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).