Gingivitis (Early Gum Disease)

Medically reviewed by Dr. CJ Henley, DMD, general dentist, Jacksonville, FL · Last reviewed October 2026

Gingivitis usually announces itself in the sink. You brush or floss and see pink in the foam, or your gums look a little puffy and red along the edges of your teeth. It rarely hurts, which is why so many people ignore it. The good news is that it's the one stage of gum disease you can fully undo.

What does gingivitis look like?

Healthy gums are pale or coral pink (or evenly pigmented brown in people with darker skin), firm, and they come to a thin, knife-edge point between the teeth. They don't bleed when you brush. With gingivitis, the edge of the gum right next to the teeth changes first:

• The gumline turns red or darker than the rest of the gum.
• The edges look rolled, puffy, or shiny instead of thin, and the little triangles between the teeth get rounded and swollen.
• The gums bleed when you brush, floss, or bite into something firm like an apple.
• You can often see soft white plaque or hard yellow-brown tartar right where the redness is.

It's often worst between the lower front teeth and around the back molars, where brushes and floss tend to miss.

Gingivitis symptoms: how can I tell if I have it?

Most people with gingivitis feel fine. That's the trouble with it. Look for:

• Bleeding gums when you brush or floss. This is the single most reliable sign. Dentists actually measure gingivitis by how many spots bleed when we gently probe the gums.
• Swollen gums, especially the points between teeth.
• Gums that look redder or darker along the edges.
• Bad breath or a bad taste that comes back soon after brushing.
• Mild tenderness, though many people have none.

A quick self-check: after brushing, floss every gap slowly. If more than a few spots bleed, and it's still happening after a week or two of flossing every day, you probably have gingivitis that needs a cleaning.

A swollen gum around one tooth is a slightly different story. If it's one spot, especially if it throbs, has a pimple-like bump, or sits behind a partly erupted wisdom tooth, think about a tooth abscess or pericoronitis rather than ordinary gingivitis. A popcorn hull or seed stuck under the gum can do it too.

What causes gingivitis?

Plaque. It's the soft, sticky film of bacteria that forms on teeth every day. When it sits along the gumline for more than a day or two, your gums react to it with inflammation. That redness and bleeding is your immune system at work.

This was shown neatly in a classic 1965 study. Healthy dental students stopped all brushing and flossing, and every one of them developed gingivitis within about 10 to 21 days. When they started cleaning again, their gums returned to normal within about a week. Plaque left alone also hardens into tartar (calculus), which you can't brush off, and which keeps plaque pressed against the gum.

Things that make gingivitis more likely or worse

• Skipping floss or rushing through brushing. Most gingivitis starts between teeth.
• Smoking and vaping. Smoking is one of the biggest risk factors for gum disease, and it can hide bleeding, so gums look healthier than they are. Evidence for vaping is newer but pointing the same way. We wrote about vaping's role in gum disease on our blog.
• Hormone changes: puberty, pregnancy, and sometimes birth control or the days before a period.
• Diabetes, especially when blood sugar runs high. Gum disease and diabetes make each other harder to control. More on how diabetes affects the mouth.
• Dry mouth from medications, mouth breathing, or radiation. Saliva helps clear plaque. See our page on dry mouth.
• Crowded teeth, braces, rough fillings, and crowns with open edges, which all trap plaque.
• Some medications can cause the gums to overgrow, which makes them harder to clean. Examples include phenytoin (Dilantin), cyclosporine, and calcium channel blockers such as amlodipine and nifedipine.
• Stress, poor sleep, and poor nutrition. Severe vitamin C deficiency (scurvy) causes bleeding, swollen gums, though it's rare today.

What is periodontitis? (When gum disease goes deeper)

"Gum disease" is the umbrella term. It covers two stages: gingivitis, where only the gums are inflamed, and periodontitis, where the inflammation has started to destroy the fibers and bone that hold the teeth in.

In periodontitis, the shallow groove where gum meets tooth deepens into a pocket. Plaque and tartar collect down there, out of reach of a toothbrush, and the body's own inflammation slowly breaks down the bone around the root. Over years, teeth can get loose and eventually be lost. It's common. A national CDC survey found that about 42% of U.S. adults age 30 and older have some degree of periodontitis, and close to 8% have a severe form.

