Gingivitis (Gum Disease): Causes, Risk Factors, and Symptoms

Written by Resurchify | Updated on: January 09, 2023

Gingivitis (Gum Disease): Causes, Risk Factors, and Symptoms

Common and moderate periodontal disease, or gingivitis, manifests as redness, swelling, and irritation of the gingiva, or gum tissue, surrounding the tooth bases. Gingivitis should be taken carefully and treated swiftly. Loss of teeth and even death can result from gingivitis's more severe sequela, periodontitis.

Neglecting to properly care for one's teeth and gums is the leading cause of gingivitis. Regular dental examinations and cleanings, together with twice-daily brushing and flossing, can help stop and even reverse gingivitis.

What is Gingivitis?

Inflammation of the gums, often known as gingivitis, is typically brought on by a bacterial infection. Periodontitis is a more severe infection that can develop if gingivitis is not treated.

According to the American Dental Association, gingivitis and periodontitis are two of the leading causes of adult tooth loss.

Difference Between Gingivitis and Periodontitis

Inflammation of the gums, or gingivitis, typically comes first, followed by periodontitis (gum disease). However, not everyone with gingivitis develops periodontitis. Gingivitis is a common dental condition that almost everyone has at some point in their lives, but because of its mild symptoms, it is often overlooked. However, if left untreated, it might lead to more severe oral complications. The good news is that with regular dental care, including brushing, flossing, and exams, you can avoid or even reverse tooth loss.

In the preliminary period of gingivitis, inflammation and bleeding of the gums during tooth brushing are brought on by the accumulation of plaque bacteria. While irritation to the gums is common, the teeth remain securely in their sockets. At present, no permanent damage to bone or other tissues has happened.

Plaque, a film of bacteria and food debris, forms around your teeth when you don't brush, floss, and rinse with mouthwash twice daily. The buildup produces acids that eat away at the enamel, the protective covering of your teeth, leading to decay. Tartar, the hardened by-product of plaque, builds along the gum line after 72 hours and makes it difficult to clean the teeth and gums thoroughly. The result of this accumulation is gingivitis, inflammation, and irritation of the gums.

Pockets grow between the gum and bone tissue that surrounds the teeth in a person with periodontitis. It's easy for bacteria to get stuck in the tight crevices between your teeth and gums. As plaque develops and spreads beyond the gum line, the immune system engages in a battle against the germs. Plaque bacteria and the body's "good" enzymes involved in combating infections produce toxins or poisons that deteriorate the bone and connective tissue that anchor teeth in place. Over time, gum disease causes pockets to widen and further damage to gum and bone. Because of this, teeth become unsteady and eventually fall out. Adult tooth loss is typically brought on by gum disease.


The bacteria in our mouths are a constant reminder of how dirty we are. Plaque, an invisible film of germs, mucus, and other debris, constantly forms on teeth. Plaque can be removed from teeth by brushing and flossing. Tartar, the hardened remnant of plaque that was not removed, cannot be eliminated by brushing. Tartar can only be removed by a dentist or dental hygienist during a professional cleaning.

Cigarette smoking is the most important risk factor for gum disease, but there are many more. Gum disease treatment may be less effective if the patient smokes. Other risk factors include diabetes, hormonal shifts in females, drugs that reduce saliva production, certain diseases and related medications (such as AIDS), and a person's genetic predisposition.

What is Periodontal Disease?

Infections and inflammation of the gums and bones that support the teeth are the primary causes of periodontal disorders. Gingivitis is a mild form of periodontal disease in which the gums become inflamed and red and may bleed. In its advanced stage, called periodontitis, the gums recede from the tooth, bone is lost, and teeth become loose or fall off. Adults are more likely to suffer from periodontal disease. Dental problems, such as cavities and gum disease, are common.

The following information about the prevalence of periodontitis in the United States is taken from a recent CDC report1:

Of all adults aged 30 and up, about half suffer from periodontal disease.

Age is a major risk factor for developing periodontal disease; 70.1% of persons aged 65 and up have some form of the disease.

Those at or below the poverty line (65.4%), those with less than a high school education (66.9%), and current smokers (64.2%), as well as men overall (56.4% vs. 38.4%), are at higher risk for developing this illness.

