Gum Disease

Everything You Need To Know About Gingivitis

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Inflamed, tender or bleeding gums? Here's everything you need to know about gingivitis and how to heal your gums and mouth.

by Dr. Burhenne


Gingivitis is the first stage of gum disease and should not be ignored. Gingivitis is the most common form of gum disease and if left untreated it will progress into plaque and tartar buildup, periodontitis, and major oral health complications.

Unfortunately, there’s a lot of conflicting advice and information surrounding gingivitis online. Most of this misinformation comes from outdated dental advice that recommends sterilization of the mouth as a way to heal and prevent gingivitis.

We now know the mouth contains an oral microbiome that needs to thrive for you to be healthy. Our oral microbiome hosts over 1000 different species of bacteria, which have been linked to mental health, weight, and even to dementia. You need these bacteria to exist in a healthy balance.

To clear the air of any misconceptions and provide you with the most cutting edge advice, we are going to take a comprehensive look at gingivitis. In this guide to gingivitis, we are going to cover:

  • Gingivitis 101
  • The true gingivitis definition
  • How do you get gingivitis?
  • Is gingivitis contagious?
  • Is gingivitis an autoimmune disease?
  • Can you cure gingivitis?
  • 9 Home remedies for gingivitis
  • When to see your dentist for gingivitis treatment

Your mouth is the gateway to your immune system and is therefore critical to your overall health. What you eat and your dental habits have a downstream effect on your body. Understanding gingivitis gives you the knowledge necessary to stop its impact on your health.

With this article, I hope you take home three very important points.

  1. To stop gingivitis, you must address the root cause.
  2. Diet is your first line of defense against gingivitis.
  3. Mouthwash often does more harm than good when it comes to fighting gingivitis.

The two questions my patients ask me most often are, “What do you do when you have gum disease?” and “How do I get healthy gums?” This article contains the answers to both these question in detail.

Gingivitis 101

To truly understand and prevent gingivitis, it’s first important to understand the anatomy of your teeth and gums and how they are connected. Don’t worry — you don’t need a dental degree to get the key takeaways.Gingivitis Tooth Anatomy

  • Periodontium is the portion of your mouth that makes up the teeth and supporting structures. Everything around the tooth.

  • Sulcus is the gap or pocket or fold  between the gum and tooth.
  • Gums are also called gingiva. When these are healthy, they are pale pink, shiny smooth and firm.
  • Periodontal disease refers to any condition that occurs in the gap between the gum and tooth – or the sulcus. Gingivitis and periodontitis are two types of periodontal disease.

Now, for the true gingivitis definition:

Gingivitis is the inflammation of the gingiva or gums. Gingivitis is the result of the  body responding to harmful bacterial overgrowth in the sulcus and can lead to to a more severe condition if left untreated. Gingivitis causes lesions on the gums and can eventually lead to periodontitis (gum disease).

What gingivitis is not – Gingivitis is sometimes mistaken for periodontitis. The major difference between these two is that there is no bone loss with gingivitis. Gingivitis precedes periodontitis and can be reversed with proper diet and dental care — unlike bone loss due to periodontitis which is permanent.

How do you get gingivitis?

Gingivitis occurs when there’s an overgrowth of one bacterium or a disruption of the bacterial equilibrium in the area of the pocket and even beyond in the mouth.

You see, our mouths are brimming with bacteria at all times. Even a healthy mouth is packed with millions of bacteria. The sulcus – the gap between gum and tooth – is an ecosystem of bacteria. When this ecosystem is in equilibrium, your gums, teeth, and mouth function in a healthy state

When there’s an increase in harmful bacteria, they build up on your teeth in a film called plaque. While some plaque in your sulcus is actually beneficial to your gums against outside invaders, if it becomes too thick and changes its structure it can eventually cause swelling and redness of your gums. When plaque remains on the teeth too long, it hardens and becomes tartar.

Inflammation is how your body deals with the build up of harmful bacteria.  If this inflammation is chronic, it leads to health complications including loss of gum tissue and eventually loss of bone structure around the teeth — and even eventually loss of the tooth itself.

The most common gingivitis misconception is this: Preventing gingivitis means killing all your mouth’s bacteria with a strong mouthwash.

If you blast this delicate little ecosystem with antibacterial chemicals, such as germ-killing mouthwash, you disrupt everything. You kill the bad bacteria but you also kill the good bacteria.

So, unless your mouthwash says, “packed with probiotics!” stay away from anything claiming to be a medicinal or gingivitis mouthwash. Your oral microbiome will thank you for this.

Gingivitis happens for one of two reasons:

  1. An overall increase in harmful bacteria from poor dental hygiene or a weak immune system.
  2. A bacterial imbalance where harmful bacteria overtake the beneficial bacteria, either by outnumbering them or outcompeting them.

When you use a mouthwash capable of “killing 99% of all germs…” you are seriously harming your mouth and making gingivitis more likely. Additionally, if you eat a lot of sugar (harmful bacterial loves sugar) or have a diet lacking in proper nutrients, you’re boosting your harmful bacteria and starving the beneficial bacteria.

To stop gingivitis, you must address the root cause of this runaway bacteria. Typically, this means improving your diet or dental habits.

Gingivitis symptoms

Healthy gums are pale, pink, strong, and are snugly wrapped around your teeth. Here are symptoms of gingivitis you should never ignore.

  • Swollen gums
  • Red or purple gums
  • Gums that bleed easily
  • Tender or painful gums
  • Receding gums
  • Bad breath

Gingivitis risk factors

While gingivitis can develop in anyone, there are some factors that can increase your risk for developing gingivitis. Important gingivitis risk factors include:

  • Poor dental hygiene
  • Tobacco use – smoking or chewing
  • Mouth breathing
  • Dry mouth – naturally occurring or due to medications
  • Sleep disordered breathing – An estimated 40 to 50 percent of the population has some form of this, which includes sleep apnea, upper airway resistance syndrome, and more.
  • Aging
  • Aggressive brushing or flossing
  • Osteoporosis
  • Genetics
  • Poorly done dental work that is difficult to clean
  • Wisdom teeth
  • Poor nutrition – due to poor diet or poor absorption caused by gut issues
  • Autoimmune disorders
  • Other conditions that impair the immune system such as HIV, chemotherapy, bacterial or viral infections – especially herpes and Epstein-Barr virus
  • Hormonal disruptions – such as pregnancy, birth control use, or endocrine disorders
  • Prescription drugs including antihistamines, calcium channel blockers, phenytoin – a seizure medication, any immunosuppressant such as cyclosporine, and blood pressure medication

Is gingivitis contagious?

Many patients often ask me, “Is gingivitis contagious?” or “Can you get gum disease from kissing?

The short answer is — Yes.

Studies have found it’s possible to transmit gingivitis and periodontitis bacteria from person to person. This transmission can occur from parent to child through sharing utensils or between romantic partners.

A kiss can exchange up to 80 million bacteria. But before you stop kissing your partner, there’s good news. A healthy immune system can fight off gingivitis causing bacteria. And in a healthy person, sharing with someone’s biome can add to your biomes diversity.

Through a healthy diet packed with proper nutrients, good dental habits, and regular checkups, you can help your immune system maintain the proper balance of bacteria in your oral microbiome.

Which bacteria is responsible for gingivitis?

You’ve heard a lot about these ‘harmful’ bacteria, but which ones are they exactly? Which bacteria are known for causing gingivitis? Here are some of the main culprits:

These are some of the harmful bacteria which need to be limited in your oral microbiome — but not completely removed as their existence is vital to the ecosystem of the oral microbiome in it’s entirety.

Is gingivitis an autoimmune disease?

Studies suggest that gingivitis may in some cases be classified as an autoimmune disease. Autoimmune disease occurs when your immune system attacks healthy tissue – in the case of gingivitis, your gums.

Research has found that gingivitis causes a person’s immune system to produce inflammatory cytokines. This causes inflammation in the gums and the rest of the body. While you want some cytokines because they help fight infection– too many cytokines contribute to chronic inflammation.

In particular, your mouth is impacted by cytokines interleukin-1beta, interleukin-18, and tumor necrosis factor-alpha (TNF-alpha). These bad boys run rampant in a mouth with gingivitis and cause damaging inflammation. Also, your white blood cells produce matrix metalloproteinases (MMPs) enzymes, which destroy connective tissue.

Inflammation and autoimmune disease go hand-in-hand. It’s still not clear which comes first, inflammation or autoimmunity. One thing is for sure though — the best way to fight gingivitis, inflammation, and autoimmune disease is with your diet.

Can you cure gingivitis?

By definition, gingivitis is a stage of gum disease which is still reversible. That being said, the earlier you catch gingivitis the easier it is to treat.

The “cure” for gingivitis is actually a process that allows the beneficial bacteria and the harmful bacteria to live in harmony. There isn’t a quick fix or a medication you can take to eliminate gingivitis. To cure your gingivitis, you’ll need to implement a nutrient dense diet and better oral health, and possibly visit your dentist.

For a true cure to gingivitis, check out the home remedies and essentials checklist below.

9 Home remedies for gingivitis

Everyone should begin their gingivitis treatment at home. Before you dive into these home remedies, review the Gingivitis Essentials Checklist below. If you aren’t doing all of these, you should start with the essentials first.

Gingivitis Essentials Checklist

  • Do you brush your teeth twice a day?
  • Are you using an electric toothbrush?
  • Do you use a toothbrush with extra soft bristles?
  • Do you replace your toothbrush regularly?
  • Do you floss every day?
  • Do you get your teeth cleaned at least once a year?
  • Do you limit sugar intake?
  • Don’t use harsh mouthwashes.
  • Don’t use tobacco products
  • Avoid medications known for causing gingivitis

These are critical to preventing or addressing your gingivitis — I recommend you implement anything missing as soon as you can.

Here are the 9 home remedies for gingivitis.

1. The gingivitis fighting diet

The best thing you can do for your dental health is to eat a nutrient-dense diet that boosts your immune system and naturally fights gingivitis.

