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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Gingivitis

Gum disease; Periodontal disease

Last reviewed: February 25, 2014.

Gingivitis is inflammation of the gums.

Causes

Gingivitis is a form of periodontal disease. Periodontal disease is inflammation and infection that destroys the tissues that support the teeth. This can include the gums, the periodontal ligaments, and the tooth sockets (alveolar bone).

Gingivitis is due to the long-term effects of plaque deposits on your teeth. Plaque is a sticky material made of bacteria, mucus, and food debris that builds up on the exposed parts of the teeth. It is also a major cause of tooth decay.

If you do not remove plaque, it turns into a hard deposit called tartar (or calculus) that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become infected, swollen, and tender.

The following raise your risk for gingivitis:

  • Certain infections and body-wide (systemic) diseases
  • Pregnancy (hormonal changes increase the sensitivity of the gums)
  • Uncontrolled diabetes
  • Misaligned teeth, rough edges of fillings, and ill-fitting or unclean mouth appliances (such as braces, dentures, bridges, and crowns)
  • Use of certain medications, including phenytoin, bismuth, and some birth control pills

Many people have some amount of gingivitis. It often develops during puberty or early adulthood due to hormonal changes. It may last or come back often, depending on the health of your teeth and gums.

Symptoms

Exams and Tests

The dentist will examine your mouth and teeth and look for soft, swollen, red-purple gums.

The gums are most often painless or mildly tender.

Plaque and tartar may be seen at the base of the teeth.

The dentist will use a probe to closely examine your gums in order to determine if you have gingivitis or periodontitis.

Most of the time, more tests are not needed. However, dental x-rays may be done to see if the disease has spread to the supporting structures of the teeth.

Treatment

The goal is to reduce inflammation.

The dentist or dental hygienist will clean your teeth. The may use different tools to loosen and remove deposits from the teeth.

Careful oral hygiene is necessary after professional tooth cleaning. The dentist or hygienist will show you how to brush and floss.

Your dentist may recommend:

  • Having professional teeth cleaning in addition to brushing and flossing twice a year, or more often for worse cases of gum disease.
  • Using antibacterial mouth rinses or other aids
  • Getting misaligned teeth repaired
  • Replacing dental and orthodontic appliances

Any other related illnesses or conditions should be treated.

Outlook (Prognosis)

Some people have discomfort when plaque and tartar are removed from the teeth.

Bleeding and tenderness of the gums should lessen within 1 or 2 weeks after professional cleaning and good oral care at home.

Warm salt water or antibacterial rinses can reduce gum swelling. Over-the-counter anti-inflammatory medicines may also be helpful.

You must maintain good oral care throughout your life or gum disease will return.

Possible Complications

When to Contact a Medical Professional

Call your dentist if you have red, swollen gums, especially if you have not had a routine cleaning and exam in the last 6 months.

Prevention

Good oral hygiene is the best way to prevent gingivitis.

You should brush your teeth at least twice a day. You should floss at least once a day.

Your dentist may recommend brushing and flossing after every meal and at bedtime. Ask your dentist or dental hygienist to show you how to properly brush and floss your teeth.

Your dentist may suggest devices to help remove plaque deposits. These include special toothpicks, toothbrushes, water irrigation, or other devices. You still must brush and floss your teeth regularly.

Antiplaque or antitartar toothpastes or mouth rinses may also be recommended.

Many dentists recommend having teeth professionally cleaned at least every 6 months. Some plaque can be missed, even with careful brushing and flossing at home.

References

  1. Amsterdam JT. Oral medicine. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 70.
  2. Kawar N, Gajendrareddy PK, Hart T. Periodontal disease for the primary care physician. Dis Mon. 2011;57(4):174-183. [PubMed: 21569880]
  3. Chow AW. Infections of the oral cavity, neck, and head. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 60.

Review Date: 2/25/2014.

Reviewed by: Ilona Fotek, DMD, MS, Palm Beach Prosthodontics Dental Associates, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Fact sheet: Gingivitis and periodontitisFact sheet: Gingivitis and periodontitis
    Gingivitis (inflammation of the gums) often does not cause any immediate symptoms. Yet it may spread to other parts of the periodontium (the bone and soft tissue responsible for keeping our teeth firmly anchored) and cause damage there. This is called periodontitis. Even if this does not cause any symptoms at first, consequences become apparent later on. If periodontitis gets worse, it can lead to teeth becoming loose and eventually falling out. Treatment and better dental hygiene can counteract gingivitis. They can also usually help to slow down periodontitis.
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Figures

  • Tooth anatomy.
    Gingivitis.
    Gingivitis.

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