Gingivitis is a very common and mild form of gum (periodontal) disease that causes swelling (inflammation) of your gums. Because gingivitis can be so mild, you may not be aware that you have the condition. But it's important to take gingivitis seriously and get it treated because it can lead to much more serious gum disease.

If your gums are swollen and bleed when you brush, you may have gingivitis. The most common cause of gingivitis is poor oral hygiene. Good oral health habits, such as daily brushing and flossing, can help prevent gingivitis.

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Healthy tooth

Signs and symptoms of gingivitis may include:

• Swollen gums
• Soft gums
• Occasionally, tender gums
• Gums that bleed easily when brushing or flossing
• Bad breath
• A change in the color of your gums from a healthy pink to dusky red

Because gingivitis is seldom painful, you can have gingivitis without even knowing it. You may first realize something's wrong when you notice that the bristles of your toothbrush are pink — a sign that your gums are bleeding with just slight pressure.

When to see a dentist
Healthy gums are firm and pale pink. If your gums are puffy, dusky red and bleed easily, see your dentist. The sooner you seek care, the better your chances of reversing damage from gingivitis and its progression to more serious problems.

Gingivitis almost always begins with plaque. This invisible, sticky film is composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth removes plaque. But plaque re-forms quickly, usually within 24 hours.

Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar makes plaque more difficult to remove and acts as a reservoir for bacteria. What's more, you usually can't get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.

The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily.

Factors that can increase the risk of gingivitis include:

• Poor oral health habits
• Tobacco use
• Diabetes
• Older age
• Decreased immunity, such as that occurring with leukemia or HIV/AIDS
• Certain medications
• Certain viral and fungal infections
• Dry mouth
• Hormonal changes, such as those related to pregnancy
• Poor nutrition
• Substance abuse
• Ill-fitting dental restorations

Although anyone can develop gingivitis, many people first experience gum problems during puberty and then in varying degrees throughout life.

Untreated gingivitis can progress to periodontitis, a much more serious form of gum disease. Periodontitis can cause tooth loss and may even increase your risk of heart attack and stroke. What's more, women with periodontitis are far more likely to give birth to premature babies than are women with healthy gums.

If you notice any symptoms of gingivitis, make an appointment with your dentist. Here's some information to help you get ready for your appointment, and what to expect from your dentist.

What you can do
Consider preparing a list of questions to ask your dentist. Some questions you may want to discuss include:

• What is likely causing my symptoms?
• What kinds of tests, if any, do I need?
• What is the best course of action?
• Can I treat gingivitis on my own?
• What are the alternatives to the approach you're suggesting?
• Are there any restrictions that I need to follow?
• Are there any brochures or other printed material that I can take home with me?
• What Web sites do you recommend visiting?

Don't hesitate to ask other questions during your appointment at any time if you don't understand something.

What to expect from your dentist
Your dentist may ask you questions about your symptoms. He or she may ask:

• When did you first begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• What is your oral health routine?
• What medical conditions do you have?
• What medications do you take?

Diagnosis of gingivitis is generally simple. Diagnosis is based on your description of symptoms and an exam of your mouth and tongue. Your dentist will look for plaque and tartar buildup and may check for easy bleeding.

If it's not known what has caused your gingivitis, your dentist may recommend that you get a medical evaluation to check for underlying medical conditions.

There are several ways to treat gingivitis, including:

• A thorough dental cleaning
• Antiseptic mouth rinse
• Brushing
• Flossing
• Fixing dental restorations, if necessary

Gingivitis treatment usually starts by thoroughly cleaning your teeth. This includes removing all traces of plaque and tartar — a procedure known as scaling. The cleaning may be uncomfortable, especially if your gums are already sensitive or you have extensive plaque and tartar buildup. Your dentist may also recommend using an antiseptic mouth rinse to clear away bacteria. Your dentist will also review brushing and flossing techniques to make sure you're doing these effectively.

Misaligned teeth and poorly fitting crowns, bridges or other dental restorations make it harder to remove plaque. If any of these is contributing to your gingivitis, your dentist may recommend fixing these problems as well.

Gingivitis usually clears up after a professional cleaning — as long as you continue to follow a program of good oral hygiene at home. If you're consistent with your dental hygiene, you should see the return of pink, healthy gum tissue within days or weeks. You'll need to practice good oral hygiene for life, however, so your gum problems don't return.

You can take steps at home to help reduce or control gingivitis, such as:

• Get regular professional dental cleanings, on a schedule recommended by your dentist.
• Use a soft toothbrush and replace it at least every three to four months.
• Consider using an electric toothbrush, which may be more effective at removing plaque and tartar.
• Brush your teeth twice a day, or better yet, after every meal or snack.
• Floss daily.
• Use a mouth rinse to help reduce plaque between your teeth.
• Use an interdental cleaner, such as a dental pick or dental stick specially designed to clean between your teeth.
• Don't rely on tartar-control toothpaste to do the job that brushing and flossing should.

The best way to prevent gingivitis is a program of good dental hygiene, one that you begin early and practice consistently throughout life. That means brushing your teeth at least twice daily — in the morning and before going to bed — and flossing at least once a day. Better yet, brush after every meal or snack or as your dentist recommends. A complete cleaning with a toothbrush and floss should take three to five minutes. Flossing before you brush allows you to clean away the loosened food particles and bacteria.

Also, see your dentist or dental hygienist regularly for cleanings, usually every six to 12 months. If you have risk factors that increase your chance of developing gingivitis, you may need professional dental cleanings more often.