What are the signs of gingivitis?

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"Dentist with an interest in comprehensive dentistry."

Gingivitis is a reversible inflammation of the gums without associated alveolar bone loss. Gingivitis has multiple causes but the most common cause is bacterial plaque (a sticky mass of bacteria known as biofilm that grows clumped together on the surfaces of teeth and other appliances in the mouth such as braces or dentures).

When this plaque is allowed to accumulate in the gingival sulcus (a small gap that is naturally present between the gum margin and the tooth surface), gum inflammation develops as a reaction to the substances produced by plaque bacteria (endotoxins and bacterial proteins). As the layer of plaque gets thicker (as a result of a lack of thorough cleaning), oxygen gets blocked off from reaching the deeper layers inside the plaque structure. This encourages the growth of bacterial species that can thrive in an oxygen-poor environment. These species tend to be harmful and are implicated in the development of gum disease.

Up to 94% of adults have gingivitis, making it one of the most common oral diseases, along with tooth decay (caries).

Signs of gingivitis include:

  1. Red swollen gums
  2. Gums that bleed during brushing or flossing
  3. Bad breath
  4. Thick plaque debris on the tooth surface
  5. Tartar deposits on the teeth (yellow/grey/dark brown hard material at the gumline)

Assessment should be done to exclude periodontitis (which results in irreversible alveolar bone loss around the teeth) which can exist in a continuum with gingivitis. Your dentist can only assess alveolar bone levels on dental x-rays.

Since gingivitis is reversible, thorough scaling and polishing can resolve it within a short period of time, if accompanied by meticulous oral hygiene. Using an electric toothbrush correctly, plaque disclosing tablets/gel, flossing or using an interdental brush daily is paramount for preventing recurrence. See your dentist for regular (6-12 monthly) professional scaling to help clean out hard-to-reach areas, remove stubborn stains and remove tartar buildup.

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