Gingivitis: Causes, symptoms, role of the microbiome and effective tips for prevention and treatment

Gum inflammation, medically known as gingivitis, is one of the most common oral diseases and affects people of all ages. Although often considered harmless, untreated gum inflammation can have serious long-term consequences—including tooth loss due to periodontitis. The oral microbiome, a highly complex ecosystem comprised of numerous bacterial species that significantly influences our oral health, plays a key role in the development and healing of gum inflammation.

In recent years, the probiotic Streptococcus salivarius M18 has been particularly in the spotlight, as it plays a protective role in the oral flora and has therapeutic potential. In this blog post, you'll learn everything you need to know about the causes of gingivitis, how the microbiome is affected, the role of Streptococcus salivarius M18, and how you can sustainably improve your oral health with targeted measures.

What is gingivitis?

Gingivitis occurs as the body's reaction to the accumulation of bacterial deposits, known as plaque, at the gum line. Plaque consists of millions of bacteria that cluster together in biofilms and produce toxic substances that irritate the gums.

Symptoms of gingivitis

Typical signs are:

• Redness and swelling of the gums

• Bleeding gums, especially when brushing teeth or eating

• Sensitivity and pain in the gums

• Bad breath and unpleasant taste

If left untreated, the inflammation can become chronic and develop into periodontitis. This not only causes inflammation but also leads to the degradation of the bone that supports the teeth—which can lead to tooth loss in the long term.

The complex microbiome of the oral cavity

Our oral cavity is home to a vast, complex ecosystem of over 700 different microorganisms, primarily bacteria. These form the oral microbiome, which plays an important role in protecting against pathogens and is crucial for gum health.

Balance is key

In a healthy mouth, there is a balance between beneficial and potentially harmful bacteria. The microbiome regulates:

• Colonization by pathogenic germs

• The body's immune response against microorganisms

• Maintaining a stable pH and protecting the oral mucosa

If this balance is disturbed—for example, due to poor oral hygiene, smoking, stress, or medication—it is referred to as dysbiosis. This promotes the proliferation of harmful bacteria and leads to inflammation.

Bacterial changes in gingivitis

Gingivitis typically involves a significant shift in the bacterial balance. The concentration of certain pathogenic bacteria increases, while the diversity and number of beneficial microorganisms decreases.

The main players in dysbiosis:

These bacteria form dense biofilms at the gum line, which permanently activate the immune system and trigger chronic inflammation.

The important role of Streptococcus salivarius M18 as a leading pathogen

The bacterium Streptococcus salivarius M18 occupies a special position in the healthy oral microbiome. It is considered a so-called key pathogen—a microorganism that significantly influences the ecological balance of the oral flora and prevents colonization by harmful bacteria.

Why is S. salivarius M18 so important?

1. Production of bacteriocins:
   S. salivarius M18 produces antimicrobial substances, so-called bacteriocins, which specifically inhibit pathogens such as Porphyromonas gingivalis and Streptococcus mutans .

2. Reduction of plaque and inflammation:
   Studies show that this germ reduces the formation of plaque and significantly reduces inflammatory processes in the gums.

3. Strengthening the mucosal barrier:
   By promoting mucosal regeneration, S. salivarius M18 supports the resistance of the gums to mechanical and bacterial stimuli.

4. Immune system modulation:
   This germ has a positive effect on the immune system and thus helps to keep inflammation under control and prevent it from becoming excessively severe.

Use of Streptococcus salivarius M18 as a probiotic

In the form of lozenges or oral sprays, S. salivarius M18 is already successfully used for the prevention and treatment of gingivitis, tooth decay, and bad breath. Regular administration can help restore the microbiome's balance and reduce inflammation.

The interplay between microbiome, immune system and inflammation

The microbiome directly influences the body's immune response. A healthy flora supports the balance between pro- and anti-inflammatory mechanisms, thus protecting against chronic inflammation. In dysbiosis, however, the immune system overreacts, leading to tissue damage.

In addition, pathogenic bacteria can inhibit or misdirect immune cells with their toxins, further exacerbating inflammation. Therefore, strengthening the microbiome is crucial to ensure a healthy immune response.

Other factors influencing gingivitis

In addition to bacterial changes, there are several factors that increase the risk of gingivitis or make it more difficult to heal:

• Smoke:
  Causes altered microflora, suppresses the immune system and impairs healing.

• Stress:
  Influences the immune system and promotes inflammation.

• Hormonal changes:
  Pregnancy, puberty or menopause can make gums more sensitive.

• Insufficient oral hygiene:
  Leads to plaque formation and dysbiosis.

• Certain medications:
  For example, immunosuppressants or medications that reduce saliva flow.

Tips for preventing and treating gingivitis

1. Thorough but gentle oral hygiene

Regular and proper brushing (at least twice a day) removes plaque and thus reduces the number of bacteria at the gum line. Flossing or interdental brushes are also important for cleaning the spaces between your teeth.

2. Mouthwashes and probiotic care

Mouthwashes with anti-inflammatory agents (e.g., chlorhexidine) can provide short-term relief, but should not be used continuously, as they can also impair beneficial bacteria. This is where probiotic oral care products containing Streptococcus salivarius M18 come into play, specifically strengthening the microbiome.

3. Professional teeth cleaning

Regular professional dental cleanings remove even stubborn tartar and reduce the risk of inflammation.

4. Healthy diet

A balanced diet with little sugar and plenty of vegetables strengthens the immune system and promotes healthy oral flora.

5. Avoiding risk factors

Stop smoking, reduce stress and, if necessary, discuss medications that negatively affect the gums with your doctor.

Table: Summary of key points on gingivitis and microbiome