Since the bone in the jaws holds the teeth into the jaws, the loss of bone can cause teeth over the years to become loose and eventually to fall out or need to be extracted because of acute infection. Regular cleanings (correctly termed periodontal debridement, scaling or root planing) below the gum line, best accomplished professionally by a dental hygienist or dentist, disrupt this plaque biofilm and remove plaque retentive calculus (tartar) to help prevent inflammation. Once cleaned, plaque will begin to grow on the teeth within hours. However, it takes approximately 3 months for the pathogenic type of bacteria (typically gram negative anaerobes and spirochetes) to grow back into the deep pockets and restart the inflammatory process. Calculus (tartar) may start to reform within 24 hours.

Ideally, scientific studies show that all people with deep periodontal pockets (greater than 5mm) should have the pockets between their teeth and gums cleaned by a dental hygienist or dentist every 3–4 months.

Symptoms

The symptoms of gingivitis are as follows:

• Swollen gums
•  Mouth Sores 
• Bright-red, or purple gums
• Shiny gums
• Swollen gums that emit pus
• Severe oral odor
• Gums that are painless, except when pressure is applied
• Gums that bleed easily, even with gentle brushing, and especially when flossing.
• Gums that itch with varying degrees of severity

Prevention

Gingivitis can be prevented through regular oral hygiene that includes daily brushing and flossing. Mouth wash is optional, usually using a saline solution (water and salt) or chlorhexidine. Rigorous plaque control programs along with periodontal scaling and curettage also have proved to be helpful.

Researchers analyzed government data on calcium consumption and periodontal disease indicators in nearly 13,000 people representing U.S. adults. They found that men and women who had calcium intakes of fewer than 500 milligrams, or about half the recommended dietary allowance, were almost twice as likely to have gum disease, as measured by the loss of attachment of the gums from the teeth. The association was particularly evident for people in their 20s and 30s.

Research says the relationship between calcium and gum disease is likely due to calcium’s role in building density in the alveolar bone that supports the teeth.

Diagnosis

It is recommended that a dental hygienist or dentist be seen after the signs of gingivitis appear. A dental hygienist or dentist will check for the symptoms of gingivitis, and may also examine the amount of plaque in the oral cavity. A dental hygienist or dentist will also look for signs of periodontist using X-rays or periodontal probing as well as other methods.

Hypervitaminosis A, otherwise known as excess Vitamin A in the diet, has also been linked to gingivitis in cats and dogs. Whether this is applicable to humans remains unclear.

If gingivitis is not responsive to treatment, referral to a periodontist (a specialist in diseases of the gingiva and bone around teeth and dental implants) for further treatment may be necessary.

Treatment

A dentist or dental hygienist will perform a thorough cleaning of the teeth and gums; following this, persistent oral hygiene is necessary. The removal of plaque is usually not painful, and the inflammation of the gums should be gone between one and two weeks. A gargling of brine water also helps. Oral hygiene including proper brushing and flossing is required to prevent the recurrence of gingivitis. Anti-bacterial rinses or mouthwash, in particular chlorhexidine digluconate 0.2% solution, may reduce the swelling and local mouth gels which are usually antiseptic and anaesthetic can also help. For serious cases, dentists can oversee special treatments that allow medication to be maintained around the teeth and in the sulcus long enough to kill gingivitis causing bacteria via non-invasive devices known as Perio Trays.