Gingivitis is inflammation of the gums caused by dental plaque that builds up along the gum line. It is reversible with good oral hygiene, but without care it can progress to periodontitis with bone and tooth loss.
Key symptoms
- Gums that bleed when brushing or flossing
- Red, swollen or tender gums
- Bad breath
- Usually painless; sudden pain and ulcers suggest a necrotizing form
What you find on exam
- Red, puffy gum margins that bleed on gentle probing
- Visible plaque or tartar along the teeth
- No loose teeth or gum recession, which point to periodontitis
- Risk clues: pregnancy, diabetes, smoking, drugs such as phenytoin or nifedipine
Tests
- Diagnosis is clinical, from the mouth exam
- Dental referral for probing depths and X-rays if periodontitis is suspected
- Glucose or HbA1c if diabetes is suspected
- Blood count if bleeding seems excessive or there are bruises
Treatment basics
- Brush twice a day with fluoride toothpaste and clean between the teeth daily
- Professional dental cleaning to remove plaque and tartar
- Short course of chlorhexidine mouth rinse if needed
- Address risk factors: stop smoking, control diabetes, review drugs
Red flags
- Severe gum pain, ulcers, a gray membrane and fever (necrotizing gingivitis)
- Gum bleeding with easy bruising or fatigue (possible blood disorder)
- Facial swelling, fever or trouble opening the mouth (spreading dental abscess)
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.