Gingivitis is the gums’ swelling and the beginning stage of gum infection. Gingivitis in children can result from infection-causing bacteria present in plaque.
When a child’s teeth begin to grow, their gums can become vulnerable to bacteria that cause infections. If gum infection is not treated on time, the gums can get destroyed along with supporting structures, a condition called periodontal disease (periodontitis). Management includes maintenance of oral hygiene with regular dental visits.
Read on to know more about gingivitis in children, including its causes, symptoms, and treatments.
Is Gingivitis Common In Children?
Gingivitis is a common condition in children. Around 73% of children between the ages of six and 11 years in developed countries experience gingivitis. Also, it has been observed that the incidence of gingivitis increases as children hit puberty (1). Increased preference for high-risk foods, such as sugary beverages, and inadequate oral hygiene may be the reasons behind it.
What Are The Types Of Gingivitis?
Gingivitis in children can be grouped into the following types based on its cause.
- Eruption gingivitis: This type of gingivitis is observed during tooth eruption in children. Ideally, there should be no gingivitis around any erupting tooth. However, if the child is not maintaining proper oral hygiene or there is plaque accumulation around an erupting tooth, it can result in gingivitis.
- Plaque-induced gingivitis: Plaque-induced gingivitis is the most common form of gingivitis found in children. There are many factors, such as poor oral hygiene, braces, and crowding of teeth, that could contribute to the development of this type of gingivitis.
- Acute gingival disease: This type of gingivitis occurs suddenly, often due to infection by a virus, such as the Herpes simplex virus, trauma or fungal infection, such as candidiasis. Some cases, such as like acute necrotizing ulcerative gingivitis (ANUG), may cause severe inflammation and destruction of the gingiva.
- Gingival diseases that arise due to systemic factors: There are some factors or conditions that could lead to gingivitis in children. A few examples are certain diseases, vitamin deficiencies, hormonal imbalance, and certain medications that can cause gingival overgrowth and increased inflammation of the gums (2).
Stages Of Gingivitis
There are two stages of gingivitis based on its severity.
- Gingivitis: The mildest form of the gum disease is gingivitis. In this stage, gums are red, swollen, and may bleed on touching or while brushing. It is often painless, and the child may be unaware of it. Prompt treatment during this stage can help resolve it in a few days.
- Periodontitis: If gingivitis is not treated, the infection from the gums can spread to the underlying supporting tissues of the teeth and may reach the bone surrounding the teeth. In mild cases, there will be small pockets that form between the child’s teeth and gums. Plaque and calculus accumulate within these pockets and cause the gums to become severely red and swollen. The teeth begin to loosen and drift apart. Some of the other symptoms may include halitosis (bad breath), gum recession, and pain in the gums or jaw (3).
If mild cases of periodontitis are not treated, the infection progresses, causing advanced periodontitis that permanently damages the supporting tissues of a child’s teeth. A child may even lose a few teeth permanently due to this condition.
What Causes Gingivitis In Children?
There are many causes that lead to gingivitis in children and include the following.
- Plaque buildup: Plaque buildup on teeth is the primary cause of gingivitis in children (4). Plaque is the sticky, colorless film constantly forming on the teeth and is made of saliva, the food we eat, and liquids we consume. It contains bacteria that cause gum irritation and give rise to gingivitis.
- Poor oral hygiene: The primary reason for plaque buildup in children is poor oral hygiene. Plaque, in the initial stages, is soft and easy to clean, but if not removed with regular brushing, it hardens to form tartar (5). Plaque and tartar around the teeth irritate the gums and cause gingivitis.
- Hormonal changes: Gingivitis is common during puberty in both boys and girls. During this phase, the hormonal changes cause an exaggerated response of the gums to the plaque, leading to swollen gums and gingivitis (6). Not all children may show these effects during puberty.
- Poor nutrition: Nutritional deficiencies could lead to gingivitis in some children. Insufficient intake of proteins, fats, vitamins, and minerals may result in symptoms, such as decreased salivation, the impaired healing ability of the gum tissues, and increased risk of bacterial infections. These conditions could trigger gingivitis and periodontitis gradually (7).
What Are The Risk Factors For Gingivitis In Children?
The following lifestyle choices and conditions may increase a child’s risk of developing gingivitis (2).
- Improper brushing and flossing
- Excess carbohydrate intake
- Dental conditions, such as crowded teeth or the presence of braces
- Systemic health conditions
- Nutritional deficiencies, such as vitamin C deficiency
- Decreased saliva flow due to dehydration or medications
- Frequent mouth breathing
What Are The Symptoms Of Gingivitis In Children?
Below are the common signs and symptoms of gingivitis and periodontitis in children (8).
- Red, swollen gums
- Gums bleed when touched, brushed, or flossed
- Gums appear to peel away from the teeth
- Halitosis (bad breath)
- Increased spacing between teeth
- Pus accumulation between the gums and the teeth
- Change in jaw alignment or bite
When Should You Visit Your Pediatric Dentist?
If your child shows any sign or symptom of gingivitis or periodontitis, visit a pediatric dentist immediately. Treating gingivitis in the early stages helps to stop the progression of the disease.
How Is Gingivitis Diagnosed In Children?
