What gingivitis is
Gingivitis is inflammation of the gingiva — the soft tissue that surrounds the base of each tooth. It's the earliest, mildest form of gum disease, and it is almost entirely caused by plaque left undisturbed at the gum line for long enough to trigger an immune response.
Crucially, gingivitis affects only the soft tissue. The ligament and bone that hold the tooth in place are still intact. That's what makes it reversible: remove the cause, and the tissue heals.
Signs and symptoms
- Bleeding when brushing or flossing — the most common early sign.
- Gums that look red or puffy rather than pale pink and firm.
- Tenderness when the gum is touched.
- Bad breath that doesn't clear up after brushing.
- Gum tissue that appears swollen between teeth.
Gingivitis is generally not painful. If you notice throbbing, a bad taste that won't go away, pus, or a loose adult tooth, the picture is more consistent with periodontitis or an abscess and warrants a dental visit rather than more brushing.
What causes it
The direct cause is plaque — a soft, sticky film of bacteria that reforms on tooth surfaces within hours of cleaning. When plaque sits at the gum line, some of its bacterial products provoke an inflammatory response.
Factors that make it more likely include:
- Skipped brushing sessions or ineffective technique
- Never cleaning between teeth
- Tartar (hardened plaque) that home care can't remove
- Hormonal shifts — puberty, menstruation, pregnancy, menopause
- Certain medications, including some for blood pressure and epilepsy
- Poorly fitting fillings, crowns, or partial dentures that trap plaque
- Dry mouth caused by mouth-breathing or medications
How it's diagnosed
At a routine cleaning, a hygienist or dentist will check for redness, swelling, and bleeding on gentle probing. A diagnosis of gingivitis specifically requires that bone loss has not yet occurred, which is confirmed by probing depths of 3 mm or less and X-rays that show intact bone.
How it's treated
Treatment is straightforward but requires consistency:
- Professional cleaning to remove existing plaque and tartar.
- Improved home care — brushing twice a day with fluoride toothpaste, and cleaning between the teeth once a day.
- Occasional adjunct — a short course of an antimicrobial mouth rinse if a dentist recommends it.
Most gingivitis resolves within 1–2 weeks of consistent care. If bleeding persists longer than that, the picture may be more than plain gingivitis, and a re-evaluation is warranted.
Preventing recurrence
- Brush thoroughly twice daily using a soft brush and fluoride toothpaste. See the Tooth Brushing Guide.
- Clean between every pair of teeth once a day — floss, floss picks, or interdental brushes. See the Flossing Guide.
- See a dentist at the interval they recommend for your risk profile.
- Watch for medications that cause gum overgrowth, and talk to your prescriber if they do.
- If you smoke, quitting has one of the largest single effects on future gum health.