What is gingivitis (mild gum disease)?

You may sometimes notice your gums bleeding when you brush and wonder if it’s a sign of anything serious. Gum bleeding, even without pain, is a common symptom of gingivitis.

Gingivitis (derived from Latin, gingivae “gums” and –itis “inflammation” i.e. gum inflammation), is an early stage of periodontal (gum) disease. 

Dr Dawn Siow, Associate Consultant from the Department of Restorative Dentistry at National Dental Centre of Singapore (NDCS), a member of the SingHealth group, shares more on the condition.

If you have gingivitis (mild gum disease) and want to know how to manage it, read this article.

What causes gingivitis?

The primary cause of gingivitis is dental plaque. This is a collection of bacteria and food debris that grows on all surfaces of the mouth, including around teeth and gums. If dental plaque is not removed, it hardens to form tartar, which are calcified deposits of bacteria that cannot be brushed off and must be removed by a dental professional.

Gingivitis usually happens because of poor oral hygiene. Think about your brushing habits. Do you brush twice everyday with toothpaste? How about flossing and rinsing with mouthwash? If the answer to these questions is no, it is likely that you have a buildup of dental plaque and tartar which can cause gingivitis.

Why do I have gingivitis even if I brush daily?

You can get gingivitis even if you brush every day. Gum disease can be caused by other factors:

  • Poor brushing and flossing habits

  • Crooked or overcrowded teeth

  • Hormones (produced by your body) e.g. during puberty or pregnancy

  • Some kinds of medications like steroids (man-made hormone chemicals) and oral contraceptives (birth control)

Does gingivitis hurt?

In the majority of cases, gingivitis is painless. Occasionally, some people may feel irritation or mild aching from the gums.

The most common symptom of gingivitis is gum bleeding, which brings us to the next point.

What are the symptoms of gingivitis?

Gum inflammation symptoms include:

  • Redness, 

  • Bleeding, and 

  • Gum swelling

But you may not always get pain with gingivitis, even when your gums are swollen and bleeding. If you’re currently dealing with gingivitis, look out for our next article on gingivitis management. 

How do you prevent gingivitis (mild gum disease) from happening? 

Let’s look at 5 tips to maintain good oral health and prevent gingivitis.

1. Keep your teeth clean with good oral hygiene

Good oral hygiene is important to prevent gum disease. You should follow these brushing and flossing tips to keep your teeth and gums clean:

Brushing

Brush your teeth
at least twice daily

Brush your teeth twice daily - after waking up in the morning and before sleeping at night. Make sure you brush your teeth for at least 2 minutes each time. 

While it’s important to brush your teeth thoroughly, you should not use too much force to clean your teeth. Brush gently to avoid hurting your gums or damaging your teeth. Over-brushing can cause receding gums (when your gums move away from your teeth, exposing gaps between the teeth and gums) and teeth abrasion.

Here’s a step-by-step guide on how to brush your teeth and gums properly.

The right way to choose and 
maintain your toothbrush

Manual or electric toothbrush

Dental professionals recommend a soft-bristled, small-headed toothbrush to effectively clean away plaque from all areas of the mouth. 

You can choose an electric toothbrush if you find it hard to do manual brushing.

Replace your toothbrush every 3 months or when signs of wear and tear appear

Check the toothbrush you're using. Are the bristles frayed, flattened, or damaged? If yes, it's probably time to replace your toothbrush

Damaged bristles are not so effective for cleaning your teeth. 

In general, you should replace your toothbrush every 3 months or when it shows signs of wear and tear. 

Replacing it regularly also prevents bacterial buildup in the bristles. 

​Choose the correct toothpaste

Fluoride toothpaste is best for preventing cavities.

However, the type of toothpaste you choose depends on your needs, whether for sensitive teeth or plaque removal. 

Ask your dentist or dental hygienist for recommendations.

Flossing

Floss daily

​​Brushing removes most but not all the plaque from your teeth, as it can’t reach the narrow areas between your teeth. 

That’s why you need to floss. Flossing removes food particles trapped in between your teeth.

Follow these steps to floss properly 

​1. Unroll about 45cm of dental floss from the packet. If you find it hard to estimate 45cm visually, use your arm's length as a guide.

2. Use about 5cm of floss each time you floss a tooth. Wrap the remaining floss around your middle fingers.

3. Hold the 5cm of floss between your thumbs. Gently push it through the gap between your teeth with a back-and-forth sliding action.

Remember to floss the bottom of each tooth to clean your gum line. Then, move the floss upwards and out of the gap to remove trapped food debris.