The pediatric dentist will evaluate the symptoms and the health of the gums. An X-ray will be conducted to examine the inner tissues surrounding the teeth and the jaw bone. Advanced periodontitis may spread to the lower jaw bone, causing damages visible in an X-ray (8).
Mild cases of gum disease with no bone or support tissue involvement are usually diagnosed as gingivitis. Advanced cases are termed periodontitis. The treatment plan varies depending on the diagnosis. In some cases, the child may be referred to a periodontist (gum specialist) for further evaluation and treatment.
How Is Gingivitis Treated In Children?
The treatment of gingivitis in a child depends on the child’s age, overall health, and symptoms. A dentist could suggest the following treatment methods and interventions to improve the gums’ health (4).
- Regular teeth cleaning: It is the most basic procedure suggested in cases of mild gingivitis in children. Regular brushing and flossing of the teeth could remove plaque and tartar, improving the gums’ health. The dentist may suggest a specific toothpaste or mouthwash to improve the outcomes.
- Deep cleaning: Deep cleaning is performed at the dentist’s clinic in cases of advanced gingivitis. The procedure cleans plaque and tartar from under the gums. The dentist may also perform other procedures to tighten the gums or modify the braces in case the child is wearing them.
- Antibiotics: In advanced cases of gum disease, the child may be given topical antibiotics or antibiotic mouthwashes to reduce the inflammation caused by the bacteria. Severe cases with deeper infections within the dental tissue could require treatment with oral antibiotics.
- Identifying and eliminating the cause: Gingivitis can occur due to systemic conditions, certain medications, nutritional deficiencies etc. It is important to diagnose and eliminate the cause to achieve a healthy periodontal health.
- Gum surgery: Surgical procedures are usually performed in cases of advanced periodontitis where a larger area of the gums, the entire roots of the teeth, or a section of the jaw bone is infected. The aim of the procedure is to remove all infected tissues, clean the remaining tissues, and perform any attachment procedures to improve the tightness of the gums around the teeth.
How Can Gingivitis Be Prevented In Children?
Gingivitis is a preventable condition in children. Here are some ways you can prevent gingivitis in your child (8).
- Regular brushing twice a day for at least two minutes each time
- Inculcate the habit of flossing the teeth
- Take your child for regular checkups at the dentist
- Serve your child a healthy diet to avoid nutritional deficiencies
- Encourage your child to rinse their mouth with plain water after each meal
- Speak to the dentist and learn specific care for dental braces
Frequently Asked Questions
1. Does saltwater help in preventing gingivitis?
Rinsing with saltwater alone cannot help prevent gingivitis if the child has poor oral hygiene or does not follow proper oral hygiene practices, such as brushing (9). Although saltwater is advised to promote healing after dental surgery or to reduce inflammation following an infection, it cannot be used as a substitute for brushing and flossing.
2. Does gingivitis in children go away?
Gingivitis in children is a treatable condition, and early diagnosis increases the prognosis. When diagnosed early and treated promptly, gingivitis can be reversed quite easily to restore gum health in a child.
3. Can I give my child gingivitis?
Reports suggest that although gingivitis may not be contagious, the bacteria causing the condition may spread from a parent to a child. In addition, studies reveal that children with a familial history of oral and gum problems such as periodontitis are more likely to develop this condition (10).
4. How long does it usually for gingivitis to resolve?
Symptoms caused due to a benign form of gingivitis may resolve within four days. However, if your child has painful gums and a fever that lasts for more than three to four days, get them evaluated by a dentist for prompt intervention and to prevent further complications (11).
Gingivitis in children is common and preventable. It is important to maintain oral hygiene and keep up with your child’s dentist visits to ensure that their teeth and gums are healthy. If your child develops gingivitis, you need to be aware of the symptoms to seek timely treatment. The signs are easy to recognize, and early diagnosis may suggest simple care of their dental health or antibiotics. However, delay in the treatment may prompt surgical intervention. Hence, follow a dental routine will help prevent gingivitis in your child altogether.
- Plaque build-up, poor nutrition, and hormonal changes are common causes of gingivitis in children.
- Improper brushing techniques, medications, and nutritional deficiencies can increase the risk of gingivitis.
- Some signs of gingivitis in children are pus accumulation, halitosis, and swollen gums.
2. Ray J. Jurado, Gingivitis, Pediatrics Central
3. Periodontal Disease, Children’s Wisconsin
4. Periodontal Disease in Children, Stanford Children’s Health
5. Dental Plaque, Cleveland Clinic
6. Telgi R. Chaitra et al., Hormone Effect on Gingiva: Pubertal Gingivitis, BMJ Case Reports
7. G. A. Scardina and P. Messina, Good Oral Health and Diet, Journal of Biomedicine and Biotechnology
8. Periodontal Disease in Children, University of Rochester Medical Center
9. Jeyaraj Hoover et al., Effect of a Rinse Containing Sea Salt and Lysozyme on Biofilm and Gingival Health in a Group of Young Adults: A Pilot Study, International Journal of Dentistry
10. Basak Dogan et al., Consistent Intrafamilial Transmission of Actinobacillus actinomycetemcomitans Despite Clonal Diversity; American Academy of Periodontology
11. Jeyaraj Hoover et al., Gingivitis and gum disease; Raising Children Network.