The key difference for you: gingivitis is reversible, but bone loss from periodontitis isn't. Periodontitis can be stopped and kept stable with deep cleanings and regular maintenance visits, and lost bone can sometimes be partly rebuilt with surgery, but the gums and bone won't simply grow back on their own.

Not all gingivitis turns into periodontitis. Many people have gum inflammation on and off for years without bone loss. Genetics, smoking, and diabetes have a lot to do with who progresses. Since there's no way to tell at home which group you're in, it makes sense to treat gingivitis early.

Signs that it may be periodontitis, not just gingivitis

• Gums pulling back so teeth look longer
• Loose or shifting teeth, new gaps, or a bite that feels different
• Pus between the teeth and gums
• Bad breath that doesn't go away
• Pain or tenderness when chewing

Plenty of people with periodontitis have none of these until it's fairly advanced. That's why we measure pocket depths and check X-rays at a comprehensive dental exam.

Gingivitis vs. periodontitis: how they compare

Other causes of swollen or bleeding gums

Plaque-related gingivitis is far and away the most common reason gums bleed. A few other conditions can look similar, and some of them need a different approach.

Blood thinners like warfarin, apixaban (Eliquis), or daily aspirin can make gums bleed more readily, but they don't cause gingivitis by themselves. If your gums bleed a lot on a blood thinner, keep taking it and let us look for the cause.

Does gingivitis go away? How long it takes

Yes. Gingivitis is curable in the true sense of the word. Once the plaque is gone and stays gone, the gums go back to normal. How fast depends mostly on whether tartar is involved.

Can you cure gingivitis in a week? Sometimes, if it's mild and there's no tartar. Many people notice a real difference within 7 days of flossing every day and brushing carefully. For most, it takes closer to 1 to 2 weeks. If tartar has built up along the gumline, no amount of home care will remove it, and the gums next to it will keep bleeding until a dentist or hygienist cleans it off. After a professional cleaning, the swelling usually settles over the following week or two.

Gingivitis won't go away on its own if nothing changes. It can wax and wane with stress, hormones, or illness, but the plaque has to go for the gums to heal.

How to get rid of gingivitis at home

Treating gingivitis at home comes down to removing plaque thoroughly every day, especially at the gumline and between the teeth. Products help a little. Technique helps a lot.

The daily routine

1. Brush twice a day for 2 full minutes with a soft brush and fluoride toothpaste. Angle the bristles about 45 degrees toward the gumline and use small, gentle circles. Hard scrubbing doesn't help and can wear the gums down.
2. Clean between your teeth once a day. Floss, small interdental brushes, or a water flosser all work. Research suggests interdental brushes may do slightly better than floss where the gaps are big enough for them. The tool you'll actually use every day is the right one.
3. Floss the right way. Wrap the floss into a C around each tooth and slide it gently just under the gumline, then up and down a few times. Snapping it straight down into the gum hurts and misses the plaque.
4. Keep going even if it bleeds. Bleeding when you first start flossing is expected. It usually settles within about a week. Stopping because of the bleeding keeps the cycle going.
5. Add an antiseptic rinse if you like. An alcohol-free rinse with the ADA Seal can reduce plaque and gingivitis a bit more. It doesn't replace brushing and flossing.
6. Look at your gums in good light once a week. You should see the redness and puffiness fading.

If you have braces, a bridge, or implants, floss threaders, interdental brushes, or a water flosser make it much easier. Our home care instructions have more tips for specific situations.

Over-the-counter products for gingivitis

Look for the ADA Seal of Acceptance on the package, which means the company showed the product does what it claims.

Chlorhexidine rinse (Peridex, PerioGard) is stronger and is prescription-only in the U.S. We cover it below.

