Periodontal health and gingivitis
Biofilm-induced gingivitis presents with inflammation without attachment loss attributable to periodontitis. It can resolve with effective plaque control.
Understand
Gingival inflammation without periodontitis-related attachment loss is distinct from periodontitis. Bleeding is a useful sign but must be interpreted with probing and plaque findings.
Assess
Record distribution, plaque, bleeding, recession and local irritants. Exclude other causes of gingival enlargement or inflammation when the pattern is atypical.
Apply
Demonstrate personalised plaque control and remove local deposits where indicated. Reassess resolution; a persistent isolated site may require a different diagnosis.
Key distinctions
Periodontal health can exist on an intact or reduced but stable periodontium. Bleeding, plaque and probing must be interpreted against a history of attachment loss. Gingivitis may be widespread and symptomatic, yet it is not synonymous with periodontitis. When inflammation persists despite good plaque control, consider non-plaque-induced gingival disease or a local contributing factor.
Think through a case
A patient has generalized bleeding with shallow probing and no periodontitis-related attachment loss. Gingivitis is an appropriate diagnosis and a self-care response can be monitored.
The distinction to remember
Do not call all bleeding “periodontitis”; determine whether supporting tissue has been lost.
Test your recall
Can gingivitis be reversible?
Show answer
Yes, when the cause is controlled.