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Children and adolescents are commonly diagnosed with gingivitis, especially around puberty. Gingivitis is the mildest form of gum disease. It causes inflammation of the gums without any loss of attachment or bone.
Gingivitis develops in response to bacteria that live in the gingival margin, in the spaces between your teeth, and in the surrounding gum tissues (sulcus). Gingivitis is reversible, which means the supporting structures of your teeth are not permanently damaged.
Children are more likely to develop gingivitis than periodontal disease. Periodontal disease (periodontitis) is a serious form of gum disease that permanently damages the gums and supporting structures of teeth.
Gingivitis affects about 73 percent of children between 6 and 11 years of age.
Young children, especially those who still have their baby (primary) teeth, acquire less plaque buildup than adults. As a result, they are less likely to develop gingivitis.
However, the chance of developing gingivitis increases with age, starting around age 5.
Once an adolescent hits puberty (between 10 and 16 years of age), the prevalence of gingivitis is close to 100 percent. This risk declines slightly and stays constant as a child reaches adulthood.
Puberty-associated gingivitis is caused by changes in hormones, similar to the hormonal changes that occur during pregnancy.
Girls have the highest risk of developing gingivitis around age 10. Boys are more likely to develop gingivitis around age 13.
During the early stages of life, children should pay close attention to their dental hygiene to prevent gingivitis during puberty. Many of the risk factors associated with gingivitis are preventable with lifestyle changes.
Common causes of gingivitis in children include:
Neglected brushing and flossing can lead to gingivitis. Dentists recommend brushing and flossing twice a day to help prevent gum disease, tooth decay, and other oral diseases. Mouth breathing can also dry out the teeth and gums, leading to gum disease over time.
Gingivitis forms due to the long-term buildup of plaque, which is a sticky film that contains cavity-causing bacteria. The gums can become irritated and inflamed if the plaque is not removed.
Puberty and menstruation can cause gum inflammation and sensitivity. Also, if a woman has gingivitis while pregnant, the disease can be transferred to her baby.
Tobacco is one of the primary causes of gum disease. Teenagers who smoke or chew tobacco are seven times more likely to develop gum disease than non-smokers. Those who have never smoked tobacco have the lowest risk of developing gingivitis.
Constant stress weakens the immune system and increases inflammation. High-stress levels combined with poor oral hygiene can lead to gum disease over time.
Poor nutrition makes it difficult for the body to fight off infections, which puts children at a higher risk of developing gum disease. The buildup of dental plaque is also more likely, especially if a child consumes sugary foods and drinks often.
Symptoms of gingivitis in children and adolescents include:
The best way to prevent gingivitis in children is to establish brushing and flossing habits early on.
Children and adolescents should brush at least twice a day with fluoride toothpaste and floss before going to sleep. Visiting a pediatric dentist every six months for professional teeth cleanings, x-rays, and dental exams are also necessary for gingivitis prevention.
Gingivitis is a reversible disease. If the disease isn’t caught early, it will become persistent into adulthood. Untreated gingivitis can turn into periodontal disease (periodontitis). Unfortunately, surgery is the only way to treat aggressive periodontitis. This is because it severely damages the teeth, gums, and surrounding bones. Without surgery, tooth loss can occur.
In addition to practicing good oral hygiene at home, plaque that lives in hard-to-reach areas must be removed twice a year during routine teeth cleanings.
During these appointments, a pediatric dentist will examine your child’s mouth and clean their teeth using small instruments. These instruments remove plaque that cannot be removed with a standard toothbrush.
If your child's gingivitis hasn’t persisted, no further treatment is necessary. However, if the disease develops into pediatric periodontal disease, more invasive treatments or surgery will be necessary.
“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
Nowak, Arthur J. Pediatric Dentistry: Infancy through Adolescence. Elsevier, 2019.