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Salem Health: Infectious Diseases & Conditions, 2nd Edition

Gingivitis

by Debra Wood

Category: Diseases and conditions

Anatomy or system affected: Gums, mouth, teeth, tissue

Also known as: Gum disease

Definition

Gingivitis is a mild, often reversible form of gum disease in which the gum tissue, which surrounds the teeth, is inflamed. If left untreated, gingivitis can progress to a serious condition called periodontitis (inflammation of the support tissue and bone).

Causes

Gingivitis is caused by a substance that forms on teeth called plaque. Plaque is a sticky material, composed of bacteria, mucus, food, and other substances. It hardens to form tartar or calculus. Plaque that is left on teeth for an extended time can cause gingivitis. Toxins produced by bacteria in dental plaque irritate the gum tissue and cause infection, inflammation, and pain.

Risk Factors

Risk factors for gingivitis include inadequate brushing and flossing; stress; clenching or grinding teeth; poor nutrition; diabetes; breathing through the mouth; human immunodeficiency virus infection; improper bite; advancing age; pregnancy; birth control pills; family members with gum disease; poorly fitting dentures; some medications taken for high blood pressure, heart disease, and depression; some seizure medications; drinking alcohol; smoking; and Down syndrome. Also, males are at higher risk for gingivitis.

Symptoms

Gingivitis is often painless, with symptoms developing when the condition becomes worse. Symptoms may include swollen and puffy gums, tender gums, redness in the gums or around the teeth, bleeding gums during brushing or eating, gum tissue that recedes or changes shape, and persistent bad breath.

Screening and Diagnosis

A dentist will examine teeth and gums and assess them for swelling and areas where the tissue might be pulling away from the teeth and forming a pocket. Early diagnosis of the problem enables prompt treatment and the possibility of reversing the condition. One should see a dentist every six months for a cleaning because gingivitis may have no symptoms in its early stages.

Stages of gingivitis.

Infect2e_p0466_1.tif

Treatment and Therapy

Gingivitis therapy aims to remove the irritating plaque and prevent its return. Treatment includes regular dental checkups and good oral hygiene; careful and frequent brushing and flossing; a healthful diet that is low in saturated fat and rich in whole grains, fruits, and vegetables; and self-care brushing. One should thoroughly brush and floss teeth using a soft-bristled toothbrush held at a 45-degree angle to the line where the teeth and gums meet, and should move the brush in small circular movements along the gum line and chewing surfaces of the teeth. An electronic toothbrush may make brushing easier for people with physical limitations. One should replace the brush when the bristles become bent or frayed, or every three to four months.

Brushing removes bacteria from the teeth, but the brush cannot reach everywhere it is needed. Flossing helps rid food and bacteria from between the teeth. The best method for flossing includes holding the floss tight and then gently bringing it down between the teeth. One should avoid popping the floss against the gum. It is ideal to curve the floss around the tooth and rub up and down. Finally, it is best to adjust the floss so a fresh section is used for each tooth. A dentist may recommend additional self-care treatments, such as massaging the gums with a rubber tip. Rinses to fight bacteria and plaque buildup may help some persons.

Dental health professionals check for gingivitis and remove plaque that has built up on teeth. A visit every six months is usually considered adequate. Persons with gingivitis may need more frequent cleanings. If the disease progresses and plaque builds up below the gum line, the area should be scraped off and smoothed with dental tools. Accumulated plaque and tartar buildup make it easier for bacteria to grow.

If an area has progressed to periodontal disease, surgery or medication may be required. Treating an underlying medical problem may improve the health of the gums. In persons with recurring or persistent gingivitis, a dentist will evaluate whether some other condition may be contributing to the gum disease.

Prevention and Outcomes

Strategies to prevent gingivitis include good dental habits, such as brushing teeth twice daily. There is some data that rotating oscillating electric toothbrushes are more effective in controlling gingivitis than is brushing by hand. Other strategies include flossing at least once a day, visiting a dentist’s office for a cleaning every six months, eating balanced and nutritious meals, avoiding smoking, and avoiding alcohol.

Further Reading

1 

Icon Health. Gingivitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, Calif.: Author, 2004.

2 

Lamont, R. J., and H. F. Jenkinson. “Life Below the Gum Line: Pathogenic Mechanism of Porphyromonas Gingivalis.” Microbiology and Molecular Biology Reviews 62, no. 4 (1998): 1244-1263.

3 

Langlais, Robert P., and Craig S. Miller. Color Atlas of Common Oral Diseases. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2009.

4 

Newman, Michael G., Henry H. Takei, and Perry R. Klokkevold, eds. Carranza’s Clinical Periodontology. 10th ed. St. Louis, Mo.: Saunders/Elsevier, 2006.

5 

Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Gingivitis. San Diego, Calif.: Icon Health, 2002.

6 

Sutton, Amy L., ed. Dental Care and Oral Health Sourcebook. 3d ed. Detroit: Omnigraphics, 2008.

Web Sites of Interest

American Academy of Periodontology

http://www.perio.org

American Dental Association

http://www.ada.org

Canadian Dental Association

http://www.cda-adc.ca

Canadian Dental Hygienists Association

http://www.cdha.ca

See also: Acute necrotizing ulcerative gingivitis; Cold sores; Herpes simplex infection; Herpesviridae; Herpesvirus infections; Inflammation; Mouth infections; Tooth abscess; Vincent’s angina.

Citation Types

Type
Format
MLA 9th
Wood, Debra. "Gingivitis." Salem Health: Infectious Diseases & Conditions, 2nd Edition, edited by H. Bradford Hawley, Salem Press, 2020. Salem Online, online.salempress.com/articleDetails.do?articleName=Infect2e_0242.
APA 7th
Wood, D. (2020). Gingivitis. In H. B. Hawley (Ed.), Salem Health: Infectious Diseases & Conditions, 2nd Edition. Salem Press. online.salempress.com.
CMOS 17th
Wood, Debra. "Gingivitis." Edited by H. Bradford Hawley. Salem Health: Infectious Diseases & Conditions, 2nd Edition. Hackensack: Salem Press, 2020. Accessed September 16, 2025. online.salempress.com.