Gum Disease (Gingivitis)

  • Medical Author:
    Steven B. Horne, DDS

    Dr. Steve Horne began his career at Brigham Young University obtaining his BA in English. He earned his Doctorate of Dental Surgery in 2007 from the University of Southern California where his pursuit for academic excellence landed him on the Dean's List. He was recognized for his superior clinical skills and invited to help teach other dental students in courses on restorative dentistry, prosthodontics, and tooth anatomy. During dental school, he provided dental care for underserved populations of Los Angeles and Orange County, Mexico, and Costa Rica with AYUDA. Following dental school, Dr. Horne entered active duty with the U.S. Army and practiced dentistry at Fort Knox, Kentucky, for four years. During this time, he was deployed to Baghdad, Iraq, and received multiple Army Achievement Medals, the Army Commendation Medal, and served as Company Commander. Dr. Horne currently practices full time at Torrey Pines Dental Arts in La Jolla, California, as a general dentist. Dr. Horne is a member of the American Dental Association, the California Dental Association, and the Academy of General Dentistry. Dr. Horne is married to his wife, Christy, and they have a chocolate Labrador named Roscoe.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

View Cosmetic Dentistry: Before and After Slideshow Pictures

Gingivitis Symptoms and Signs

Bleeding Gums

Bleeding of the gums is sometimes referred to as gingival bleeding, and it may occur during brushing or flossing. The soreness can be accompanied by swelling of the gum tissues. Most commonly, gingivitis is the result of plaque buildup on the teeth around the gum line.

Quick GuideDental Health: The Ugly Truth About Your Toothbrush

Dental Health: The Ugly Truth About Your Toothbrush

What is gum disease (gingivitis)?

Gum disease, or gingivitis, is inflammation of the tissues surrounding and supporting the teeth and is most commonly a result of poor dental hygiene. Gingivitis is a very common condition and varies widely in severity. It is characterized by red, swollen gums that bleed easily when teeth are brushed or flossed. Gingivitis is not the same thing as periodontitis, although sometimes a person may be affected by both.

What is the difference between gingivitis and periodontal disease?

While gingivitis is inflammation of the gums around the teeth, periodontal disease occurs when the bone below the gums gets inflamed or infected.

Gingivitis starts when food debris mixes with saliva and bacteria-forming plaque that sticks on the surfaces of teeth. If dental plaque and tartar aren't removed by brushing with toothpaste and flossing, it can become mineralized and form tartar, or calculus. Tartar is very hard and can only be removed by a professional dental cleaning.

Both dental plaque and tartar are filled with harmful bacteria, and if they aren't removed from teeth, they will begin to irritate the gums and cause gingivitis. If left untreated, gingivitis will often extend from the gums to the bone and lead to periodontitis. When the underlying bone gets infected, it will start to recede away from the teeth and form deep gum pockets. These pockets collect plaque and bacteria as they are very difficult to keep clean, and more bone loss occurs. As periodontal disease progresses into later stages and more bone tissue is lost, the teeth may eventually become loose and fall out.

What causes gum disease?

Gum disease is mostly caused by improper oral hygiene that allows bacteria in plaque and calculus to remain on the teeth and infect the gums. But there are other factors that increase the risk of developing gingivitis. Some of the most common risk factors are as follows:

  • Smoking or chewing tobacco prevents the gum tissue from being able to heal.
  • Crooked, rotated, or overlapping teeth create more areas for plaque and calculus to accumulate and are harder to keep clean.
  • Hormonal changes in puberty, pregnancy, and menopause typically correlate with a rise in gingivitis. The increase in hormones causes the blood vessels in the gums to be more susceptible to bacterial and chemical attack. At puberty, prevalence of gum disease ranges between 70%-90%.
  • Cancer and cancer treatment can make a person more susceptible to infection and increase the risk of gum disease.
  • Alcohol affects oral defense mechanisms.
  • Stress impairs the body's immune response to bacterial invasion.
  • Mouth breathing can be harsh on the gums when they aren't protected by the lips, causing chronic irritation and inflammation.
  • Poor nutrition, such as a diet high in sugar and carbohydrates and low in water intake, will increase the formation of plaque. Also, a deficiency of important nutrients such as vitamin C will impair healing.
  • Diabetes mellitus impairs circulation and the gums ability to heal.
  • Medications such as antiseizure medications promote gum disease.
  • Infrequent or no dental care
  • Poor saliva production

Does gum disease cause bad breath?

Bad breath, or halitosis, is most frequently associated with a condition of the mouth like gum disease. As the bacteria that are normally present in the mouth break down plaque and tartar, they release chemicals that have a strong odor. Bad breath can also come from plaque that builds up on the tongue. As the plaque and tartar are removed from the teeth and tongue with regular brushing, flossing, and professional dental cleanings, the halitosis can be eliminated. This is the easiest way to reverse bad breath, but it can take a while for the mouth odor to completely disappear. A person needs to be consistent and persistent with oral hygiene to reverse the condition.

Other causes of bad breath include partially erupted wisdom teeth, dry mouth, mouth breathing, postnasal drip, infections in the throat or lungs, tonsil stones, smoking, digestive problems, and systemic diseases like diabetes.

Medically Reviewed by a Doctor on 4/6/2016

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