • It's caused by the build-up of plaque on your teeth due to not brushing and flossing regularly enough.
  • Symptoms include red and tender gums, and bleeding when brushing or flossing.
  • You can usually treat gingivitis at home yourself through good oral hygiene, such as brushing your teeth twice a day and flossing them once each day.
  • If left untreated, gingivitis may progress into more serious gum diseases, known as periodontitis.
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Gingivitis is a sign that there is excess 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 bacteria. These bacteria, along with mucus and other particles, constantly form a sticky ‘plaque’ on your teeth. If you don’t brush and floss regularly, the plaque can harden and form ‘tartar’ (also known as ‘calculus’). Calculus increases the rate at which plaque forms, as it provides a base for the bacteria. This causes inflammation of your gums, or gingivitis.

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 are at increased risk of you: 

  • have poor brushing habits, which leads to plaque and tartar building up
  • smoke
  • have diabetes (especially if poorly controlled)
  • are obese
  • have a weakened immune system
  • have a dry mouth (saliva is protective) – this can be caused by some medications and aging
  • 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:

  • 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). If your gingivitis is chronic, use any mouthwash daily. If your gingivitis persists, see a dentist.

You should also:

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

If left untreated, gingivitis may progress to more deep-seated inflammation and infections in the 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 as smokers typically do not have bleeding gums as they have poor blood supply to the gums. If you are 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 are starting to fight the plaque.

The following links provide further information about gingivitis. Be aware that websites from other countries may have information that differs from New Zealand recommendations. 

Dental plaque and gum disease(external link) Patient Info, UK, 2017
Gum disease(external link) NHS Choices, UK, 2016
Gingivitis and periodontal disease(external link) WebMD, 2017

Resources

Ministry of health - teeth care for families(external link) Ministry of Health, NZ, 2012
Available in the following languages: English(external link), Cook Islands Māori(external link), te reo Māori(external link), Niuean(external link), Samoan(external link), Tokelauan(external link), Tongan(external link)
Take care of your teeth(external link) Ministry of Health, NZ, 2007

References

  1. Chapple IEC et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium(external link) J Clin Periodontol. 2018 Jun;45 Suppl 20:S68-S77
  2. EL Morelli, JM Broadbent, JW Leichter, WM Thomson. Pregnancy, parity and periodontal disease(external link) Australian Dental Journal. 2018; 0: 1–9.
  3. Robinson P, Deacon S A, Deery C et al. Manual versus powered toothbrushing for oral health(external link) Cochrane Database Syst Rev 2005; CD002281.
  4. Smoking and oral health(external link) Better Health Australia, 2017

See also pages for clinicians on gum conditions and periodontitis 

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Jonathan Broadbent, Associate Professor, Dental Public Health, Department of Oral Sciences, University of Otago

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