Gingivitis: what it is, causes and symptoms

Blood on the toothbrush after brushing is frightening. Often it is gingivitis: the mildest inflammation of the gums, which can be reversed. I explain step by step what it is, where it comes from and when you can no longer put it off.

What gingivitis is

Gingivitis is inflammation of the gums in which the dentogingival junction is not yet disrupted. In simple terms: the gum is red and swollen, but does not yet pull away from the tooth. This is a mild form of gum disease, and it can usually be reversed with daily toothbrushing, cleaning between the teeth and regular professional cleanings at the dentist or hygienist.

If gingivitis is left untreated, it can progress to periodontitis. Then the gum pulls away from the tooth, pockets form between them that become infected, and the bone, gum and connective tissue holding the tooth are destroyed. In the worst case, teeth fall out. Gingivitis is common and occurs more often in men than in women.

Symptoms of gingivitis

The most common sign is blood. The gums bleed when you brush your teeth, use floss or eat something hard, such as an apple. The gums themselves become swollen, red and painful.

• bleeding when brushing teeth and when eating hard food;
• redness, swelling and tenderness of the gums;
• bad breath and an unpleasant taste;
• the gums shrink in volume (recede);
• tooth mobility, and in severe cases tooth loss and abscess.

Chronic gingivitis is more insidious: there is almost no pain, the course is sluggish, sometimes bleeding when brushing and bad breath appear, and it is found incidentally during a preventive examination.

Causes of gingivitis

The cause is plaque. If it is not removed with a brush and cleaning between the teeth, it accumulates and irritates the gum. The inflammation is directly caused by bacteria, less often by viruses and fungi.

There are factors that help plaque win: smoking, poor hygiene, tartar, diabetes mellitus, pregnancy, vitamin C deficiency, reduced immunity, malnutrition, bite problems, problematic fillings, impaired nasal breathing, use of oral contraceptives, as well as acute respiratory infections, flu, tonsillitis and other infections. Children aged 3 to 6 years are at risk.

Gingivitis in children

In children, simple marginal gingivitis is most common, and it is related to oral hygiene.

What parents see: blood on the toothbrush, red and swollen gums, sometimes bad breath. If a child has painful or bleeding gums, they should be seen by a dentist.

Gingivitis in pregnancy

Hormonal levels do not themselves trigger inflammation. But they can complicate existing gingivitis caused by plaque. A separate form is pregnancy gingivitis: it occurs relatively rarely, can occur even in women with good hygiene, and the gums are swollen and prone to bleeding. Pregnant women, adolescents and people with diabetes can also have hyperplastic gingivitis — the gingival papillae enlarge in volume. Regular dental check-ups during pregnancy are not a formality.

How it is diagnosed and when to see a dentist

At the appointment, the dentist examines the teeth and gums. They may refer you to a specialist for additional tests. Examinations may include a dental examination and a panoramic dental X-ray.

See a dentist if your gums bleed when brushing or eating hard food, if they are painful and swollen, or if you have bad breath. Preventive check-ups are needed even without complaints: once every 2 years, and up to age 18 — once a year.

Book an urgent appointment if your gums are very painful and severely swollen, your teeth become mobile or fall out, ulcers or red spots appear in the mouth, or if a lump appears in the mouth or on the lip.

Gingivitis by itself is not a reason to call an ambulance. 103 or 112 — for life-threatening conditions, such as severe difficulty breathing or loss of consciousness; for severe pain and gum swelling, an urgent dental appointment is needed.

If your gums bleed or hurt, see a dentist: they will examine you and tell you what is happening in your case. This article is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer