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Health condition · Clinically reviewed

Gingivitis, bleeding gums caught early and reversed.

The earliest stage of gum disease - fully reversible with professional cleaning and a two-minute daily routine. Ignore it and it becomes periodontitis.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a UK dental clinician before publication.

  • 02

    Sourced from guidance

    Checked against BSP, BDA, NICE and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance on periodontal staging, oral hygiene and drug-induced overgrowth.

Key facts

Gingivitis at a glance.

The essentials, in plain English - what it is, why it matters, and how it is treated in the UK today.

  • What it is

    Inflammation of the gingiva - the earliest, reversible stage of periodontal disease driven mostly by dental plaque biofilm.

  • How common

    Very common - up to half of UK adults have some degree of gingivitis at any one time.

  • Types

    Plaque-induced, non-plaque-induced, acute necrotising ulcerative (ANUG), hormonal, and drug-induced gingival overgrowth.

  • Earliest sign

    Bleeding on brushing is the most sensitive early sign - do not dismiss it as normal.

  • Reversible

    With professional cleaning and good home care, gingivitis fully reverses - there is no attachment or bone loss yet.

  • Systemic links

    Linked to cardiovascular disease, diabetes (bidirectional), adverse pregnancy outcomes and rheumatoid arthritis.

Why this guide matters

Reversible today, avoidable tomorrow.

Gingivitis is the fork in the road - treat it and gums heal, ignore it and periodontitis and tooth loss follow.

  • It is a warning sign, not a nuisance

    Bleeding gums are your gums telling you the biofilm has won this week - and that a small course-correction now saves your teeth later.

  • The systemic links are real

    Gum inflammation is linked to cardiovascular disease, diabetes, adverse pregnancy outcomes and rheumatoid arthritis - it is a whole-body issue.

  • Home care matters more than mouthwash

    Two minutes of brushing twice a day plus daily interdental cleaning outperforms any rinse - professional cleaning does the rest.

How the diagnosis is made

From bleeding gums to a clear plan.

The steps a UK dentist or dental hygienist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Dental history and risk review

    Smoking, diabetes, pregnancy, medications and family history - all shape both diagnosis and treatment.

  2. 02

    Assessing

    Visual gum inspection

    Red, swollen, tender gums with rolled margins - the classic picture of plaque-induced gingivitis.

  3. 03

    Assessing

    Basic Periodontal Examination

    The BPE screening probe - a sextant-by-sextant score that flags whether periodontitis is present.

  4. 04

    Confirming

    Bleeding on probing and indices

    Bleeding on probing is quantified using a gingival index - the objective marker of active inflammation.

  5. 05

    Confirming

    Probing depths and attachment

    Pockets under 4 mm with no attachment loss confirm gingivitis - deeper pockets or loss mean periodontitis.

  6. 06

    Confirming

    Radiographs if indicated

    Bitewing or periapical films rule out early bone loss when the BPE or attachment findings are borderline.

  7. 07

    Preparing

    Screen for systemic drivers

    Diabetes screening, medication review (phenytoin, amlodipine, ciclosporin) and hormonal context where relevant.

Typical timeline: a first appointment to a settled plan within a fortnight.

Symptoms

What gingivitis actually looks like.

The classic mix of red, bleeding, tender gums - and the features that mean it is time to escalate rather than watch and wait.

  • Red, swollen gum margins

    The gumline looks bright red and puffy rather than pale pink and stippled - the classic first sign.

  • Bleeding on brushing or flossing

    The earliest and most sensitive sign - healthy gums do not bleed when you clean them properly.

  • Tenderness and mild discomfort

    Gums feel sore, especially at the margin - not the deep, throbbing pain of an abscess.

  • Halitosis (bad breath)

    Persistent bad breath despite brushing is often a marker of active gum inflammation and biofilm.

  • Plaque and calculus at the gumline

    A visible white or yellow band at the gum margin - and hardened tartar between the teeth.

  • Hormonal flares

    Puberty, pregnancy and the menstrual cycle can amplify gum inflammation even with unchanged plaque.

  • Drug-induced overgrowth

    Phenytoin, calcium channel blockers and ciclosporin can cause firm, lobulated overgrowth of the gums.

  • Red flag - ANUG

    Sudden painful ulceration of the gum tips, punched-out papillae, fetor and fever - urgent dental review.

Treatment

How gingivitis is treated in the UK.

Professional cleaning and daily home care first - antimicrobials, drug review and periodontology when needed.

  • Professional scaling and polishing

    Removal of supragingival plaque and calculus by a dentist or hygienist - the cornerstone of every plan, repeated 3 to 6 monthly.

  • Twice-daily brushing, two minutes

    A fluoride toothpaste, a soft or medium brush and a modified Bass technique - the single biggest thing you can do at home.

  • Interdental cleaning

    Floss or interdental brushes daily - sized by the dentist or hygienist. Between the teeth is where gingivitis lives.

  • Chlorhexidine 0.12% mouthwash

    A short-term antimicrobial rinse - useful for flare-ups and after periodontal treatment. Staining limits long-term use.

  • Smoking cessation

    Smoking masks bleeding and worsens progression to periodontitis - stopping is the highest-value change many patients can make.

