Gingival Flap



Plaque, a substance that forms on teeth, causes gingivitis. Plaque is sticky and made of bacteria, mucus, food, and other substances. It hardens to form tartar or calculus. Plaque left on teeth for a long period of time can lead to gingivitis. Toxins are produced by bacteria in dental plaque. The toxins can irritate the gum tissue and cause infection, inflammation, and pain.

Risk Factors

Gingivitis is more common in older adults, especially men.

Things that raise the risk are:

  • Dental issues, such as:
  • Improper bite
  • Poorly fitting dentures
  • Poor brushing and flossing habits
  • Diets high in sugars and low in certain nutrients
  • Diabetes
  • HIV infection
  • Hormone changes from pregnancy or birth control pills
  • Family members with gum disease
  • Some medicines taken for:
  • High blood pressure and heart disease
  • Depression
  • Seizures
  • Using alcohol, or smoking or chewing tobacco



Gingivitis is often painless, with symptoms developing when it becomes worse.

Symptoms may include:

  • Swollen, puffy gums
  • Tender gums
  • Redness in the gums or around the teeth
  • Bleeding gums during brushing or eating
  • Gum tissue that recedes or changes shape
  • Ongoing bad breath
  • Teeth that are loose or separating


The dentist will examine teeth and gums. This will involve looking for swelling and tissue pulling away from the teeth (pockets). The dentist may probe any pockets to see how deep they are. X-rays of the mouth can look for bone loss. Early diagnosis and treatment may help reverse the condition.



The goal is to remove the irritating plaque and prevent its return.

Treatment involves education about proper teeth and mouth cleaning. It may also include:

  • Regular dental check-ups and cleanings
  • Careful and frequent brushing and flossing
  • Quitting smoking—for those who smoke
  • A healthful diet that is:
  • Low in saturated fat and sugars
  • Rich in whole grains, fruits, and vegetables

A dental visit every 6 months is usually enough. People with gingivitis may need more frequent cleanings. If the disease progresses and plaque builds up below the gum line, the area must be scraped off and smoothed with dental tools.

Sometimes gingivitis persists or returns. Other conditions that could contribute to gum disease may need treatment.


To help reduce the risk of gingivitis:

  • Practice good dental habits:
    • Brush your teeth and tongue with fluoride toothpaste at least twice per day.
    • Use a soft-bristled toothbrush or a powered toothbrush.
    • Floss at least once per day.
    • See your dentist as advised for regular cleanings and check-ups.
  • Eat balanced, nutritious meals.
  • Avoid smoking.
  • Avoid or limit alcohol use. This means no more than 2 drinks per day for men and 1 drink per day for women.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.