Gingivitis vs Healthy Gums (What’s the Difference?)

Category: Adult Dentistry, Common Questions, Dr. Advocate's Insights, Oral Health

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By: Dr. Advocate
Updated: November 24, 2022

Gingivitis vs. Healthy Gums | My Dental Advocate

You may have gingivitis and not even know it! Harmful bacteria that cause gingivitis can progress into severe gum disease or creep into your bloodstream (yuck!). Most patients with gingivitis or gum disease are unaware because they don’t have pain. Understanding the differences between gingivitis and healthy gums will help you evaluate your oral and systemic health. Let’s take a closer look from a dentist’s perspective.

Recommended Reading: Gingivitis | The Ultimate Guide

Gingivitis vs. healthy gums – what’s the difference?

Healthy gums appear firm and coral pink. It’s not uncommon to have a stippling surface resembling an orange peel. In addition, the architecture of the jaw bone below the gums is readily visible and variable. Signs of unhealthy gums include redness, swelling and puffiness. In addition, harmful bacteria cause your gums to bleed when you brush or floss. Gum disease will continue to advance if the bacteria are not removed, leading to the gums appearing to pull away from the teeth and generalized bone loss.

Factors that can undermine healthy gums include tobacco use, malnutrition, poor oral hygiene, and poor immune response. In addition, certain medications, including antihistamines, decongestants, and painkillers, can cause dry mouth and promote gum disease. Gum disease and cavity-causing bacteria thrive in dry, acidic environments. If you struggle with dry mouth, consider reading our dry mouth product review and dry mouth oral rinse review.

As a dentist, I remind my patients that healthy gums aren’t just essential for oral health. Maintaining healthy gums has a direct impact on your overall health. According to a recent study, bacteria that cause gum disease (periodontitis) are directly linked to chronic health conditions, including Alzheimer’s, diabetes and heart disease.

Recommended Reading: What is Gingivitis? Causes, Symptoms & Treatment 2022

What is gingivitis?

Gingivitis is inflammation of the gums caused by harmful bacteria. If your dentist or hygienist does not remove harmful bacteria, the bacteria will congregate and multiply into advanced gum disease. The bacteria that infects the gums lead to swollen, red and puffy gums. Gingivitis is a common gum issue and a clear warning sign that we must be more proactive about our oral health; however, oral hygiene improvements can help prevent this ailment.

Recommended Reading: 14 Gingivitis Home Remedies That Work! (Dentist Recommended)

What does gingivitis look like?

Let’s take a closer look at what gingivitis and gum disease looks like in the mouth. We’ll order them from least to most severe so you can see a distinct transition from health to harm. Take note of the colors of the gum, inflammation, plaque and tartar present. Although we have great pictures available, an accurate diagnosis is incomplete without gum measurements, dental x-rays and medical/dental information.

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Gum Disease Pictures | My Dental Advocate

Causes of gingivitis

Harmful bacteria in the mouth infect gum tissue surrounding the tooth. Soft and hard tissue (bone) become inflamed leading to periodontal disease. When bacteria stay on the teeth for an extended period, they form a sticky film called plaque, which eventually hardens to tartar, also called calculus.

Tartar build-up typically occurs above the gums however it can spread below the gum line, which makes the teeth more challenging to clean. When the bacteria progress below the gum line it invades sensitive space around the teeth. The bone and gums physically move away from the “harmful agent” (bacteria). Other causes of gingivitis and periodontitis include:

  1. Poor oral hygiene – If regular brushing and flossing habits are not maintained, dental plaque will form on teeth, causing gum inflammation. However, improved oral hygiene and regular visits to the dentist for routine cleanings aid in the removal of dental plaque. A more severe gum disease (periodontal disease) will occur if left untreated.
  2. Poor nutrition – Harmful bacteria rely on sugars and carbohydrates to multiply. The bacteria begin to proliferate (increase in number) after it congregates – brushing, flossing and routine cleanings prevent harmful bacteria from forming above and below the gum tissue. Foods high in sugars and carbohydrates are sticky and desirable for oral bacteria.
  3. Dental plaque – Occurs when food debris is not removed, most commonly along the tooth and gum margin. It may feel a bit “fuzzy” when you run your tongue over it. Dental plaque is composed of bacteria that “eat” sugars. Acid formation and other byproducts form, leading to gum inflammation. To limit dental plaque, brush twice daily and floss nightly.
  4. Tartar – Plaque that stays on your teeth can harden under your gumline into tartar (calculus), which invites more bacteria formation. Tartar protects plaque from breaking down, creating a protective shield for bacteria. In addition, tartar formation causes gum irritation and inflammation. Unlike plaque, tartar cannot be removed at home and requires a dental cleaning to remove it.

