Gingivitis refers to inflammation of the gums that surround the teeth. The irritation is typically caused by a build-up of plaque on the tooth surfaces along the gum line.

Gingivitis is one periodontal disease. There are many periodontal diseases, with gingivitis being less severe than the others.

Gingivitis is also referred to as periodontal disease, gum disease, acute necrotizing ulcerative gingivitis (ANUG), trench mouth and periodontitis.

Periodontitis is a condition that often accompanies gingivitis, occurring when gingivitis is not successfully treated. The tissues supporting the teeth can become damaged and eventually lead to tooth loss. Unchecked gingivitis can also lead to trench mouth, or Acute Necrotizing Ulcerative Gingivitis (ANUG); a potentially life-threatening ailment.

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  • Swollen, shiny, or bright red gums
  • Gums that are receding, exposing more tooth surface
  • Mouth sores, or gums that are oozing pus
  • Severe bad breath or other foul oral smell
  • Gums that are tender, painful, or prone to bleeding
  • Pockets along the gums
  • A persistent bad taste in the mouth
  • Teeth that feel loose or are visibly shifting
  • Changes in the way your teeth fit together when you bite down, or shifts in the fit of dentures
  • Teeth that appear longer or larger


The simplest cause of gingivitis is a bacterial infection of the gums. The infection is not contagious, and typically builds slowly over time. Plaque naturally builds on the teeth. Over time, this plaque will be mineralized by minerals that are found in the saliva; it will gradually become calculus, or tartar. This tartar houses bacteria, and as it spreads into the gum line, it can irritate the gums.

As this process continues and the plaque and tartar become thicker, the bacteria are able to thrive. As they flourish, they begin releasing toxins into the gums, further inflaming the soft tissue. Gingivitis typically will not actually develop unless there is some other underlying medical condition or illness that allows it to occur.
Stress plays a role in the development of gingivitis; especially with more severe cases.

Some diseases increase the risk of developing gingivitis, including pregnancy, uncontrolled diabetes and the hormone changes that accompany puberty. The use of birth control pill can also play a role, as can ingestion of heavy metals.

Condition of Teeth

The condition of your teeth and dental work can also play a role. When teeth are not aligned properly, fillings have rough edges or dental work is not property fitted the chances for developing gingivitis increase. These are all places where plaque and tartar can hide and grow.

There are also some medications that can allow the development of gingivitis. These include medications taken for high blood pressure, organ transplants and seizures. Gingivitis can be genetic, and it is also commonly seen in people with poor oral hygiene habits.

Risk factors

When gingivitis is allowed to progress unchecked, bacteria and toxins can use these areas under the gum line to actually enter the bloodstream. Dental challenges, including gingivitis, are thought to be a contributing factor in heart disease.

Other diseases lined to gingivitis include diabetes, arteriosclerosis, osteoporosis, and pancreatic cancer. The microorganisms linked to gum disease are also associated with stroke and heart disease.

When the bacteria experience accelerated growth, the condition can quickly become Acute Necrotizing Ulcerative Gingivitis, or ANUG. Stress, poor nutrition and a compromised immune system all lend to this particular development. People who are suffering from this advanced condition will also have extremely bad breath, the gums will be in a great deal of pain, and the overall deterioration of the gums will continue.

When to Consider a Doctor

If you have been working with your dentist to treat your gingivitis, and it continues to plague you, there may be an underlying illness at play. An appointment should be made with your doctor to diagnose and treat the underlying cause.

Gingivitis is the first step on the road to periodontitis, and eventually tooth loss. However, the progression can be halted with proper treatment and prevention.

As the gingivitis advances, and periodontitis sets in, the inner layer of the gum that surround the teeth can begin to pull away from the teeth. This creates a pocket where debris and tartar can collect, opening the door for infection and further complications. The more the pockets open up, the more the disease advances.

Prevention tips

Prevention tips for gingivitis

Plaque is constantly growing on the teeth, but it will typically take about three months for the pathogenic bacteria to begin invading the areas between the gums and teeth.

Regular brushing and flossing can help prevent the infection from taking hold.

Regular visits to the dentist are necessary to prevent infections and gingivitis.

The best dental regimen at home still will not remove all the plaque and tartar.

Make the time to see your dentist at least twice a year for deep cleanings.

Some people have larger pockets between their teeth and gums. Any person with pockets larger than 5 mm is said to have deep periodontal pockets; and should see their dentist every three to four months, rather than the standard two times a year.

Prevention Checklist

Choose toothpaste that has fluoride. They are not any more expensive than the other toothpastes, but can help prevent plaque from taking hold.

Stress impairs your immune system. Find some ways to relieve stress to keep your immune system strong and functional. Eating a well-balanced diet is also essential to a healthy immune system.
Do not clench or grind your teeth as this action can create excessive force on the gums and lend to their weakening.

Brush and floss properly. This means taking the time that is truly needed. It should take you three to five minutes to brush and floss your teeth. Flossing should be done before you brush. This opens up those areas between the teeth so your toothbrush can clean them effectively.

You should also take time to brush along the gum line. Angle the toothbrush towards the gums, and then flatten it out to focus on the teeth. When you are done brushing, your gums should feel like they just a comforting massage. You should also alternate between two toothbrushes so that they each have time to dry out completely.

