Worried about gingivitis? This comprehensive guide is chock full of information that can help you to detect early signs of the various types of gingivitis so you can seek treatment before your condition escalates into an irreversible disease.
What is Gingivitis?
Gingivitis is a condition in which the gums become red and inflamed in areas where plaque biofilm was not sufficiently removed. The root words come from gingiv = gingiva (gums) and itis = inflammation of.
Gingivitis is the earliest and most simple form of gum disease; however, unlike more severe forms of gum disease, gingivitis can be reversed and completely cured.
Gums that are swollen, tender, or discolored may very well be signs of gingivitis, but you’ll soon learn how to spot the symptoms like a pro so you can seek immediate treatment.
What Causes Gingivitis?
Gingivitis can be caused by several different factors that are both internal and external. The most common cause of gingivitis is poor oral hygiene, which allows bacteria to congregate at the gum line. In response to the buildup of bacteria and plaque biofilm, the gums become inflamed and tender.
Gingivitis is our inflammatory system’s response to bacteria in an area of the mouth where there shouldn’t be any bacteria. Bacterial plaque easily congregates at the gum lines of the teeth and may extend to areas under the gums and between the teeth. When this bacterium is not removed adequately on a routine basis, the body begins to attack the area, sending antibodies to destroy the plaque.
It is similar to having an injury on another part of your body: If there is an open wound that collects dirt and germs and you neglect to keep it clean, the area will become red, swollen, and sore. If you avoided cleaning this area, the infection would persist and become worse, leading to other problems. The same is true when germs and bacteria are not removed efficiently from the gum lines and between the teeth. Not brushing properly, often enough, or avoiding flossing can all cause gingivitis.
Other causes include:
- A hormonal imbalance or sudden surge of hormones
- Certain types of medication
- Various diseases and illnesses such as HIV, anemia, etc.
- Nutritional deficiencies
Dangers of Gingivitis
Because the beginning stages of periodontitis (periodontal disease) evolve from gingivitis, it is extremely important to tackle your symptoms before they can cause irreversible problems.
If gingivitis is allowed to persist and goes untreated, the area becomes so infected that destruction of gum attachment and bone levels occur around your teeth. This attachment loss starts out small, allowing food to pack under your gums and letting tartar build up on the root of your teeth.
The infection becomes worse and worse until there is so much bone loss that teeth easily begin to fall out. Once you have lost teeth due to periodontal disease, ordinary tasks like speaking or eating become painful and difficult.
As if all of that weren’t bad enough, the effects of gingivitis can also have a negative impact on other parts of your body. When your immune system is strained by gingivitis, it makes it difficult for your body to fight other conditions from which you may be suffering. The more severe your gum infection is, the more likely you are to suffer from severe health problems. By treating or preventing gum infections like gingivitis, you can increase your body's ability to recover from conditions such as:
- Cardiovascular disease
- Arterial plaque
- Heart attack
- Premature labor
- Erectile dysfunction
Types of Gingivitis
Like many health complications, gingivitis can take many different forms. Below, we’ve highlighted all of the different types of gingivitis that may occur.
Acute Necrotizing Ulcerative
Acute Necrotizing Ulcerative (also commonly referred to as trench mouth) is a terribly painful form of gingivitis that results in small, sensitive ulcers between teeth. This severe form of gingivitis is less common than others and causes the gums to appear to have punched out areas in the tissue. Acute Necrotizing Ulcerative usually results in a heightened immune response and inflammation of the lymph nodes.
Sometimes, certain types of medications can spur an overgrowth of gum tissue formerly known as gingival hyperplasia. This form of gingivitis is typically caused by three main types of drugs: immunosuppressants, anticonvulsants, and some calcium channel blockers like Verapamil or Nifedipine.
This condition is simple to treat and is often managed by addressing your medication needs with your primary care physician. In extreme cases, there may be some gum modification through laser therapy by your dentist.
During puberty and pregnancy, the swell of hormones in women can often cause a mild form of gingivitis that usually takes care of itself over time. Unfortunately, due to an unstable hormonal imbalance comprised mainly of estrogen and progesterone, this can’t always be prevented with top-notch hygiene habits. Even with very good oral hygiene, there may be some swelling and bleeding of the gums.
Severe nutritional deficiencies have a tendency to cause pallor of the gums and heavy bleeding. If you are anemic and have bleeding during brushing or flossing, consider taking iron supplements and addressing your dietary needs. Malnutrition can contribute to various oral symptoms and extend far beyond different types of gingivitis.
Plaque-included gingivitis is perhaps the most common form of this mild gum disease. The name is very self-explanatory, as this type of gingivitis is a result of a plaque buildup. As a consequence of poor oral hygiene, bacteria builds around the gums and causes them to become red and inflamed.
Chronic gingivitis is what doctors call the most advanced stage of gingivitis that occurs before developing into periodontal disease. This is a general term for gingivitis that is left unchecked and allowed to gradually escalate into a far more severe form of periodontal disease.
Linear Gingival Erythema
Linear Gingival Erythema is a form of gingivitis that is commonly associated with HIV, although it has occurred in a small number of individuals without HIV. Linear Gingival Erythema is easy to spot, as it causes unnaturally red margins of the gum lines. This type of gingivitis doesn’t always result in bleeding gums and unfortunately, isn’t always prevented or reversed by an improvement in oral hygiene.
Signs & Symptoms
To help you detect early signs of gingivitis, we’ve compiled a list of common symptoms to watch for. If you think you may have this mild form of gum disease, use this list to determine whether or not you should seek immediate treatment from a professional.
- Gums between the teeth (papilla) are round, swollen, or blunted
- Inflammation around the margin of the gum lines
- Redness ranging from a slightly darker pink to severely red or purple gums (due to the blood supply under the diseased tissue area)
- Tenderness or pain
- Bleeding during brushing or flossing
If your gums are healthy, they should appear coral in color and protrude as sharp, narrow papilla between the teeth. Gums along the margins of the teeth are completely smooth, following a natural contour along the tooth and bone.
By correctly brushing and flossing on a regular basis for at least two weeks your symptoms should cease. If the symptoms continue to exist then you may have more advanced gum disease or need a professional cleaning to remove calcified areas of bacteria, which are called tartar or calculus. Once tartar collects on the teeth, it cannot be brushed or flossed off; it must be removed by a dental health care practitioner equipped with the right tools.
How to Prevent Gingivitis
The best way to prevent gingivitis is to adopt healthy dental habits and stick to an adequate oral hygiene routine. Use these tips to improve your oral health and prevent gingivitis.
- Brush twice a day
- Always use a soft-bristled toothbrush
- Consider an electric toothbrush
- Use a pure, antibacterial toothpaste
- Brush gently at a 45-degree angle toward the gum line
- Floss daily
- Use enough to floss each tooth with a clean, unused section of the strand
- Wrap your floss in a C shape against each tooth, sliding up and down two to three times under the gum lines
- Consider using a water flosser
- Eat a balanced diet and get plenty of exercise
- Avoid tobacco
- Receive routine preventive care from your dentist
- Rinse with a pure mouthwash