Warning Signs

Indicators of periodontal disease include:

  • Problems with one's taste or smell that just won't go away
  • gums that are red or inflamed
  • Gum pain or bleeding
  • Discomforting munching
  • Tooth decay
  • Teeth sensitivity
  • Detached gums
  • Any modification to the biting relationship between your teeth
  • When partial dentures need to be adjusted for fit

Cause of Gingivitis

Inflammation of the gum tissues is most often brought on by plaque building up on teeth due to a lack of proper dental hygiene. Examples of how plaque might cause gingivitis are as follows:

The teeth develop tartar or plaque. Plaque is a microorganism-rich, invisible film that forms on teeth when meal starches and sugars react with the bacteria already present in the mouth. The rapid re-formation of plaque makes its clearance a daily need.

After a while, plaque hardens into tartar. Tartar (calculus), a hardened form of plaque, can collect germs and cause periodontal disease if it is allowed to remain on the teeth and under the gums. Tartar makes plaque removal harder, provides bacteria with a protective barrier, and irritates the gums. To eliminate tartar, professional dental cleaning is required.

Inflammation of the gums (gingivitis). When plaque and tartar are allowed to build up on teeth, they irritate the gingiva, the tissue that lines the tooth socket, leading to inflammation. Your gums swell up and start bleeding readily after some time. Additionally, dental caries (tooth decay) may develop. Gingivitis can lead to periodontitis and the loss of teeth if not addressed.

Types of Gum Infections

Increased plaque on teeth is a common culprit in cases of gingivitis. Numerous causes, including poor dental hygiene, might contribute to bad breath.

  • Drugs including phenytoin, cyclosporine, calcium channel blockers, and hormonal birth control pills and injections - These medications can cause gingivitis or make it worse because they can lead to an overgrowth of gum tissue and make plaque hard to remove)
  • Vitamin C Deficiency (this is rare in the United States)
  • Leukemia is exacerbated by hormonal shifts, such as those seen in pregnancy and menopause.
  • Bismuth, a heavy element present in some cosmetics, and nickel, a precious metal, can both be a health hazard.
  • Although plaque buildup is a major contributor to gingivitis, there are other causes of gum infection. Among these are viral or fungal diseases such as thrush incomplete eruption of a tooth (known as an "impacted tooth") (if this happens, the flap of gum over the tooth can trap debris and cause gingivitis)

How Does My Dentist Diagnose Gum Disease?

The following are some of the things your dentist will look for during your dental exam:

  • Issues with bleeding, swelling, stiffness, and depth of pockets in the gums (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease)
  • Alignment, sensitivity, and movement of teeth
  • Bone loss in the jaw can indicate tooth decay.

How Is Gum Disease Treated?

Gum disease treatment aims to facilitate healthy gum reattachment to teeth, lessen inflammation, pocket depth, and infection risk, and halt the progression of the condition. How well you responded to previous therapies, the severity of your condition, and other factors all play a role in determining what kind of care is available. Treatment options range from antibiotics and antibiotic therapy to surgical repair of damaged connective tissue.

Helpful Tips

Gum and tooth health can be maintained by:

Use Fluoride Toothpaste And Brush Your Teeth Twice Daily.

Plaque between your teeth can be easily removed by flossing daily. A dental practitioner may also suggest using an alternative tool, such as a specific brush, wooden or plastic pick, or "water flosser." Maintaining regular checkups and cleanings with your dentist. Putting down the cigarettes will be for good.

Professional Dental Care

Scaling is the first step that may be performed by a dentist. The goal is to get rid of any built-up tartar or plaque. If there is a lot of tartar accumulation or the gums are particularly sensitive, this might be painful. Following thorough teeth cleaning, the dentist will take the time to educate the patient on the significance of maintaining good oral hygiene and the proper way to brush and floss.

Appointments for subsequent monitoring of plaque and tartar buildup may be suggested. The dentist can then promptly identify and treat any recurrences. Restoration of decayed teeth also helps maintain oral health. Crooked teeth, poorly fitted crowns or bridges, and other dental issues might make it more difficult to effectively remove plaque and tartar from your teeth. They may also cause gum irritation.

How Can Gum Disease Be Prevented?

Most cases of gingivitis are reversible, and gum disease can be stopped in its tracks with regular plaque removal and rinsing. Plaque control requires daily brushing and flossing in addition to expert cleanings twice a year.