Recommended Reading: 6 Best Mouthwashes for Gingivitis & Gum Disease 2022

Symptoms of gingivitis

It’s possible to have gingivitis and periodontitis without any symptoms. However, in mild cases of gingivitis, there may be no discomfort or noticeable symptoms. Often, it remains undetected for quite some time. The symptoms of gingivitis are somewhat non-specific. Additionally, the pink-salmon coloring and stippling in the gum tissue will often disappear. Also, the gums may appear shiny as the gum tissue becomes inflamed and stretched over the tissue surface.

Mouth with Gingivitis | My Dental Advocate


  • Red & purple gums
  • Swollen & puffy gums
  • Gum inflammation & discoloration
  • Gum separation & recession
  • Bleeding gums
  • Halitosis (bad breath)
  • Tender gums

Recommended Reading: Acute Necrotizing Ulcerative Gingivitis (ANUG) “Trench Mouth”

Treatment of gingivitis

If you’re diagnosed with gingivitis, don’t panic. Treatment is standard and includes a prophylaxis dental cleaning by your dentist or dental hygienist. In addition, oral health improvements are necessary to prevent harmful bacteria from re-seeding on your teeth.

For example, brush twice daily, floss regularly and use mouthwash nightly. Suppose you have braces or more significant gaps between your teeth. Use a water flosser. I recommend using BURST water flosser because of its portability, large water tank and replacement tips.

Recommended Reading: 5 Best Toothpastes for Gingivitis & Gum Disease 2022

Visit your dentist at least every 6 months for a dental check-up and routine dental cleaning.

Risk factors for gingivitis

Specific risk factors increase the likelihood of developing gingivitis and periodontitis. Certain medications, such as antiseizure and immunosuppressants, can lead to gingival hyperplasia (gum overgrowth).

Dentist with Older Patient | My Dental Advocate

Other risk factors include

  • Smoking or chewing tobacco
  • Dry mouth
  • Hormones
  • Vitamin C deficiency
  • Immunosuppressants
  • Cardiovascular drugs
  • Leukemia & HIV/AIDS
  • Suppressed immunity
  • Cancer
  • Diabetes
  • Pregnancy (hormones)
  • Genetics (family history)
  • Viral & fungal infections
  • Orthodontics/braces
  • Stress/anxiety
  • Depression
  • Crooked teeth
  • Poor-fitting dental appliance
  • Poor-fitting fillings
  • Poor oral hygiene

Recommended Reading: Pregnancy Gingivitis: Causes, Symptoms & Treatment 2022

Frequently asked questions (FAQ)


No, gingivitis is reversible and responds better to periodontal treatment. Contrary, gum disease is irreversible and requires scaling and root planing. In addition, a referral to a periodontist may be necessary to prevent further bone loss.

Yes, gum disease can be present without bleeding if gum disease is in an inactive stage. In addition, gum disease with deep pocketing around the teeth may limit the amount of visible bleeding.

No, unfortunately, gum disease is irreversible. However, gum disease can be active or inactive, depending on various factors. Maintaining gum disease in a dormant state will prevent further bone loss.

Final thoughts

Gingivitis consists of gum inflammation without bone loss, whereas periodontitis (gum disease) features gum infection with bone loss. In addition, gingivitis is reversible, whereas periodontal disease is irreversible. Understanding these significant differences will empower you for improved oral health.

The more you know, the more healthy habits you can develop, saving you and your family from avoidable and potentially expensive dental procedures. Talk to your dental professional for more suggestions on improving oral health and check back for more blog posts and relevant information. Please share this site and let us know what else you’d like to know!

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About the Author

Dr. Advocate is an actual board-certified dentist with clinical practice experience and a mission to provide accurate dental patient education. He believes everyone should access easy-to-read dental resources presented in layman’s terms with relevant, up-to-date dental research and insight to improve their oral health.