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Gingivitis, also referred to as mild gum disease, is characterized as the inflammation of the gingiva (gums). In gingivitis, the damage is reversible and the supporting structures of teeth, such as bones, are not permanently lost.
Gingivitis is the earliest stage of periodontal disease (PD), which is a severe form of gum disease that develops from untreated gingivitis due to long-term plaque buildup. PD seriously damages the gums and bones, and surgery is typically the only treatment option for this disease. The earlier your dentist catches gingivitis, the less likely PD or tooth loss will occur.
More than half of American adults are affected by gingivitis and the prevalence is even higher as people age. Children and teens are also at risk of developing gingivitis, especially during puberty. Many people do not find out they had gingivitis until periodontal disease develops. This is because mild gum disease typically does not cause pain, show clear warning signs, or affect everyday life.
“About 50 percent of adults aged 30 or older (65 million people) have signs of gum disease.”
Stage 1 — As excess plaque builds up in the mouth, foreign bacteria and proteins are released. This causes an immediate response that results in the migration of inflammatory cells to the gingiva. These cells produce cytokines, which are small proteins that signal to other cells.
Stage 2 — Some of the activated cytokines cause dilated blood vessels, which means they become porous and leaky in the infected area (gingiva). Cytokines also tell other cells to create destructive proteins to help destroy bacterial cells. When these cells kill bacteria, they also damage healthy cells, which causes the tissues to break down.
Stage 3 — Blood cell leakage occurs in the gingiva, which causes redness and swelling. As a result, gingivitis forms.
Gingivitis is the earliest stage of periodontal disease, also referred to as periodontitis. Many of the risk factors associated with both diseases are similar and preventable with lifestyle changes:
Tobacco doesn't actually "cause" gum disease. However, it can contribute to it by causing dry mouth, which leads to more plaque accumulation. Smokers are seven times more likely to develop gum disease than non-smokers. Those who have never smoked tobacco have the lowest risk of developing gum disease.
Inconsistent brushing and flossing habits can cause gingivitis. So, it is recommended to brush and floss twice a day to help prevent gum disease, cavities, and other oral health conditions.
Gingivitis forms due to the long-term buildup of plaque, which is a sticky film that coats teeth and contains decay-causing bacteria. When plaque is not removed completely, the gums become inflamed and irritated over time.
Constant stress weakens the immune system and increases inflammation. High-stress levels, in combination with poor oral hygiene, are also linked to the formation of gum disease.
Due to extreme hormonal changes during pregnancy, roughly 60 to 75 percent of pregnant women develop gingivitis. Additionally, the disease can be transferred from mother to baby, which may lead to low birth weight or preterm birth. Puberty, menopause, and menstruation also cause increased inflammation and sensitivity in the gums.
Poor nutrition makes it difficult for the body to fight infection, which puts people at a higher risk of developing gum disease. The buildup of dental plaque is also more likely, especially when consuming sugary or processed foods long-term.
Cancer, diabetes, and HIV make it difficult to fight infections, such as gum disease. Some prescription medications can also increase your risk of gum disease. For example, this includes blood pressure medications, heart disease medications, and immunosuppressants.
Dry mouth occurs when the salivary glands in the mouth do not make enough saliva. This condition is often a side effect of aging. However, medications and radiation therapy can also lead to dry mouth, and eventually gum disease.
Routine brushing, flossing, and professional teeth cleanings help prevent gingivitis, but there is still a possibility of formation even with proper oral care. In particular, common warning signs and symptoms of gingivitis formation include:
The best way to prevent gingivitis and more severe gum diseases is by brushing and flossing regularly, using mouthwash, and visiting the dentist for professional teeth cleanings.
Since gingivitis is reversible, good oral hygiene is the best way to prevent the disease. There are three different outcomes for someone with gingivitis:
The reversal of early gingivitis is relatively simple and focuses on the removal of plaque during professional teeth cleanings. During the treatment, a dentist or dental hygienist examines the patient’s teeth and cleans them using small instruments. These instruments remove plaque and tartar that a normal toothbrush cannot reach.
If the gingivitis hasn’t persisted, no further treatment is needed. Although, if periodontitis has formed, further treatment is necessary. This may include scaling and root planing, flap surgery, bone grafting, or gum grafting.
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“Gingivitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 4 Aug. 2017, www.mayoclinic.org/diseases-conditions/gingivitis/symptoms-causes/syc-20354453.
National Institutes of Health (NIH). Periodontal (Gum) Disease: Causes, Symptoms, and Treatments. NIH Publication, 2013. https://www.nidcr.nih.gov/sites/default/files/2017-09/periodontal-disease_0.pdf
Kachlany, Scott C. Infectious Diseases of the Mouth. Chelsea House, 2007.