It is recommended that you brush your teeth twice daily. Use fluoride toothpaste and a toothbrush with gentle bristles. After three months, or sooner if the bristles get frayed, you should get a new toothbrush. Used ones won't do a good job of removing plaque. When you brush your teeth, you remove plaque from the areas of your teeth that your toothbrush can reach.

If you floss, you'll get rid of the food and plaque stuck in your teeth and along your gums. Always remember to floss after eating. If you want to avoid having something stuck in your teeth, do it now. Plaque builds up in hard-to-reach locations in your mouth, but daily flossing can help. You can also use small brushes that fit in between your teeth, picks, or dental floss to clean the spaces. See your dentist for instructions on how to use them properly to avoid hurting your gums.

Please brush your teeth and gargle with water. Gingivitis can be avoided and foul breath and plaque can be combated with the help of antibacterial mouthwash. The American Dental Association states that the germs that cause plaque and gum disease can be reduced by using antibacterial rinses. Consult your dentist about the most effective mouthwash for your needs.

Gum disease can be prevented, its severity reduced, and its progression slowed by making other improvements to one's health and way of life. Those things are:

Put out your cigarette. The effects of smoking on the teeth and gums are in addition to the obvious risks to the heart and lungs. Tobacco use increases the risk of gum disease by seven times in smokers compared to non-smokers, and also reduces the effectiveness of several therapies.

We need to relax. Your body's immune system may not be able to effectively fight off illness if you're under a lot of stress.

Eat healthily regularly. Bad breath is caused by bacteria in your mouth, which are fed by the sugars and starches in meals and then produce acids that erode your tooth enamel. Typically, sugary and starchy fast food and sweets are high in calories and empty calories. Keep your teeth and gums healthy by avoiding them. A healthy immune system can do its job better if it is fed well. Help your body heal damaged tissue by eating foods rich in antioxidants like vitamin E (found in vegetable oils, almonds, and green leafy vegetables) and vitamin C (found in citrus fruits, broccoli, and potatoes).

Please don't gnash your teeth or clench your jaw in frustration. These habits may cause the teeth's supporting tissues to undergo unnecessary stress, hastening their demise.

The American Academy of Periodontology estimates that as many as 30% of Americans may be predisposed to gum disease as a result of genetics, even if they practice diligent oral hygiene and make other healthy lifestyle choices. Gum disease is surprisingly common, with the genetically susceptible being up to six times as likely to get the condition. Gum disease is often passed down from generation to generation, so if you have a family history of it, you might want to pay extra attention to your oral health. Your dentist or periodontist may suggest more frequent examinations, cleanings, and treatments to better manage the condition if you have a higher risk of developing gum disease.

If it has been over six months since your last dental checkup, it's time to schedule a cleaning to get rid of the plaque and tartar that have accumulated on your teeth in that time. If you want to know how to wash your teeth properly, you should consult a dentist. Gingivitis can be caused by overly vigorous brushing or by skipping areas. If you brush twice daily, floss once, and rinse once a day after a cleaning, your gums should heal within a week.


Gingivitis, if left untreated, can develop into a more serious illness called periodontitis, which can result in the loss of teeth.

Some systemic disorders, like respiratory illness, diabetes, heart disease, stroke, and rheumatoid arthritis, have been linked to chronic gingiva inflammation. There is evidence to show that the bacteria that cause periodontitis can enter the bloodstream through the gums and travel to other organs. There has to be more research done to confirm the association.

Trench mouth, or necrotizing ulcerative gingivitis (NUG), is an extreme form of gingivitis characterized by painful, inflamed, bleeding gums and ulcerations. Poor diet and living conditions make trench mouths frequent in poorer countries but uncommon in wealthy nations.

How is Gingivitis Treated?

To get rid of gingivitis, you should start brushing your teeth regularly. If you have diabetes, you should monitor your blood sugar levels and cut back on smoking. While quitting smoking might be challenging, a doctor can help you develop a personalized strategy to help you succeed.