  • Treat underlying drivers

    Optimise diabetes control, review culprit medications and address hormonal or nutritional contributors where present.

  • ANUG regimen

    Debridement plus metronidazole 400 mg three times daily for 3 days (or amoxicillin) and chlorhexidine - specialist input if severe or recurrent.

  • Specialist periodontology

    For refractory disease, drug-induced overgrowth, or when attachment loss appears - non-surgical therapy, local antibiotics, or surgery.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your dentist or periodontist knows your mouth and history and can tell you which parts apply to you. If in doubt, get seen.

  • British Society of Periodontology (BSP). BSP implementation of the 2017 classification of periodontal diseases.

  • British Dental Association (BDA). Prevention and management of periodontal diseases in primary care.

  • NICE CKS. Gingivitis and periodontitis.

  • SDCEP. Prevention and Treatment of Periodontal Diseases in Primary Care.

Red flags

When gum symptoms need urgent attention.

Most gingivitis is manageable in general dental practice. These are the situations that are not - and where specialist care is needed.

  • Acute necrotising ulcerative gingivitis

    Painful, ulcerating punched-out papillae with fetor and systemic upset - needs same-day dental review and antibiotics.

  • Rapidly progressing bleeding and pain

    A sudden change in gum symptoms - especially in an immunocompromised patient - deserves urgent assessment.

  • Gum overgrowth on medication

    Phenytoin, amlodipine, nifedipine or ciclosporin can cause dramatic overgrowth - review the drug and refer to periodontology.

  • Unexplained loose teeth

    Mobility is not gingivitis - it means attachment or bone loss, and periodontitis needs a formal work-up.

  • Bleeding gums with easy bruising

    Consider a bleeding disorder, leukaemia or medication effect - do not dismiss as ordinary gingivitis.

  • Pregnancy epulis or severe pregnancy gingivitis

    A rapidly enlarging gum swelling in pregnancy - benign but bleeds heavily. Dental review is warranted.

  • Recurrent gum abscesses

    Repeat abscesses may signal undiagnosed diabetes, periodontitis or a foreign body - not simple gingivitis.

  • Persistent halitosis with a metallic taste

    A red-flag combination in an unwell patient - consider ANUG, systemic disease or a deep periodontal source.

  • Non-plaque-induced lesions

    Lichen planus, pemphigoid and allergic contact reactions can mimic gingivitis - refer to oral medicine when unusual.

Living with it

A treatable condition, with a clear ladder.

Four habits that make the biggest difference day to day - brushing, cleaning between the teeth, regular check-ups and quitting smoking.

A quiet reminder

Consistency beats intensity, every time.

A steady two-minute routine, kept up for months, does more than any heroic weekend of oral care.

  1. 01 Routine

    Brush for two minutes, twice a day

    A fluoride toothpaste, a soft-to-medium brush and gentle, angled strokes at the gumline - not scrubbing.

  2. 02 Between

    Clean between your teeth daily

    Floss or interdental brushes reach where a toothbrush cannot - the front line against gingivitis.

  3. 03 Check-ups

    See your dentist and hygienist

    Every 3 to 6 months for many people - the frequency your dental team recommends is the right one.

  4. 04 Habits

    Stop smoking, cut back sugar

    Smoking cessation and lower dietary sugar make a bigger difference than any mouthwash on the shelf.

Frequently asked

Everything we get asked about gingivitis.

Quick answers on bleeding gums, ANUG, pregnancy and drug-induced overgrowth.

  • What is gingivitis?

    Gingivitis is inflammation of the gums, most commonly caused by dental plaque building up at the gumline. It shows up as red, swollen gums that bleed easily. Crucially, there is no loss of the deeper attachment or bone yet - which means gingivitis is fully reversible with good treatment.

  • Is bleeding when I brush really a problem?

    Yes. Bleeding on brushing is the earliest and most sensitive sign of gum inflammation. Healthy gums do not bleed when cleaned properly. If your gums bleed for more than a few days, book a dental review rather than switching to a softer brush and hoping it settles.

  • How is gingivitis different from periodontitis?

    Gingivitis is limited to the gum surface - the underlying bone and attachment are intact. Periodontitis is what happens when the inflammation extends deeper, destroying attachment and bone and eventually loosening teeth. Untreated gingivitis is a major stepping stone to periodontitis.

  • Can pregnancy cause gum problems?

    Yes. Pregnancy hormones exaggerate the gum response to plaque, so even a small amount of biofilm can trigger swelling and bleeding. Pregnancy gingivitis and pregnancy epulis are both recognised and both settle with careful cleaning and dental support.

  • My blood pressure tablet is making my gums swell - what should I do?

    Calcium channel blockers such as amlodipine and nifedipine, along with phenytoin and ciclosporin, can cause firm gum overgrowth. Do not stop your medicine on your own. Book a dental and GP review so the drug can be considered for switching and the overgrowth managed.

  • Is mouthwash enough to treat gingivitis?

    No. Chlorhexidine mouthwash is a useful short-term antimicrobial for flare-ups and after procedures, but it does not remove plaque or calculus. The core treatment is professional cleaning plus daily brushing and interdental cleaning at home.

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