Poor or inconsistent dental hygiene is considered the most common cause of gingivitis and its progression to more serious gum disease. When brushing, flossing and routine dental checkups are neglected, plaque builds up and hardens into tartar on teeth and down around the roots of teeth below the gum line. This buildup coats teeth, making it harder for gums to attach to tooth surfaces. As the space between the teeth and gums grows, more bacteria gets below the gum line and multiplies. Every time food and debris are left on the teeth and in the mouth, bacteria have an opportunity to grow and spread, and they run with it, multiplying rapidly and seeping into every available opening in the spaces between teeth and the pockets between teeth and gums. These pockets grow as gums lose their attachment to teeth, and when the gingivitis advances for too long without treatment, gum tissues then start to break down or degenerate and the advancing gum disease becomes irreversible.
Sometimes great oral hygiene isn't enough to prevent and stop gingivitis, though, and it's time to get aggressive. Life changes such as puberty, pregnancy and menopause bring hormone changes, and these cause either an increase or a decrease in hormonal balance. Increased progesterone in pregnant women, for example, leads to increased blood flow in the mouth and teeth and gums swell and can get sore. Gum tissues become vulnerable to bacteria as they pull away from teeth, and simple brushing may even be painful. This condition is known as pregnancy gingivitis, and not only does it cause discomfort and possible long-term damage to gum health, but it also may lead to low-weight babies or early births.
Studies show a connection, though not a proven link, between the oral health of the mother and a healthy full-term delivery, as well as an infant's birth weight. Pregnancy gingivitis is very common, so extra precautions against gum disease need to be taken. Women also experience changes in hormones and gum health due to dry mouth during menopause, as well as through the hormonal changes brought on when taking oral contraceptives [sources: AAP; ADA; March of Dimes].
Men and women of all ages can also experience gingivitis and periodontitis due to illness or disease. Some short-term viruses attack the body and, in turn, increase the bacteria levels in the mouth, and chronic conditions do the same but for many years. Diabetics often have increased risk for infections and need to fight bacteria in their bodies and mouths. People with heart disease have increased risk of infections reaching the bloodstream, and links between gum disease and coronary issues are common though not definitive.
Individuals with compromised immune systems from malnutrition or HIV, for example, also have increased risk for gum disease as their bodies have less immunity against disease-causing microbes and infection. Genetics can play a role as well, and some people are predisposed to having gum problems. Even being in overall good health but eating a poor diet lacking in vitamins and nutrients increases the risk of gum disease [source: AAP]. Smoking also greatly increases the likelihood of gum disease and makes it harder to treat [source: NIH].
Just reading about the risk factors may make your mouth hurt a little bit, so let's look at some options for treatment and relief, next.