Gingivitis treatment at the dentist

When you come in with bleeding or swollen gums, this is what we do:

• Measure and look. We gently measure the gum pockets around each tooth, note where they bleed, and take dental X-rays to check the bone level. That's how we tell gingivitis from periodontitis.
• Professional cleaning. For gingivitis, a regular cleaning removes the tartar and plaque above and just below the gumline. Most people need nothing more than that, plus better daily cleaning.
• Deep cleaning for periodontitis. If pockets are deep and there's bone loss, we do scaling and root planing, which cleans the root surfaces below the gumline, usually with local anesthetic for comfort. Then we see you more often to keep it stable.
• Prescription rinse. A short course of chlorhexidine rinse can help with stubborn inflammation. It can stain teeth and change taste for a while, so we use it for a limited time.
• Fix plaque traps. Smoothing a rough filling, replacing a crown with a gap at its edge, or adjusting a partial denture that's collecting plaque.
• Coaching that fits your mouth. We'll show you exactly where you're missing and which tools fit your gaps.
• Coordinate with your physician when diabetes, a medication, or another health problem is part of the picture. Our care for medically complex patients covers how that works.
• Refer or biopsy when the gums don't behave like plaque gingivitis, and refer to a periodontist (a gum specialist) for advanced periodontitis or gum surgery.

We'll usually want to recheck your gums a few weeks after the cleaning to make sure the bleeding has cleared.

How to keep gingivitis from coming back

• Clean between your teeth every day, not just the week before a dental visit. Gingivitis can return within a couple of weeks of slacking off.
• Get regular cleanings. Every 6 months suits most people. If you've had periodontitis, it's usually every 3 to 4 months.
• Quit smoking or vaping. Your gums may bleed a bit more for a while after you quit. That's circulation returning, not a sign things are worse.
• Keep diabetes in good control and let us know if your A1c changes.
• Manage dry mouth with water, sugar-free gum, and a conversation with us or your doctor about your medications.
• Replace your toothbrush every 3 to 4 months, or sooner if the bristles splay.

Pregnancy gingivitis, kids, and other special cases

Pregnancy gingivitis

Pregnancy gingivitis is very common. Hormone changes make the gums react much more strongly to plaque, so they swell and bleed easily, usually most noticeably in the second and third trimesters. A dental cleaning is safe during pregnancy and the second trimester is often the most comfortable time for it. Keep up brushing and flossing even when the bleeding is discouraging, and tell us you're pregnant so we can plan. Alcohol-free rinses are a sensible choice. A single red lump that grows on the gum may be a pregnancy tumor (pyogenic granuloma), which is harmless but worth showing us.

Children and teens

Kids get gingivitis too, and it often flares during puberty or with braces. Parents should help with brushing until about age 7 or 8 and check flossing for a while after that. In a young child, swollen, bleeding gums along with fever and many mouth sores is more likely a first herpes infection than gingivitis. Regular checkups through childhood are part of our family dentistry care.

Cancer treatment and weakened immunity

Chemotherapy and head and neck radiation can make gums bleed and get infected more easily, and dry mouth after radiation speeds up plaque buildup. Getting gums healthy before treatment starts helps. Our head and neck cancer dental care page explains what we do before, during, and after treatment. People with HIV, transplant medicines, or low white counts should also have bleeding gums checked sooner rather than later.

Heart health and other conditions

You may have read that gum disease causes heart disease. The honest version: people with periodontitis do have more heart and blood vessel disease, but the American Heart Association has concluded that the research shows an association, not proof that gum disease causes it. They share risk factors like smoking and diabetes. Healthy gums are worth having for their own sake.

When to see a dentist about bleeding or swollen gums

Gingivitis FAQ

Related conditions

Sources

1. Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: case definition and diagnostic considerations. J Clin Periodontol. 2018;45(Suppl 20):S44–S67.
2. Löe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol. 1965;36:177–187.
3. Eke PI, Thornton-Evans GO, Wei L, et al. Periodontitis in US adults: National Health and Nutrition Examination Survey 2009–2014. J Am Dent Assoc. 2018;149(7):576–588.
4. Worthington HV, MacDonald L, Poklepovic Pericic T, et al. Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. Cochrane Database Syst Rev. 2019;4:CD012018.
5. Lockhart PB, Bolger AF, Papapanou PN, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012;125(20):2520–2544.
6. National Institute of Dental and Craniofacial Research. Periodontal (gum) disease. National Institutes of Health.

This page is for general education and isn't a diagnosis. Every mouth is different. If you have a sore you're worried about, see your dentist or physician. Photos marked Wikimedia Commons are used under their listed licenses and may have been cropped or resized.