Gingivitis –Types, Cause, Symptoms, Prevention & Treatment Options

Do you bleed while brushing your teeth? Are your gums swollen and irritated? This might be because of the gingivitis. Gingivitis is an infection of gum due to various reasons such as progressive plaque formation or injury to gingiva while brushing or any other external action. There are several types of gingivitis such as acute, recurrent, chronic, localized, generalized, marginal, papillary, and diffuse gingivitis.

Gingivitis can be reversed with proper care and treatment. Here is some more information on gingivitis, it types, its stages, causes, treatments and prevention options.


What is gingivitis?

Gingivitis is an inflammation of gingiva. It is characterized by redness, swelling, and pain in the gums. The primary cause of gingivitis is poor oral hygiene due to which accumulation of food particles around the teeth turns into plaque. (1)

Plaque is a sticky colorless or yellow film found on the surfaces of teeth. Plaque is composed of bacteria and organic matter of food.

Bacteria thriving in plaque are acidic in nature which destroys the surrounding tissues of enamel and the soft tissues of gingiva, causing teeth decay and gingivitis.

If treated earlier or at initial stage gingivitis is reversible and can be treated easily. Otherwise, you might end up losing one of your teeth.

Types of gingivitis

On the basis of course and duration


It is of sudden onset and last for a short period and can be painful. A less severe form of acute gingivitis is termed as subacute.


It reappears after having been eliminated by treatment or disappearing spontaneously.


It is slow in onset and is of long duration. It is painless unless complicated by acute or subacute exacerbation.

On the basis of distribution


It is confined to the gingiva of single or a group of teeth.


In general gingivitis, the entire mouth is infected.

Marginal gingivitis

It involves the margin of gum lines and may also include a portion of the contagious attached gingiva.

Papillary gingivitis

Papillary gingivitis involves the interdental papilla and often extends into the adjacent portion of the marginal gingiva.

Diffuse gingivitis

It involves the gingival margin, the interdental papilla, and the attached gingiva.

Stages in gingivitis

 Stage I – initial lesion

The first manifestation of gingival inflammation is all internally like vascular changes consisting of dilation of capillaries and an increase in blood flow. Therefore no clinical signs appear at this stage. It occurs within 2-4 days of plaque accumulation.

Stage II – the early lesion

This stage is usually seen following 4-7 days of plaque accumulation. In this stage clinical signs of erythema(redness) appear, mainly owing to the proliferation of capillary loops between ridges. Bleeding on probing may also be evident.

Stage III – the established lesion

The lesion generally develops after 14-12 days of plaque accumulation. Blood vessels become engorged and congested. Therefore blood flow becomes sluggish. The established lesion can be described as moderately to severely inflamed

Stage IV – the advanced lesion

Here, the lesion extends into the alveolar bone (bone in which teeth are embedded) and is known as the phase of periodontal destruction or periodontitis.

Signs and symptoms

  • Bleeding from gums while brushing the teeth.
  • Receding of gum, teeth seem to be elongated or pulled away from the teeth.
  • Redness, swelling and tenderness of gums.
  • Loose teeth.
  • Teeth sensitivity while exposed to hot or chill food.
  • A dental abscess, the formation of pus between teeth and the gum.
  • Gingival pockets, the creation of space between teeth and the gum.
  • Bad breath and bad taste.

Causes of gingivitis

The primary cause of gingivitis is a dental plaque. Plaque is caused due to the negligence of dental health. When you eat, food particles are stuck in the sulcus (junction between the teeth and gum).

When not cleaned properly it forms plaque followed by tarter the calcium-rich plaque. In no time tater infects teeth and gums leading to teeth decay and destruction of gingival tissues.

The main causative agents are the bacteria or microbes present in the plaque. These microbes promote the inflammatory response of gingival tissues.

  • Poor oral hygiene.
  • Overconsumption of sticky and starchy food.
  • Deficiency of certain vitamins like vitamin C and K.
  • During puberty and menopause due to hormonal changes.
  • Patient of diseases like cancer, diabetes, and HIV might also face gingivitis due to poor body immune system.
  • Some medication promotes gingivitis because of its property to reduce the flow of saliva.
  • Medication used for seizures and high blood pressure are sometimes known to be a cause of enlargement of gingiva.
  • Smoking or chewing of tobacco and drinking of alcohol increases the risk of gingivitis.
  • Some people are likely to develop gingivitis due to inherited traits.


Proper oral care

Toothpaste must have an adequate amount of fluoride.

  • The toothbrush should be changed every three months.
  • Use of an electric toothbrush for proper cleaning.
  • Brushing technique should be followed.
  • Brush your teeth twice a day and rinse your mouth after every meal.
  • You should also include flossing in your daily routine with mouth rinsing as many people ignore flossing.

Healthy diet

You should maintain a well-balanced diet.

  • Nutritious food improves your body immunity to fight against the infections on gum.
  • Anti-oxidants, vitamin E (green leafy vegetable, nuts, oils) and vitamin C (citrus fruits, broccoli, potatoes) containing must be included in the diet as it helps in repairing of damaged tissues.

Bad habits

With the change in the lifestyle, people intake various types of intoxicants for short time pleasure and for stress relieve, which cause them their health. Therefore, the following habits should be avoided entirely.

  • Smoking of cigarettes.
  • Chewing of tobacco
  • Overconsumption of alcohol

Healthy lifestyle

Stress and unhealthy mental state make it difficult for the body’s immunity system to fight off any diseases and infections. To avoid stress, one must keep calm by following the below points.

  • Meditation is a simple process of breathing and observing your surrounding without any reaction, which can be practiced even at your working desk or while traveling for work. Few minutes of daily practice can help you ease anxiety.
  • Meeting up and talking to your well-wishers can help you to a great extent.
  • Be calm and composed.

Visit a dentist every six months

You must visit a dentist or dental hygienist for cleaning and scaling of the teeth twice a year. Tartar should be removed as it creates a protective sheath for bacteria which causes inflammation along the gum lines.


Promptness in the treatment is always a best as gingivitis can be successfully reversed. Therefore you should never neglect the signs and symptoms of gingivitis. It can be treated as follows

Professional dental cleaning

Plaque and tarter which are hard to reach and hard to clean is removed with dental instruments, and this procedure is called scaling. It may take few visits to the dentist in case of extensive plaques and tartar.

Correction of dental defects, such as over contoured or poorly fitting crowns and other restoration.


Home remedies

  • Use of an electric toothbrush.
  • Oil pulling– swish your mouth with unrefined coconut oil for 20-30 minutes before brushing the teeth. (2)
  • Use mouthwash with specific ingredients like thymol and menthol.
  • Flossing of teeth once a day.
  • Use medicated toothpaste.

Over to you

Maintaining oral hygiene is the most effective step to prevent any dental disease and gingivitis is one among them. Early signs and symptoms should always be taken into consideration.

If treatment is prompt and proper, gingivitis can be reversed. If gingivitis is left untreated for a longer period, it infects the periodontal ligament (bone supporting the teeth) known as periodontitis.

And the ultimate solution will be an extraction of a tooth. To protect your teeth, you must take care of oral health care.


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