Additional options for treatment are:

  • Surgical tooth cleaning Antibiotic drugs and dental work
  • Cleaning the teeth - You may get a thorough cleaning of your teeth without having to go under the knife. All of these methods of plaque and tartar removal can alleviate gum discomfort by:
  • Scaling - The scaling process involves the removal of tartar from both the tooth surface and the gum line.
  • Root-zone therapy - This process eliminates rough patches and cleans the root surface of plaque and tartar.
  • Lasers - Scaling and root planing are two methods for removing tartar, however, this one may be less invasive and cause less bleeding during treatment.
  • Medications

Gum disease can be treated with a wide variety of pharmaceuticals, including but not limited to the following:

  • To kill bacteria in your mouth, use a chlorhexidine-based antiseptic mouthwash.
  • After root planing, pockets can be inserted with time-release antiseptic chips containing chlorhexidine.
  • Following scaling and planing, minocycline antibiotic microspheres can be placed into pockets.
  • Inflammation of the gums that doesn't go away can be treated with antibiotics taken orally.
  • The antibiotic doxycycline can inhibit enzymes that cause tooth decay.


Extreme cases of gingivitis may necessitate surgical intervention, particularly if they have already resulted in the loss of gum or bone structure. A periodontist can perform a variety of procedures on the gums, including:

  • Corrective surgery involving a flap. With flap surgery, the gums are retracted to allow access to the deeper crevices, where plaque and tartar have built up. After that, the gums are sutured so that they completely enclose the tooth.
  • Grafts of bone and other tissues. When the jaw and teeth are irreparably injured, a graft may be the only option for repair.
  • During a gum transplant procedure, tissue is taken from the palate and used to cover the tooth's exposed root. This aids in halting further bone and gum tissue loss.
  • Bone grafting begins with an operation remarkably dissimilar to flap surgery, with the exception that instead of replacing missing tissue, the bone graft serves to stimulate the regeneration of jaw bone.
  • A procedure to extend the crown of a tooth. Gingivitis can cause an overgrowth of the gum tissue in some patients. A periodontist can modify your gum and bone tissue to reveal more of your teeth if this is the case. This may also be required before some dental restoration or aesthetic operations.

Health Conditions Associated With Gum Disease

Researchers at the National Institute of Dental and Craniofacial Research and the Centers for Disease Control and Prevention (CDC) have found that people with periodontal disease are more likely to experience the following health problems:

  • Cardiovascular Disease and Diabetes
  • Lung disease stroke
  • In addition, it raises a mother's chances of having a baby that is born prematurely or underweight.

Gum disease has been linked to various diseases, although it hasn't been proven to directly cause them. Additional study is required to clarify the nature of this connection.

What are the Stages of Periodontitis?

Inflammation is the initial stage of periodontitis, which progressively worsens.

Inflammation (Gingivitis)

Inflammation of the gums, or gingivitis, is the first stage of periodontitis. Bleeding gums during dental hygiene routines is an early indicator of gingivitis.

You may also see a change in the color of your teeth. The term for this is "plaque." Plaque forms on teeth when bacteria and leftover food particles combine. Your mouth is always harboring bacteria, but they only pose a threat when their numbers increase drastically. If you don't take good care of your teeth by regularly brushing, flossing, and seeing a dentist, this could happen.

Periodontal Disease In Its Infancy

There is a separation between the gums and teeth called "pocketing" that develops in the early stages of periodontitis. The crevices are home to microorganisms that are bad for you. Your body's response to the infection, in the form of a retreating gumline, is an indication of how hard your immune system is working to rid itself of the illness. You may even lose some bone tissue and feel bleeding while brushing and flossing.

Periodontal Disease At A Moderate Stage

Moderate periodontal disease can cause bleeding and pain around the teeth, as well as receding gums if left untreated. Your teeth will loosen and shift as the bone that supports them deteriorates. To add insult to injury, the infection may trigger a systemic inflammatory reaction.

Progression Of Periodontal Disease

The condition progresses and the connective tissue that supports your teeth in place weakens. Your teeth's supporting structures—gums, bones, and so on—will deteriorate. Bad breath and a nasty taste in the mouth are only two of the symptoms of advanced periodontitis. Most of your teeth will probably fall out.


The Centers for Disease Control and Prevention reports that there may be connections between gum disease and other major health problems. The oral bacteria that enter the bloodstream are often harmless in people with functioning immune systems. However, these microbes are linked to health issues like stroke and heart disease under specific conditions. Unfortunately, not only does diabetes increase your risk for gum disease, but gum disease may also worsen your blood sugar control.



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