Gingivitis means inflammation of the gums (gingiva). It commonly occurs because of films of bacteria that accumulate on the teeth – plaque; this type is called plaque-induced gingivitis. Gingivitis is a non-destructive type of periodontal disease. If left untreated, gingivitis can progress to periodontitis, which is more serious and can eventually lead to loss of teeth.
A patient with gingivitis will have red and puffy gums, and they will most likely bleed when they brush their teeth. Generally, gingivitis resolves with good oral hygiene – longer and more frequent brushing, as well as flossing. Some people find that using an antiseptic mouthwash, alongside proper tooth brushing and flossing also helps.
In mild cases of gingivitis, patients may not even know they have it, because symptoms are mild. However, the condition should be taken seriously and addressed immediately.
There are two main categories of gingival diseases (1999 World Workshop in Clinical Periodontics):
A symptom is something the patient feels and describes, such as painful gums, while a sign is something everybody, including the doctor or nurse can see, such as swelling.
In mild cases of gingivitis there may be no discomfort or noticeable symptoms.
Signs and symptoms of gingivitis may include:
The accumulation of plaque and tartar
The most common cause of gingivitis is the accumulation of bacterial plaque between and around the teeth, which triggers an immune response, which in turn can eventually lead to the destruction of gingival tissue, and eventually further complications, including the loss of teeth.
Dental plaque is a biofilm that accumulates naturally on the teeth. It is usually formed by colonizing bacteria that are trying to stick to the smooth surface of a tooth. Some experts say that they might help protect the mouth from the colonization of harmful microorganisms. However, dental plaque can also cause tooth decay, and periodontal problems such as gingivitis and chronic periodontitis.
When plaque is not removed adequately, it causes an accumulation of calculus (tartar – it has a yellow color) at the base of the teeth, near the gums. Calculus is harder to remove, and can only be removed professionally.
Plaque and tartar eventually irritate the gums.
Gingivitis may also have other causes, including:
A dentist or oral hygienist checks for gingivitis symptoms, such as plaque and tartar in the oral cavity.
Checking for signs of periodontitis may also be recommended; this may be done by X-ray or periodontal probing.
If the patient is diagnosed early on, and treatment is prompt and proper, gingivitis can be successfully reversed.
Treatment involves care by a dental professional, and follow-up procedures carried out by the patient at home.
Gingivitis care with a dental professional:
What the patient can do at home:
In the vast majority of cases, if gingivitis is treated and the patient follows the dental health professional’s instructions, there are no complications. However, if the condition is left untreated, gum disease can spread and affect tissue, teeth and bones, leading to periodontitis.
Possible complications from gingivitis may include: