Gingivitis: Early, Reversible Gum Inflammation
For anyone with red, swollen or bleeding gums, which the NHS advises getting checked by a dentist: what gingivitis is, why it happens, how quickly it improves and how it is treated. UK guidance states gingivitis can be reversed by reducing plaque at and below the gum line, and untreated it can progress to periodontitis.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, GDC 301711, a General Dental Practitioner and the principal dentist at Deepcar Dental Care, reviewed this page. His qualifications include BDS, BSc (Hons) and MSc (Leeds).
What is gingivitis?
Gingivitis is early gum disease: inflammation caused by plaque that stays within the gum and does not damage the bone holding the teeth.
Delivering Better Oral Health, the UK government's prevention toolkit for dental teams, defines gingivitis as inflammation from the interaction between dental plaque and the body's immune response, known as the host response. It states this inflammation is reversible by reducing plaque at and below the gingival margin, where the gum meets the tooth. Our gum disease page explains how gum disease develops.
What are the signs and symptoms of gingivitis?
The main signs of gingivitis are gums that bleed when you brush, floss or eat hard foods, and red, swollen and sore gums. The NHS advises getting these signs checked by a dentist.
Delivering Better Oral Health notes early gum disease may cause no symptoms, and the Leeds Teaching Hospitals NHS Trust gum disease leaflet notes gums bleed less easily in smokers. If you have no dentist or cannot get an emergency appointment, call 111 or visit 111 online. NHS guidance gives these actions:
- Gums that bleed when you brush or eat hard foods: see a dentist.
- Gums that are painful and swollen: see a dentist.
- Gum disease with very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip: ask for an urgent dentist appointment.
- A child with sore, bleeding gums: see a dentist.
- Toothache that lasts more than 2 days, does not go away with painkillers, or comes with a high temperature, pain when you bite, red gums, a bad taste or a swollen cheek or jaw: see a dentist.
- Swelling around your eye or neck, or swelling in your mouth or neck that makes it hard to breathe, swallow or speak: go to A&E or call 999, and do not drive yourself.
For urgent problems that do not need A&E, our urgent dental care pages explain how to reach us.
How are gums checked for gingivitis?
In UK guidance, the quick screening check is the basic periodontal examination (BPE), made with a special probe. Delivering Better Oral Health gives code 1 for bleeding on probing, with higher codes for plaque traps such as calculus and for deeper pockets.
At Deepcar Dental Care, BPE screening is carried out at every examination.
Why does gingivitis happen?
Gingivitis happens when plaque builds up along the gum line and the gums react to its bacteria.
The toolkit describes plaque as a highly organised film of bacteria, a biofilm, on the teeth, and a disruption in the balance between it and the immune system can start gingivitis. Plaque left in place hardens into calculus, or tartar, which the Leeds leaflet notes cannot be removed by brushing.
The toolkit advises assuming a higher risk with diabetes, says tobacco has a profound effect on periodontitis risk, and lists some medicines among the risk factors. Smoking cessation advice is available at the practice.
How long does gingivitis take to get better?
Gingivitis has no fixed healing time, but evidence suggests gum inflammation improves within weeks once thorough plaque removal begins.
In experimental gingivitis studies, healthy volunteers stop cleaning for two or three weeks so that mild gingivitis develops, then start again. In a 2022 trial of 117 healthy adults, bleeding and inflammation scores fell over two weeks of normal cleaning but had not fully returned to their starting levels. In a 2017 study of 20 people aged 70 or over, bleeding was comparable to the start three weeks after professional cleaning and resumed home cleaning.
The Leeds leaflet explains that inflamed gums may bleed when first cleaned properly, because of the inflammation rather than damage, and that this reduces if you keep going. The NHS still advises seeing a dentist if your gums bleed when you brush or eat hard foods.
To ask about gingivitis, book online or call 0114 288 2121.
How is gingivitis treated?
Gingivitis is treated by removing the plaque that causes it, through thorough daily cleaning and, where needed, professional removal of hardened calculus.
NHS guidance says that for early gum disease, a dentist will give cleaning advice, advise you to stop smoking if you smoke, and advise a professional clean. Delivering Better Oral Health adds that controlling risk factors is the mainstay of managing gingivitis, and that calculus trapping plaque may need removing where there are signs of disease.
How can you treat gingivitis at home?
The Leeds leaflet states gingivitis can be prevented and treated by thorough oral hygiene. NHS and Leeds guidance includes these steps:
- Brush with fluoride toothpaste at least twice a day, then spit rather than rinse.
- Angle the bristles towards the gum to clean below the gum line. A rechargeable powered brush with a small round head removes plaque more effectively than a manual one, though both can be effective if used properly.
- Clean between your teeth every day. Interdental brushes are usually the most effective, with floss for gaps too narrow for a brush.
- Do not use mouthwash straight after brushing, and do not smoke.
Mouthwash does not physically remove plaque, the Leeds leaflet notes, so it cannot replace cleaning. Delivering Better Oral Health finds high-certainty evidence that chlorhexidine mouthrinse reduces plaque and gingivitis, but advises only short-term use because of staining, taste change and soreness.
What happens if gingivitis is not treated?
Untreated gingivitis can progress to periodontitis, which damages the gum attachment and the bone around the teeth, and that bone loss is largely irreversible.
Delivering Better Oral Health calls gingivitis a predictor of periodontitis and then tooth loss, though not everyone with gingivitis develops periodontitis. With gum disease, the NHS advises asking for an urgent dentist appointment for very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip.
How can you stop gingivitis coming back?
Gingivitis can return if plaque builds up again, so daily plaque removal and regular check-ups help keep it away.
Delivering Better Oral Health names good plaque removal and avoiding tobacco as the main preventive goals, and the NHS advises regular dental check-ups, especially if you are pregnant or have type 2 diabetes. For more on daily care, browse the gum disease prevention section.
Frequently asked questions
Can gingivitis go away on its own?
Gingivitis can clear once the plaque causing it is reduced by thorough cleaning. Delivering Better Oral Health states the inflammation is reversible by reducing plaque at and below the gum margin, and the Leeds Teaching Hospitals leaflet notes calculus cannot be removed by brushing. If your gums bleed when you brush, the NHS advises seeing a dentist.
How do you know when gingivitis has gone?
Gingivitis has settled when the gums are no longer inflamed, judged by checking for bleeding on probing. Delivering Better Oral Health defines gum health as fewer than 10% of sites bleeding on probing. The NHS advises seeing a dentist if your gums bleed when you brush.
Can children get gingivitis?
Yes, children and teenagers can get gingivitis, and the NHS advises seeing a dentist if your child has sore, bleeding gums. Delivering Better Oral Health names toothbrushing from infancy, and cleaning between the teeth from age 18 or earlier if gum disease is evident, as the main skills required.
What is the difference between gingivitis and periodontitis?
Gingivitis is inflammation contained within the gum, while periodontitis causes loss of the attachment between gum and tooth. Delivering Better Oral Health describes them as separate conditions, both started by plaque. Bone lost to periodontitis is largely irreversible, whereas gingivitis can be reversed.
Can you book a hygiene appointment without seeing a dentist first?
Yes, you can book directly with our dental therapist at Deepcar Dental Care without seeing a dentist first. You do not need to register as a patient, and hygiene appointments can be booked online through the booking portal. A hygiene appointment lasts 30 to 60 minutes.
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Deepcar Dental Care is at 334 Manchester Road, Deepcar, Sheffield, S36 2RH. There is free parking directly outside, the practice is on the ground floor and wheelchair accessible, and patients describe their visits in our patient reviews.
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