How to Cope With Gingivitis: Tips and Guidelines

A young woman having toothache in the dentist’s chair — Gingivitis is inflammation, swelling, and bleeding of the gum tissue caused by the bacteria that naturally coat the teeth. RainStar / Getty Images

You're brushing your teeth, and when you rinse and spit, you see a little blood. No big deal, you think to yourself. It happens all the time. Well, it's time to think again, because that bit of blood may be a much bigger deal than you think. It may be a sign of gingivitis, the first stage of gum disease. According to the American Dental Association, gum disease -- not dental caries, or "cavities" -- is the leading cause of tooth loss among adults. In this article, we'll help you understand how to prevent gingivitis and, if you already have gum disease, what to do about it. But first, let's get to know the problem a little better.

Gingivitis is inflammation, swelling, and bleeding of the gum tissue caused by the bacteria that naturally coat the teeth. The bacteria form a sticky, whitish film on the teeth called plaque. If plaque isn't thoroughly removed every day, the bacteria produce toxins that irritate the gums, making them red, swollen, and likely to bleed easily. Eventually, the toxins destroy gum tissue, causing it to separate from the tooth and form pockets. The pockets hold more bacteria and detach even further. This is periodontitis, an irreversible stage of gum disease that can destroy the bone and soft tissue that support the teeth.

If you have gingivitis, you're not alone. According to the American Dental Association and the American Academy of Periodontology, three out of four adults have gingivitis. Most gingivitis results from poor oral hygiene--not brushing and flossing correctly or often enough and not having teeth professionally cleaned on a regular basis. However, a number of factors can increase your risk. Dentists say that people who are chronically stressed seem to develop gum problems more often than laid-back types. Hormones influence risk, too, which is why the condition often flares up in women who are pregnant or menstruating. Likewise, adolescents, whose hormones are going crazy, sometimes develop gingivitis. Some diseases, such as diabetes, and some drugs, including phenytoin (an anticonvulsant), are associated with gingivitis. Finally, if you tend to breathe through your mouth rather than your nose, you may be setting yourself up for this unpleasant condition, since moving air in and out of your mouth causes the gums to dry and could result in an overgrowth of gum tissue.

If you have gingivitis, don't break out those false teeth just yet. Read on to the next to the next section for some tips on how to combat gum disease.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Gingivitis Tips

The most common cause of gingivitis is poor oral hygiene. Fortunately, gingivitis is reversible, and better oral hygiene is the solution. Here are some tips to prevent gingivitis and, if you already have it, to "clean it up."

Use the "three-three" rule. The American Dental Association says that most people spend less than one minute per day on dental hygiene. That's far from adequate, say dentists. Here' s a good rule of thumb: Brush your teeth three times a day for at least three minutes each time. That may seem like a lot of brushing--not to mention the flossing that should follow -- but those nine minutes each day could spare you a great deal of oral distress.

Try brushing dry. "Dry" brushing -- or brushing without toothpaste -- while doing other activities such as watching television can help remove dental plaque.

Be consistent. You will be less likely to miss teeth as you brush if you develop a routine and stick with it. Start with the same part of your mouth every time you brush, always moving from one section to the next in the same order.

Lighten up. One of the biggest mistakes people make when they brush is pushing too hard with the toothbrush. Try the following experiment: Apply the bristles of your toothbrush to the back of your hand. Push as hard as you normally would for toothbrushing, and try to move the brush around. Then apply only a tiny amount of pressure and move the brush. You'll find that the hard pressure doesn't allow the tips of the bristles -- the part of the brush that cleans the teeth -- to move.

In addition, avoid a "traveling" stroke. Instead of moving the brush up and down and traveling rapidly over several teeth, brush a couple of teeth at a time, holding the brush in one place.

Use a softie. Using a toothbrush with stiff bristles can damage the sensitive tissue in your mouth and even cause gingivitis. Always use a toothbrush with soft bristles.

Brush your tongue and palate. Many dentists advise patients to brush the tongue and the roof of the mouth when they clean their teeth, which will cut down on the amount of bacteria present and increase circulation in the tissue.

Electrify 'em. Okay, so you hate to brush. It's awkward and boring, or maybe it's too difficult because you don't have as much dexterity as you used to. Try a "rotary" electric toothbrush. Beware, however, that not all electric toothbrushes are created equal. Ask your dentist for a recommendation.

Floss, and floss again. Toothbrush bristles are not designed to clean between teeth. That's a job for dental floss, which -- despite what you might think -- is not optional. Use a waxed floss (it's easier to move between the teeth without getting hung up), and whenever possible, floss at least twice a day.

Irrigate it. While water irrigation devices like the Waterpik don't take the place of flossing, they do clean debris out from pockets in the gums and from between teeth. They also massage the gums.

Use tartar-control toothpaste. Tartar is a hardened material that often contains bacterial debris and sometimes even plaque. Brushing with the right toothpaste can help prevent plaque from hardening into tartar. Look for a tartar-control toothpaste with the American Dental Association Seal of Acceptance or Recognition, an indication that the product has been properly tested.

Brush with baking soda. Once or twice a week, brush your teeth with baking soda. The white powder is just abrasive enough to help clean your teeth without harming their enamel. Make a paste with a little baking soda and water, and brush thoroughly, especially around the gum line. Not only will the baking soda scrub off the plaque, it will also neutralize acidic bacterial wastes, deodorize, and polish your teeth.

Rinse it. Most antiplaque rinses and antimicrobial mouthwashes (such as Listerine) contain alcohol, which kills bacteria in the mouth. Fewer bacteria means less plaque on your teeth. However, rinsing your mouth is not a substitute for regular, thorough brushing and flossing.

Bring on the salt water. Try rinsing your mouth with a warm saltwater solution (half a teaspoon salt to four ounces warm water). Swish it around in your mouth for 30 seconds, then spit (don't swallow). The salty solution will soothe your inflamed gums; as a bonus, it will also wipe out some bacteria.

Try hydrogen peroxide. If the bleeding persists when you brush your teeth, try an oral 3 percent hydrogen peroxide solution (not the 20 percent hydrogen peroxide used for cuts). It's available without a prescription at pharmacies and in the dental section of some stores. Mix equal parts hydrogen peroxide and water, rinse with it for 30 seconds, then spit (don't swallow).

Eat a carrot. Any time you can't brush after eating, you're giving bacteria in your mouth the opportunity to cause gingivitis. But face it, sometimes you just can't brush. When you can't brush, try to end your meal with an abrasive food, such as a raw carrot or even popcorn, which will scrape some of the plaque from your teeth and stimulate the gums.

Swish. If you can't brush right after eating, at least rinse your mouth out thoroughly with water. A little H2O therapy can wash away debris and provide some relief if your gums are inflamed.

Aside from your usual check-ups, our next section will discuss when you should seek medical attention for your gums.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

When to See a Doctor

Most cases of gingivitis can be effectively treated at home with the remedies described in the previous section. But some symptoms need to be checked out by your dentist. The American Dental Association recommends calling your dentist if:

You have persistent bad breath.
There is pus between the teeth and gums.
Your "bite," the way your teeth fit together, has changed.
You have loose or separating teeth.
Your gums consistently bleed.
The gums at the gum line appear rolled instead of flat.
Your partial dentures fit differently than they used to.
Your gingivitis doesn't improve after three or four days of home care.

Take care of your gums and they'll take care of you--by holding on to your teeth. Keep our guidelines in mind to make sure your gums are in good shape.^©Publications International, Ltd.This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.