Gingivitis is the initial and reversible form of gum disease and is characterized by inflammation or swelling of the gums.

What is Gingivitis?

Gingivitis is diagnosed based on periodontal probings and the appearance of the gums. Healthy gums have a stippled texture and are often described as the outside of an orange peel.   Red, swollen, tender gums that bleed when manipulated, as with flossing, are all potential signs of gingivitis.   Inflammation of the gums is most commonly caused by plaque, white film that collects on teeth a few hours after brushing. Plaque is a collection of bacteria, bacterial byproducts and biofilm.  Plaque irritates the gum tissue, which causes swelling and puffy appearance.  It is important to mention that gingivitis is a reversible condition during which no permanent tissue destruction occurs.  This is in contrast to periodontitis where irreversible changes usually occur.

Clinical diagnosis of gingivitis is made when inflammation of the gums is present without any bone loss around the teeth.   This is confirmed by obtaining periodontal probings to determine the presence and involvement of gum disease. Periodontal probings can increase slightly during gingivitis, usually about 1 mm, due to inflammation of the tissue. Swollen, puffy tissue can bleed easily during probing, brushing, or flossing.

Treatment of Gingivitis

At this stage, the disease can easily be controlled with good oral hygiene and a simple professional cleaning. Flossing once a day and brushing at least twice a day will eliminate any irritants that collect on the teeth and allow the tissue to heal. Good regular oral hygiene practice will prevent subsequent inflammation of the gum tissue. It is normal for the gums to bleed when flossing the first few times. After a few days,  the tissue will go back to normal and no bleeding should be expected.

Other Forms of Gingivitis

As we mentioned earlier gingivitis refers to the inflammation of the gum tissue. The most common cause of inflammation is plaque. There are other conditions that can also lead to inflammation of the tissue that may be aggravated by plaque build-up. These include inflammation of the gum tissue due to  medications, irregular filling or crown margins, allergic reaction to certain material, pregnancy, puberty, mouth breathing, and some systemic medical conditions. These secondary causes of gingivitis can make it more difficult to manage the inflammation of the tissues. It is even more imperative to maintain excellent oral hygiene in instances where there may be other contributing factors.  If you have excellent oral hygiene but your hygienist always tells you that you suffer from gingivitis, the cause should be evaluated further.