Most gingivitis is caused by inflammation, an off-balance oral microbiome or lack of nutrients – all of which can be traced back to your diet. The other main cause is poor dental hygiene, which should also be addressed.

Here’s where to focus your attention to improve your diet and your oral health. Think Paleo!

  • Increase pre- and probiotics by eating more kimchi, sauerkraut, kefir, and unsweetened Greek yogurt.
  • Boost inflammation fighting antioxidants by eating more berries, dark leafy greens leeks, and goji berries.
  • Increase anti-inflammatory omega-3s by eating more salmon, grass-fed beef and butter.
  • Add more delicious and inflammation fighting spice to your meals. These include turmeric, ginger, and garlic.

2. Make your own toothpaste

My Chocolate Lover’s DIY Probiotic Toothpaste recipe was designed specially to support the beneficial bacteria of your oral microbiome. It’s packed with prebiotics, probiotics, and nourishes the most helpful mouth bacteria. This toothpaste also promotes remineralization and a healthy pH.

Plus, it’s delicious!

I first designed this toothpaste for my family and patients but the feedback was so wonderful I wanted to also share it with you. Check it out here.

3. Take probiotics

If you really want to beat gingivitis, you must boost the beneficial bacteria in your mouth. Taking probiotics will help your oral and gut microbiome health and boost your immune system.

Probiotics will also help you with bad breath. Instead of damaging your microbiome with harsh mouthwash, try probiotic lozenges.

4. Coconut Oil pulling

Coconut oil pulling improves bacterial balance in the mouth, prevents tooth decay, reduces gingivitis, improves breath, and whitens teeth. Plus, it’s delicious. What’s not to love about coconut oil pulling?

5. Scrape your tongue

Tongue scraping is the unsung hero of dental health. You should be scraping your tongue every time you brush to remove bacteria. Tongue scraping reduces gingivitis, prevent cavities, makes food taste better, boosts your immune system, and rids you of bad breath. Some studies estimate between 80 to 90 percent of bad breath comes from buildup of food, bacteria, fungi, and dead cells on the back of the tongue. Yuck!

6. Turmeric gel

Many dental home remedies include items that are natural, yet still antibacterial, such as essential oils. Though these natural options are a little better than many conventional products, using anything that is a strong antibacterial you run the risk of wrecking your oral microbiome.

Turmeric is one of the few exceptions to this natural antimicrobial rule. Though it is antimicrobial it is also powerfully anti-inflammatory, making it a good option for problematic gingivitis. Research has found turmeric gel (also called oral curcuma gel) to be effective against gingivitis mostly for its anti-inflammatory properties.

7. Sea salt water rinse

Salt water is great for gingivitis inflamed gums. Rinse with sea salt in warm water two to three times per day. Rinsing with sea salt helps remove food build up, eases inflammation and pain, reduces harmful bacteria, and improves bad breath.

8. Breath through your nose

This one might surprise you but breathing through your nose is important to maintaining the right pH for beneficial bacteria in your mouth. If you breathe through your mouth, it will cause the tissues to dry out and even healthy gums to bleed.

Check your anterior gums (front of the mouth) in comparison to your posterior gums (by your molars). If you notice only the gums in the front of your mouth are swollen, it could be caused by mouth breathing. Try mouth tape for mouth breathing during sleep or make an appointment with your dentist to go over more permanent solutions for both day and night mouth breathing.

9. Baking soda rinse

Baking soda reduces plaque buildup, improves bleeding gums, and inflammation. Baking soda also works through neutralizing an acidic pH in the mouth. Generally, harmful bacterial prefer an acidic mouth. I usually only recommend a baking soda rinse if your gingivitis has become problematic. Don’t use this as a preventative option. Do not use hydrogen peroxide. Its harmful to the oral microbiome and to the delicate tissues in the mouth!

Remember that diet is as important (if not more so) as oral hygiene when it comes to gingivitis! Eat well to nourish your oral microbiome.

When to see your dentist for gingivitis treatment

If your gingivitis isn’t going away after you’ve checked everything off the Gingivitis Essentials Checklist and you’ve tried the home remedies listed above, you should make an appointment with your dentist to discuss in-office gingivitis treatments.

Also, you should see your dentist if you’re in pain, your gums bleed regularly, you have extremely bad breath or you haven’t seen any improvement.

Your dentist can help you through some of the worst of gingivitis with a thorough cleaning. After that, fighting gingivitis is mostly up to you through a nutritious diet and good dental hygiene. For most people, gingivitis will clear up in two to three weeks after implementing a good routine. As with most health conditions, the earlier you catch it the easier it will be to treat.

If you have any conditions that make your risk of developing gingivitis higher, try to be more vigilant in checking your gums for signs of gingivitis. Most of the tips listed in this article can and should also be used as preventative measures.

Dr. Mark Burhenne

Have you tried any of these gingivitis fighting home remedies? Which ones are your favorites? Let me know in the comments below.

read next: Soothe Inflamed Gums with this Turmeric Golden Milk Tea

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Dr. Mark Burhenne DDS

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