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Gingivitis - What it is

90% of adult Singaporeans have some form of gum disease. This may range from the mildest (gingivitis) to the most severe (periodontitis). Gum disease can affect every tooth (generalised) or just some teeth in the mouth (localised).


The early stage of gum disease is gingivitis – an inflammation of the gums immediately surrounding the teeth. The first symptom of gingivitis is bleeding on brushing. In some cases, bad breath is noted. Pain is usually not a presenting symptom. Gum disease is called the ‘silent’ enemy because it may present with no symptoms at all. By the time symptoms arise, the disease may have advanced considerably. Gingivitis is reversible with proper oral hygiene and simple treatment like scaling and polishing.


Unattended gingivitis over a long time, progresses to periodontitis. This is where the disease attacks the deeper parts of the supporting structures of the tooth such as the surrounding bone and attachments. In addition to the symptoms of gingivitis, patients may complain of loose teeth, changes in tooth position, gum boils, longer looking teeth, or dull ache in the gums and teeth. Periodontitis is irreversible with just brushing alone and needs dental intervention.

Comparison between healthy gums and periodontitis - National Dental Centre Singapore 

Gingivitis - Symptoms

Gingivitis - How to prevent?

Maintenance of good oral health involves regular six monthly visits to the dentist for scaling and proper and effective home care. This means that patients must practise proper brushing and flossing and use appropriate dental aids to remove plaque from hard to access areas. Cessation of smoking and tobacco use will reduce risk factors.

Gingivitis - Causes and Risk Factors

Causes of Gingivitis

Bacteria in plaque are the cause of gum disease. These bacteria do not cause periodontal disease when removed daily by proper brushing. However, when there is inadequate oral hygiene, bacteria accumulate to form hardened deposits called tartar. Tartar cannot be removed by brushing and requires scaling.

Plaque bacteria produce toxins that irritate the gums. When bacterial toxins accumulate over time (as happens when plaque is not removed) the body mounts a response by producing enzymes. Toxins and enzymes dissolve bone and surrounding tissue holding the teeth. Periodontal disease is a chronic disease and if untreated gets worse over time resulting finally in tooth loss.

Risk Factors of Gingivitis

  • Genetic susceptibility
  • Puberty, menopause when hormonal changes occur
  • Smoking, stress, diabetes. Poorly controlled diabetics are at risk of developing gum disease
  • Medications like anti-depressants, oral contraceptives, some heart medications
  • Compromise of immune system e.g. AIDS, leukaemia, cancer treatment

Gingivitis - Diagnosis

Gingivitis - Treatments

Once you have been diagnosed with periodontitis, your dentist will decide if you can be treated surgically, non-surgically or a combination of both. Treatment aims are to control infection, prevent disease progression and return to good oral health. Non-surgical treatment involves scaling and root planing. Surgical treatment includes gum surgery, bone or tissue grafts to replace or encourage new growth of bone or gum tissue destroyed by periodontitis.

The link between periodontal disease and general health

The effects of periodontal disease are not limited to the mouth. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Additional studies point to a relationship between periodontal disease and stroke. Periodontal disease can exacerbate existing cardiac conditions.

Pregnant women with periodontal disease are seven times more likely to have pre-term deliveries and babies who are of low birth weight. Pregnant women should have a periodontal evaluation.

Gingivitis - Preparing for surgery

Gingivitis - Post-surgery care

Gingivitis - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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