Gum Disease (Gingivitis)

Written by Verneda Lights and Elizabeth Boskey, PhD | Published on July 16, 2012
Medically Reviewed by George Krucik, MD

What is Gingivitis?

Gingivitis is an infection of the gums. If left untreated, it can become a more severe infection known as periodontitis. The American Dental Association (ADA) states that gingivitis and periodontitis are the major causes of tooth loss in adults. Overall, dental infections are a serious cost burden to the U.S. economy: In 2010, Americans spent an estimated $108 billion for dental services.

What Causes Gingivitis?

Your gums actually attach to the teeth lower than the gum edges that we see. This forms a small space called a sulcus. Food can get trapped in this space and cause a gum infection or gingivitis.

Plaque is a thin film of bacteria. It constantly forms on the surface of your teeth. As plaque advances, it hardens and becomes tartar. When plaque extends below the gum line, infection can occur.

Left unchecked, gingivitis can cause the gums to separate from the teeth. This can cause injury to the soft tissue and bone supporting the teeth. The tooth may become loose and unstable. If infection progresses, you may lose your tooth or need it removed by a dentist.

Risk Factors for Gingivitis

The following are risk factors for gingivitis:

  • smoking or chewing tobacco
  • diabetes
  • certain medications (oral contraceptives, steroids, anticonvulsants, calcium channel blockers, and chemotherapy)
  • crooked teeth
  • dental appliances that fit poorly
  • broken fillings
  • pregnancy
  • genetic factors
  • compromised immunity (e.g. HIV/AIDS)

What Are the Symptoms of Gingivitis?

Many people are unaware that they have gingivitis. It is possible to have gum disease without any symptoms. However, the following can be symptoms of gingivitis:

  • gums that are red, tender and swollen
  • gums that bleed when you brush or floss your teeth
  • gums that have pulled away from the teeth
  • loose teeth
  • a change in how your teeth fit together when you bite
  • pus between teeth and gums
  • pain when chewing
  • sensitive teeth
  • partial dentures that no longer fit
  • foul-smelling breath that does not go away after you brush your teeth

How Is Gingivitis Diagnosed?

During a dental exam, your gums will be probed with a small ruler. This checks for inflammation. It also measures any pockets around your teeth. Normal depth is one to three millimeters. Your dentist also may order X-rays to check for bone loss.

Talk to your dentist about risk factors for gum disease as well as your symptoms. This can help diagnose your gingivitis. If gingivitis is present, you may be referred to a periodontist. A periodontist is a dentist who specializes in the treatment of gum diseases.

How Is Gingivitis Treated?

To treat gingivitis you must practice proper oral hygiene. You should also cut back on any smoking and control your diabetes. Other treatments include deep cleaning your teeth, medications, and surgery.

Cleaning Teeth

There are several techniques that can be used to deep clean your teeth without surgery. They all remove plaque and tarter to prevent gum irritation.

Scaling removes tartar from above and below the gum line.

Root planing smoothes rough spots and removes infected tooth parts.

Lasers may cause less pain and bleeding than scaling and root planing.


A number of medications can be used to treat gingivitis.

Antibiotic mouthwash containing chlorhexidine can be used to disinfect the mouth.

Time-release antiseptic chips containing chlorhexidine can be inserted into pockets after root planing.

Antibiotic microspheres made with minocycline can be inserted in pockets after scaling and planing.

Oral antibiotics can be used to treat persistent areas of gum inflammation.

Doxycycline, an antibiotic, can help keep enzymes from causing tooth damage.


Flap surgery is a procedure where the gums are lifted back while plaque is removed. The gums are then sutured in place to fit snugly around the tooth.

Bone and tissue grafts can be used where the teeth and jaw are too damaged to heal.

How Can Gingivitis Be Prevented?

Gingivitis can be prevented by proper and consistent oral hygiene. Make certain to eat a balanced diet and visit the dentist regularly. Brush your teeth twice daily with fluoride toothpaste. Floss your teeth every day.

Complications of Gingivitis

The Centers for Disease Control (CDC) and the National Institute of Dental and Craniofacial Research report that gingivitis is associated with an increased risk of diabetes, heart attack, stroke, and lung disease. It also increases the risk of a woman giving birth to a premature or low birth weight infant.

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