Definition: A disorder involving inflammation of the gums (gingiva).

Causes, incidence, and risk factors:

Gingivitis is the first form of periodontal disease. Periodontal disease involves inflammation and/or infection that results in destruction of the tissues that support the teeth, including the gingiva (gums), the periodontal ligaments, and eventually the tooth sockets (alveolar bone).

Gingivitis is caused by the long-term effects of plaque deposits. Plaque is the sticky material that develops on the exposed portions of the teeth, consisting of material such as bacteria, mucus, and food debris. It is a major cause of dental decay. Un-removed plaque mineralizes into a hard deposit called calculus (tartar) that becomes trapped at the base of the tooth. Plaque and calculus cause mechanical irritation and inflammation of the gingiva. Bacteria, and the toxins produced by the bacteria, cause the gums to become infected, swollen, and tender.

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  • mouth sores
  • swollen gums
  • the gums appear bright red or red-purple
  • the gums appear shiny
  • the gums bleed easily, blood appears on toothbrush even with gentle brushing of the teeth
  • the gums are tender when touched, but otherwise painless
  • bad breath

Injury or trauma to the gums from any cause, including overly vigorous brushing or flossing of the teeth, can also cause gingivitis. The risks for development of gingivitis include uncontrolled diabetes, pregnancy (because of hormonal changes that increase the sensitivity of the gingiva), general (systemic) illness, and poor dental hygiene.

Misaligned teeth, rough edges of fillings, and ill fitting or unclean mouth appliances (such as orthodontic appliances, dentures, bridges, and crowns) can irritate the gums and increase the risk of gingivitis. Medications such as phenytoin and birth control pills, and ingestion of heavy metals such as lead and bismuth are also associated with gingivitis.

Many people experience gingivitis to a varying degree. It usually develops during puberty or early adulthood due to hormonal changes and may persist or recur frequently depending on the oral hygiene status of the patient.