Classic bacterial gingivitis, which is quite common, is often painless. However, it can sometimes manifest itself with symptoms such as :

• a softer, redder and more swollen gums;
• bleeding when brushing or eating;
• some tooth mobility;
• sensitivity at all times.

In more advanced cases of gingivitis:

• loosening of the teeth;
• bad breath (halitosis).
• an abscess.

Other gingivitises can be very painful. This is the case of gingivo-stomatitis herpetica. This affection presents a good redness of the gums and is accompanied by strong pain. In addition, one notices very small white spots on the gums themselves, but also on the inside of the cheeks.

There are also many other forms of gingivitis, but they are rarer. Here are a few examples:

• Hypertrophic or hyperplastic gingivitis (epulis). In this case, the gum grows enormously and becomes fibrous, without changing much in appearance, the inflamed part appearing little;
• Pregnant gingivitis. It is characterized by a dark pink benign tumour with a shiny appearance. In this case, the depth of the gingivodental groove (space between the gum and the root of the tooth) is much greater than normal (7 to 8 mm instead of the usual 2 to 3 mm);
• Ulcero-necrotic gingivitis is a rarer condition resulting in the destruction of necrotic tissue.

• The first and most common cause of gingivitis is dental plaque, which eventually turns into tartar. Bacterial plaque forms day after day in the form of a yellowish-white deposit at the gum and tooth border (neck area). It is made up of a mixture of saliva, food debris and bacteria. This deposit is a foreign body in the mouth against which the gum reacts. This defence reaction manifests itself in the form of inflammation due to the blood supply necessary for the body’s immune defence cells to arrive;
• Other factors may be responsible for the development of gingivitis, such as certain lesions or trauma to the gums, for example when teeth are brushed too vigorously;
• Some gingivitis is also linked to specific medical conditions (such as intolerance to certain medications);
• Certain viruses that invade the mouth can also play a role in the development of gingivitis. The best known and most common is the herpes virus. It affects not only the gums, but also other parts of the mouth by creating tiny ulcers and perforations;
• Vitamin C deficiency can also lead to gingivitis;
• Finally, “mechanical” causes such as poorly fitted crowns, recent and overflowing amalgams or misaligned teeth can cause gingivitis.

The treatment aims to restore the health of the affected gums. To do this, it is necessary to reduce the inflammation and remove the infection so that the pain does not deepen.

• At home, the first thing to do is to pay attention to oral hygiene and to improve it if it is insufficient by carefully brushing your teeth after each meal;
• When gingivitis is definitely established (chronic gingivitis), given that its primary cause is most often tartar, scaling is necessary;
• If the cause of gum inflammation is an ill-fitting dental prosthesis, the dentist consulted will be able to make adjustments to optimize your comfort and reduce friction;
• In the case of aggravated gingivitis, special treatments may be necessary, such as root planing, antibiotic treatment on prescription, subgingival irrigation, etc..;
• At a later stage, if the gingivitis has degenerated into periodontitis, a gingivectomy may be necessary. This is only done in the case of a very large pocket, or in the case of generalized gingivitis, for example;
• Finally, gum grafts are sometimes performed. They are quite often performed for aesthetic reasons, but can also consist of filling and protecting teeth that have been exposed by gingivitis.

At the first signs of gingivitis, it is important to make an appointment with your dentist, especially if it becomes chronic.

One form of aggressive gingivitis is ulcero-necrotic gingivitis (symptoms described above). The bacteria that cause it can attack not only the tooth, but also the bone, making holes by destroying the interdental papillae. This form of gingivitis is very painful and debilitating and can aggravate the disease that would have triggered it. It is essential, in this case, to make an appointment with your dentist as soon as possible.

Gingivitis that is managed at the beginning does not present a risk of major complications. However, if it is allowed to progress, gingivitis will reach deeper tissues (the periodontium) and may even attack the bone supporting the tooth. If left untreated, this can lead to tooth loss or an infection such as a periodontal abscess.

In addition, the bacteria that cause gingivitis can enter the bloodstream and cause a lung infection.

While people with diabetes often have a weakened immune system that makes it easier for gingivitis to set in, gingivitis, in turn, can make diabetes harder to control, as the increased presence of bacteria in the blood causes blood sugar levels to rise.

Finally, gingivitis in a pregnant woman could be responsible for premature delivery or the birth of a low weight baby.

When the tartar that causes gingivitis is not removed, it can infiltrate between the teeth and gums and create a periodontal pocket inside which bacteria can become lodged. These bacteria attack the bone supporting the teeth and cause bone loss.

Subsequently, the margin between the gums and the teeth widens, causing the teeth to move and fall out or be extracted.

Certain factors increase the risk of triggering or developing gingivitis:

• Smoking and/or the consumption of alcohol or drugs;
• Significant hormonal changes (pregnancy, puberty, menopause, etc.);
• A weakened immune system (diabetes, HIV, leukemia, etc.);
• Taking certain medications (e.g. cancer chemotherapy);
• Certain hereditary factors;
• Gum injuries due to over-brushing;
• Age and sex: the older you get, the greater the risk of gum inflammation (even more so in men).

• The best prevention and the simplest as well as the most effective for everyone (adults and children), is to prevent the appearance of tartar by brushing your teeth regularly, at least twice a day, to remove plaque. For greater effectiveness, dental floss and interdental brushes can be used;
• The dentist should be seen regularly. The dentist can perform a scaling once or twice a year, if necessary;
• A balanced diet, not too sweet, can help prevent gingivitis;
• If your gums bleed, you should not stop brushing your teeth, on the contrary. If your gums bleed, you should not stop brushing your teeth, on the contrary. On the other hand, do it more delicately and wash your mouth with an alcohol-free, antimicrobial product at least once a day;
• Try to quit smoking: tobacco is a complicating factor in many diseases and a trigger for others. Gingivitis is no exception to this rule.