Electric Toothbrush

Invest in an electric toothbrush. Electric toothbrushes remove 98.2% of plaque compared with a traditional toothbrush that removes less than 50% of plaque.

Test and diagnosis considerations

Your dentist can successfully determine if you have gingivitis. As soon as you see the warning signs, make an appointment for a complete dental examination. Early discovery and treatment of gingivitis can be highly successful, and the damage can often be reversed.

The dentist will make the determination by talking with you about your symptoms, reviewing your medical history and performing an oral exam. Bloodwork, x-rays and tissue samples are typically only checked if the condition fails to improve with treatment. They may also check all the teeth for pockets along the gum line, and record the severity of them. This will help the dentist track how well you are healing with treatment.

Treatment options

Dental Procedures

A dentist can perform scaling or root planning along the gum line to remove the offending plaque. The process will thoroughly remove the plaque biofilm from the teeth. This is much more than a simple cleaning as it will actually go below the gum line to remove the offending bacteria and toxins.

The hygienist will thoroughly removing all tartar, or calculus, by scaling the surface of the tooth. This will leave the tooth rough, and so the planning is done to make the tooth smooth again.

The procedure is often done over several visits, with different sections of the mouth being focused on. It is common for people to require some mild anesthesia during the process.

Fees & Procedures

The fees can be several hundred dollars as this is a time consuming process. However, most insurance companies will pay for root planings. They typically will cover a certain number of root planings ever year or every couple of years.

The treatments are highly effective as they remove the cause of the gingivitis, giving your body time the time it needs to heal. After the teeth are worked on this manner, you can expect an increased sensitivity to hold and cold temperatures. This will improve over time as the gums shrink and close up around the teeth again. There may also be some tenderness to the gums, which will also improve over time.


Mentronidazole antibiotics can be prescribed for severe cases, such as ANUG. This medication is taken for one week, then a scaling or root planing is performed by a dental hygienist or dentist. This medication can be purchased for less than $25 for 250 tablets, and will help prepare the teeth for the root planing and scaling.

Good Oral Hygiene

Antiseptic mouthwashes can be used to kill the bacteria and germs that are causing inflammation to the gums. These mouthwashes only cost a few dollars. Use them after you have flossed and brushed. They will leave a protective coating in your mouth that will kill bacteria.

Studies have proven that Listerine has the ability to kill these bacteria and keep your mouth healthy. Remember to swish for at least one minute to get the maximum benefit. You can also use a solution of 50% hydrogen peroxide and 50% water as a mouthwash to kill bacteria. This should be used three times per week. With any mouthwash, take care that you do not swallow the wash as this can cause some stomach upset.

Flossing & Brushing Tips

You should floss before you brush. Flossing should be done regularly to remove all food particles, plaque, and tartar from between the teeth and around the gum line. It is so easy to skip this step of your dental hygiene, but if you have gingivitis, it is just as important as brushing.

Go high-tech. Buy a Sonicare toothbrush or other high-end electric toothbrush. The cost can run between $75 and $200, but it is well worth it. They are so much more effective at removing plaque and bacteria that the toothbrush will easily pay for itself in saved dental work. However, any toothbrush is only effective if it is actually used. Make sure you are brushing at least twice a day.

Get a proxa brush A proxa brush is a tiny little brush, much like a bottle brush, that is attached to the end of a stick. They only cost a few dollars and can be found in most drug stores and in the dental care aisle of your favorite store.

They can be used to slip into those hard to reach spots under and around dental work, or between teeth. This tool can help you keep your teeth clean and your mouth healthy.

Your Own Toothpaste

Make a paste. Using baking soda a little water, you can create a soothing and healthy paste. Use you fingers to gently rub it into your gum lines. You can then brush as normal. This will clean the gums, polish your teeth, kill bacteria and deodorize your mouth.

Try an aloe gel. Aloe has the ability to reduce the level of plaque in your mouth. And, because it’s a healing agent, it can also help sooth the gums. Use the gel to gently brush your gums. It can be found at your local pharmacy and is another inexpensive alternative.

Bring the dentist’s tools home. Dental picks are available for purchase at most drug stores. They only cost a few dollars, but can be very useful if you tend to produce a lot of plaque and tartar. If you can look on your teeth and see the tartar, then you can use these tools to remove it at home.

Other Tips

Taking the time to do this can help keep gingivitis at bay, and speed up your next dental appointment slightly. This is not meant to be a substitute for regular dental care. However, used effectively, this can be a good treatment that you can do at home.

Other Daily Habits

Smoking can impair the body’s ability to heal and prevent any treatments from being truly effective. For the best chances at full dental recovery, you should not smoke. You should reduce stress to help your body’s immune system work better.

Massage your gums. You can pinch your gums by putting your index finger on the inside and your thumb on the outside. Massaging them will increase blood flow and make them healthier, and better able to resist gingivitis. Alternatively, you can invest in the high-quality toothbrush and enjoy the gum massage it will give you every time you brush.

Eat more raw vegetables. The fibers in the food can help keep your teeth and your gums clean and in great health.

Now that you know the truth about gingivitis, what it can lead to, how to treat it and how to prevent it, you are ready to take action! You don’t have to live with bleeding, tender gums anymore. You don’t have to worry that you’ll wind up with dentures. With these tips and treatments, as well as the prevention information, you can continue enjoying your natural teeth for many years to come.




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