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Gingivitis: Causes of Gingivitis & How to Treat and Prevent Symptoms

An illustration of a white tooth imbedded in a pink gum. The tops of the gum are dark pink, and two droplets of the dark pink come from where the tooth sits in the gum.
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Written by Elliot Stein, MD.
Internal Medicine Resident, Vanderbilt University Medical Center
Last updated May 13, 2024

Gingivitis quiz

Take a quiz to find out if you have gingivitis.

Care Plan


First steps to consider

  • See a dentist if you have symptoms of gingivitis like swollen, sensitive, discolored, or bleeding gums.
  • Your dentist will likely clean your teeth and remove any plaque and tartar on your teeth.
  • For more severe gingivitis, in-office treatments may include washing (scaling) the gums, removing dead or infected tissue (debridement), local anesthetic to relieve pain, antibiotics, and other treatments.
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Symptom relief

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  • Brushing and flossing regularly can help prevent and treat gingivitis.
  • Using a mouthwash formulated to treat gum disease, and rinsing with salt water, can help reduce pain and inflammation.
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Gingivitis is a common condition consisting of inflammation of the gums of your mouth. The main symptom is swollen, discolored, bleeding gums. It is prevented and treated by good oral hygiene, and if untreated, it can progress to periodontitis.

What is gingivitis?

Gingivitis is the inflammation of the gums. It is typically caused by poor dental hygiene and the buildup of bacteria.

Its hallmark symptoms are swollen, discolored, bleeding gums. The main risk factors for the development of the disease are increasing age, smoking, and dry mouth.

It is both treatable and preventable by engaging in recommended dental hygiene practices. A dentist can also treat the disease by cleaning plaque off your teeth, giving you a special mouthwash, and flossing your teeth. If gingivitis is not treated, it can progress to a more aggressive disease, called periodontitis, or can cause an infection of the gums, including the formation of an abscess.

You should go to the nearest dentist in the next few weeks. There, the dentist or dental hygenist will clean your teeth, getting rid of that nasty plaque/tartar. Once cleaned, you should rinse your mouth twice-a-day with chlorhexidine 0.12% oral rinse (PerioGard) or half-strength hydrogen peroxide. Flossing and brushing your teeth are also essential.

Gingivitis symptoms

Main symptoms

The symptoms someone with gingivitis can expect, include:

  • Swelling of the gums: This appears as if the gums are poking through the bases of the teeth.
  • Discoloration of the gums: The gums can appear white or purple.
  • Tender gums: Brushing or rubbing the gums may hurt.
  • Bleeding gums: When the gums are rubbed (such as with a toothbrush), they may bleed.
  • Presence of pus when flossing

Complications of gingivitis

If gingivitis is left untreated, it can progress to more aggressive disease(s).

  • Periodontitis: This is a serious condition that results in the infection and destruction of the “alveolar bone” connected to the teeth. It can result in cardiovascular, reproductive, respiratory, and endocrine diseases.
  • Abscess (pocket of infection) of the gums or the jaw
  • Cardiovascular (heart) disease
  • Pregnancy problems
  • Infection of the gums
  • Problems during anesthesia
  • Spreading of infection to the bloodstream

Gingivitis causes

Gingivitis is the inflammation of the gums and structures that support the position of the teeth. This is mostly caused by poor dental hygiene. Poor hygiene allows bacteria to build up around the teeth. These bacteria can form “biofilms” or “plaques.” These plaques irritate the gums and cause the gums to swell, bleed, and hurt. Gingivitis can also be caused by certain drugs, pregnancy, diseases, and certain infections of the mouth.

Risk factors

The following factors increase the chance that you could develop gingivitis [3]:

  • Poor dental hygiene
  • Smoking, the use of other drugs, and alchol
  • Osteoporosis
  • Age
  • Pregnancy: The presence of periodontitis is also linked to giving birth to premature and low-birth-weight infants [5].
  • Diabetes
  • HIV infection
  • Certain medications: Such as phenytoin, calcium channel blockers, oral birth control, and cyclosporin
  • Malnutrition or vitamine deficiency
  • Exposure to heavy metals

Treatment options and prevention for gingivitis


The treatment of gingivitis hinges on improving dental hygiene. A dentist can help demonstrate these strategies to you. Many of the strategies are listed below in the “Prevention” section.

Other treatments that can be provided by a dentist, include:

  • Washing (scaling) of the gums
  • Removal of dead or infected tissue (debridement)
  • A local anesthetic to relieve pain
  • Antibiotics
  • Drainage of any abscesses
  • Removal of infected implants

After plaque removal by a dentist, you may find that using nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) or naproxen (Aleve) may help speed up recovery.

Other treatments depend on why you have gingivitis and are listed below:

  • Vitamin C (if you have vitamin C deficiency): Vitamin C deficiency is only common in societies where malnourishment is an issue.
  • Treatment of HIV or diabetes
  • Stopping of drugs that are known to cause gingivitis

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The following are methods to improve your oral hygiene. They are recommended even if you do not have cavities.

  • Use a toothpaste with fluoride in it (most important)
  • Brush your teeth after each meal
  • Floss between your teeth
  • Use a mouthwash: Note, this is not a replacement for brushing teeth.
  • Supervise children when they brush their teeth
  • Use an electric toothbrush or make sure to make a circling motion with the toothbrush
  • Stop smoking
  • Chewing gum with xylitol sweetener: If you like to chew gum or have breath mints, choose varieties that are not sweetened with sugar.

When to seek further consultation for gingivitis

You should always obtain regular dental care from a dentist. Regular care can prevent the development of gingivitis and periodontitis because the dentist can catch the disease before it gets worse. They can also educate you on the best oral hygiene practices and remove the causative plaque from your mouth.

If you notice that your gums are swollen, tender, or bleeding when touched, then it is time to seek the care of a dentist as you may have gingivitis. Leaving gingivitis untreated can progress to much more severe, irreversible diseases such as periodontitis, cardiovascular disease, and the spread of infection to the blood.

Questions your doctor may ask to determine gingivitis

  • Is your mouth pain getting better or worse?
  • Do you have a rash?
  • Are you allergic to anything?
  • Have you noticed a change in your hearing?
  • Have you ever been diagnosed with HIV or AIDS?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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  1. Stephen JM. Gingivitis. Medscape. Updated Jan. 18, 2018. Medscape Link
  2. Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Gingivitis and periodontitis: Overview. 2011 Oct 5 [Updated 2014 Jun 18]. NCBI Link
  3. Periodontal Disease. Centers for Disease Control and Prevention. Updated March 10, 2015. CDC Link
  4. Page RC, Schroeder HE. Pathogenesis of inflammatory periodontal disease. A summary of current work. Lab Invest. 1976;34(3):235-49. PubMed Link
  5. Saini R, Saini S, Saini SR. Periodontitis: A risk for delivery of premature labor and low-birth-weight infants. J Nat Sci Biol Med. 2010;1(1):40-2. PubMed Link
  6. Stephen JM. Gingivitis Medication. Medscape. Updated Jan. 18, 2018. Medscape Link