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What is Gingivitis?

Gingivitis due to poor oral hygiene causes enlarged swollen painful and bleeding gums.

A moderately severe case of gingivitis characterized by swollen gums (gingiva), red tissue margins, and bleeding on light stimulation. The condition is usually due to poor oral hygiene.

Gingivitis is a reversible inflammation of the gums (gingiva), with no breakdown of the attachment fibers connecting them to the teeth and underlying bone. Gingivitis is the earliest and simplest form of gum disease. It is characterized by red, puffy gums that bleed easily (Figure 1), but may or may not be sore. The disease is most often caused by bacterial plaque, and is generally reversible with removal of the plaque and excellent oral hygiene.

If ignored, the bacteria and inflammation causing gingivitis will destroy the periodontal attachment fibers between the gums and teeth, allowing bacteria to invade and destroy the underlying bone. When the attachment fibers have been lost, the patient is diagnosed with periodontal disease (periodontitis).

How does the dentist diagnose Gingivitis?

Note: ToothIQ.com contains general information. Only a dentist can properly diagnose your specific condition.

Periodontal health is typified by coral pink color with scalloped contours and stippling.

An example of healthy gums. Healthy attributes of this patient’s gums include a lack of plaque, coral pink coloring of the keratinized or attached gingiva (K); stippled texture; knife-edge margins; scalloped architecture around the necks of the teeth.

If the gums appear red, swollen or puffy, and bleed easily; but a periodontal measuring probe shows gum pockets around the teeth measure four millimeters deep or less, a diagnosis of gingivitis is made. Periodontal measurements in excess of four millimeters indicate loss of attachment fibers, and a diagnosis of periodontitis would be supported in such cases.

People often comment that flossing makes their gums bleed. However, if that is the case, examination by a dentist is recommended. Healthy gums do not bleed easily (such as when brushing or flossing), and are not tender to probing with a periodontal measuring probe.

The gums should be coral pink in color (certain races of people may have other pigments present as well), stippled in texture, with knife-edge margins where the gums scallop around the teeth (Figure 1). There is a width of at least 2 to 3 millimeters of pink, toughened gum tissue around each of the teeth, and tooth roots are ideally fully covered.

Further investigation into the underlying causes of a patient’s gingivitis is warranted if prophylaxis is performed, and the patient maintains good oral hygiene, but no improvement in tissue health is noted.

How is Gingivitis treated?

Gingivitis is generally treated with prophylaxis, oral hygiene instruction, and improved brushing and flossing. Topical fluoride has a mild anti-bacterial effect which can help fight gingivitis, and is frequently recommended to help prevent tooth decay, another possible result of poor oral hygiene.

Treatment of periodontitis may involve one or more options.

Treatment of gingivitis commonly involves use of scaling instruments and ultrasonic cleaning devices, which remove plaque, calculus, and biofilm to establish a healthy oral environment.

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Author: Thomas J. Greany, D.D.S. / Editor: Ken Lambrecht

This page was last updated on March 2, 2018.

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