From the Guidelines
Gingivitis presents as inflammation of the gums characterized by redness, swelling, and bleeding, especially during brushing or flossing. Patients may notice that their gums appear puffy or enlarged, with a bright red or purple appearance rather than the normal pink color. The gums often bleed easily when touched or during oral hygiene practices, and patients might report a metallic taste in their mouth due to the bleeding. Bad breath (halitosis) is another common symptom. Despite these signs, gingivitis typically causes minimal pain unless the condition is severe. The inflammation usually affects the marginal gingiva (the part of the gum around the neck of the teeth) and interdental papillae (the gum between teeth).
Importantly, gingivitis is reversible with proper oral hygiene, including regular brushing with fluoride toothpaste twice daily, daily flossing, and professional dental cleanings every 6 months. If left untreated, gingivitis can progress to periodontitis, which involves irreversible bone loss and potential tooth mobility. The inflammation occurs because bacterial plaque accumulates along the gumline, triggering an immune response that causes the clinical symptoms. According to a recent clinical trial 1, the use of natural product-based oral topical rinses, such as 1% chamomile mouthwash, has been shown to reduce plaque index and bleeding upon probing in patients with gingivitis.
Key characteristics of gingivitis include:
- Redness and swelling of the gums
- Bleeding during brushing or flossing
- Bad breath (halitosis)
- Metallic taste in the mouth
- Puffy or enlarged gums
- Bright red or purple appearance of the gums
- Minimal pain unless the condition is severe
- Inflammation of the marginal gingiva and interdental papillae.
It is essential to note that proper oral hygiene and professional dental cleanings can help prevent and reverse gingivitis, thereby reducing the risk of progressing to periodontitis, as supported by the findings of the clinical trial 1.
From the Research
Clinical Presentation of Gingivitis
The clinical presentation of gingivitis, which is inflammation of the gums, can be identified through several key features. These include:
- Bleeding, swollen, and red gums 2
- Gingival inflammation in response to bacterial plaque accumulation (microbial biofilms) 3
- Clinical signs and symptoms of inflammation that are confined to the gingiva 3
- Reversibility of the inflammation by removing or disrupting the biofilm 3
- The presence of a high bacterial plaque burden to initiate the inflammation 3
Symptoms and Progression
If left untreated, gingivitis can lead to periodontitis, a more serious condition where the gums separate from the teeth 2. This may result in damage to the bone and soft tissue that support the teeth, leading to loosening and unstable teeth, and if the infection worsens, eventual tooth loss may occur 2.
Types of Gingivitis
There are different types of gingivitis, including:
- Dental plaque-induced gingival conditions 3
- Desquamative gingivitis, which can be caused by various underlying conditions such as oral lichen planus, cicatricial pemphigoid, and pemphigus vulgaris 4
- Symptomatic gingivitis, which can accompany chronic periodontitis 5
Importance of Diagnosis and Treatment
Successful treatment of gingivitis depends on proper diagnosis and advanced disease stages 5. Maintaining regular dental hygiene can help prevent gingivitis and make it reversible 2. The appropriate intervention is crucial for the prevention of periodontitis 3.