4. Unroll more floss after cleaning each tooth.

​How to choose dental floss?
There are different types of dental floss 

​● Material
Nylon floss is the most common and affordable floss type, but you’ll notice that it’s thicker and tends to break easily. 

If you have very small gaps between your teeth, you shouldn’t use this type of floss.

PTFE floss is a thinner and stronger type of floss that’s good for people with sensitive gums. It’s not so likely to shred during flossing. But it’s also more expensive.

Type

You can find dental floss in different forms, aside from the traditional rolled floss type - there are regular floss and floss picks, flavoured and unflavoured, waxed and unwaxed. 

Ask your dentist for recommendations.

Rinsing with mouthwash

Use antibacterial mouthwash

​Antibacterial mouthwash is the last step in your oral hygiene regimen. 

While it is a good addition to your routine, more time should be spent on brushing and flossing which physically removes dental plaque (the primary cause of gingivitis).

Follow these steps to rinse
your mouth with mouthwash

​1. Pour around 20 ml (4 teaspoons) of mouthwash into a cup. Don’t use too little mouthwash, as it won’t be effective.

2. Gargle or swish the mouthwash around in your mouth for 30 seconds to 1 minute. Use a stopwatch or count the seconds in your head.

3. Spit the mouthwash out. You don’t need to rinse your mouth with water after using mouthwash. 

Rinse with water after meals

Brushing, flossing, and rinsing with mouthwash in the morning and at night are important, but you should also rinse your mouth or drink water after eating to remove food debris.

You can also use mouthwash in between meals to freshen your breath and wash away food pieces.

Watch this video to learn more about gingivitis!

 


2. Go for regular teeth cleaning

Have regular dental check-ups every 6 months. 

  • A dentist can perform scaling and polishing, which removes dental plaque and tartar buildup that causes gingivitis. 

  • A dentist will also show you proper brushing and flossing techniques for good dental hygiene practices.

  • Early detection and treatment prevent early gingivitis from worsening to a later stage of gum disease. So, it’s important to see a dentist to check for signs of early stages of gum inflammation. 

  • Your dentist might take dental x-rays to assess for more severe forms of gum disease.

3. Quit smoking

Research shows that smoking doubles the risk of gum disease and mouth cancer. Smoking also weakens your body’s immune system and makes it harder to fight infections like gingivitis.

You might quit faster with professional help, so try booking an appointment with a counsellor at Singapore General Hospital’s (SGH) Smoking Cessation Clinic to get personalised help with quitting smoking.

4. Eat less of these foods

● Avoid sour, starchy and sugary food

What diet causes gingivitis? Eating too much starchy and sugary foods increases the risk of gingivitis, because these foods provide sugar that bacteria feeds on.

Eat less of these foods:

Sour

Starchy

Sugary

● Citrus fruits

● Sour fruit juice, e.g., lime juice, lemonade

● Pickles and pickled food

● Wine gums


● Soft bread

● Potato chips

● Crackers

● Potatoes


● Sticky candy and sweets, e.g. caramel, toffee, chewy candy

● Sour candy and lollies

● Gummies e.g. Yupi jellies

● Carbonated soft drinks e.g. Coca-Cola, Fanta

● Doughnuts

● Sugary breakfast cereal, e.g. frosted flakes

● Dried preserved fruits, e.g. dried raisins, prunes, cranberries and apricots 

● Avoid alcohol

Alcohol dries out your mouth and causes bad breath.

● Drink more water

Does drinking water help prevent gingivitis? Yes! 

Water prevents your mouth from getting dry. It also helps remove sugar, food particles and bacteria that cause plaque to build up.

If you don’t rinse your mouth after a meal, drinking water helps too. Try having a glass of water instead of a sweet drink after eating.

● Avoid drinking too much coffee

Is coffee bad for gingivitis? 

There is no definite evidence that coffee causes or worsens inflammation of the gums. But drinking coffee with sugar can cause bacteria to build up in your mouth. Bacteria feed on sugar, and if you don’t rinse your mouth with water after drinking coffee, you’re providing a sugary environment for bacteria to grow and multiply.

5. Look out for medication that could be causing gingivitis

Sometimes, gingivitis can be triggered by drugs like antidepressants, oral contraceptives and heart medication. You might also notice it during times of hormonal changes during puberty and menopause. 

If you are getting gingivitis because of long-term medication for health conditions, ask your doctor for advice.

Conclusion

Gingivitis can be cured, but it’s always better to prevent it with good oral hygiene. Brush your teeth at least twice daily, drink plenty of water, and see your dentist at least twice annually.

Don’t underestimate the importance of a healthy mouth and healthy teeth!

Ref: H24

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Gum Disease: Causes, Symptoms and Treatment

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How to Choose the Right Toothbrush