Last updated October 15, 2026
Gingivitis is inflammation of the gum edge, caused by plaque bacteria sitting where the tooth meets the gum. It's the first stage of periodontal disease and the only one that fully reverses. A cleaning at your vet removes the plaque and tartar, and daily brushing keeps it from coming back. Once it's gone, the gum heals.
Periodontitis is what follows when the inflammation reaches the ligament and bone that hold the tooth in. That damage is permanent. Treatment can stop it getting worse and take out teeth that hurt, but lost bone doesn't grow back. So the difference between the two words is whether the gum can still return to normal.
What gingivitis looks like in a dog's mouth
Lift your dog's upper lip in good light and look at the line where the teeth meet the gums. Healthy gum there is pink, or black or mottled in dogs with pigmented gums, and it lies flat against the tooth. Gingivitis shows up as a thin red band right along that edge, a gum margin that looks puffy or rolled, and gums that bleed when you brush or leave pink smears on a chew toy. Bad breath usually comes with it.
Pale, blue or bright red gum away from that edge is a different and more urgent sign. Our chart of dog gum colors sorts pale, blue, gray, bright red and yellow gums by how fast to get to a vet.
Dark gums hide the redness, so on a dog with black gums look for swelling and bleeding instead.
Vets grade gingivitis by color, swelling and bleeding. In one research scale, very mild gingivitis is red and swollen but doesn't bleed when a probe runs along the gum, mild bleeds slowly, and moderate bleeds as soon as it's touched. Severe gingivitis has raw, ulcerated gum that bleeds on its own (Marshall and colleagues, BMC Veterinary Research, 2014).
Raw sores on the inside of the lips and cheeks, where they rest against the teeth, are a different problem. That pattern points to stomatitis, an over-reaction of the immune system to plaque that spreads past the gum edge onto the soft lining of the mouth.
Gingivitis vs periodontitis
The American Veterinary Dental College (AVDC) defines gingivitis as inflammation of the gum only. Periodontitis is inflammation of the deeper tissues, the periodontal ligament and the bone around the root.
| Gingivitis | Periodontitis | |
|---|---|---|
| What's inflamed | The gum edge | The ligament and bone holding the tooth |
| What you might see | Red line, swelling, bleeding, bad breath | The same, plus receding gums, pus or loose teeth. Often nothing extra |
| Can it reverse? | Yes, fully | No. It can be stopped, not undone |
| How it's found | Looking at the gum | Probing under the gum and dental X-rays |
The gum can look much the same in both, which is why vets don't stage gum disease from a look at an awake dog.
The four stages vets use
The AVDC grades each tooth separately, by how much of its support has gone.
| Stage | What it means | Reversible? |
|---|---|---|
| PD0 | Healthy gum | |
| PD1 | Gingivitis only, no loss of attachment | Yes |
| PD2 | Early periodontitis, under 25% of the attachment lost | No |
| PD3 | Moderate periodontitis, 25 to 50% lost | No |
| PD4 | Advanced periodontitis, over 50% lost | No |
The drawing's stages 1 to 4 are PD1 to PD4 in the table. Its color bar labels stage 1 as healthy, but stage 1 is gingivitis. Healthy gum is PD0, which the drawing leaves out.
One mouth can hold teeth at several stages at once. When Stepaniuk and colleagues (Journal of Veterinary Dentistry, 2026) examined 369 dogs under anesthesia, 39% had gingivitis only and 59.6% already had periodontitis. Our overview of dental disease in dogs shows how that rises with age and body size.
Mild redness doesn't mean a tooth is safe
A faint red line can look too minor to act on. In a long study of miniature schnauzers, about one in five teeth with the mildest redness still went on to periodontitis. Marshall and colleagues followed 52 dogs aged 1.3 to 6.9 years for up to 60 weeks after their tooth care stopped, checking every tooth under anesthesia about every six weeks. All 2,155 teeth started with some gingivitis.
By the end, 51 of the 52 dogs had at least one tooth that had moved on to periodontitis. Teeth that started with moderate gingivitis progressed more often, about one in three, but the authors found only a weak link between how red a gum looked and whether bone loss followed. Over half the teeth that progressed were front teeth, most often on the side facing the tongue. That's a surface you can't see when you lift your dog's lip. Older dogs progressed faster.
The study covered one small breed, prone to gum disease, in a research colony, and the authors work for a pet food company. Within those limits, it shows that the color of the gum says little about what's happening at the root. Act on gingivitis while it's mild and still reversible.
How a vet treats gingivitis and periodontitis
Treatment starts with a full exam under general anesthesia. The vet probes around every tooth to measure any pocket between gum and root, takes dental X-rays to check the bone, then scales the tartar off above and below the gumline and polishes the teeth smooth. For a mouth with gingivitis only, that cleaning and good home care afterward are the treatment.
Periodontitis needs more. Deeper pockets need root planing, a careful cleaning down the root surface, sometimes with an antibiotic gel left in the pocket. Teeth that have lost most of their support are usually extracted, since they hurt and can't be saved. A review by Cunha and colleagues (Antibiotics, 2022) notes that antibiotic tablets are usually not needed for gingivitis or mild periodontitis, and that the first line of treatment is always the cleaning itself. Your vet will decide case by case.
A cleaning on an awake dog isn't a substitute. The AVDC's position is that the part below the gumline, where periodontitis does its damage, can't be cleaned or checked properly without anesthesia.
In a study of nearly 60,000 dogs with periodontal disease and the same number without, worse gum disease went with a higher later risk of heart conditions such as endocarditis (Glickman and colleagues, Journal of the American Veterinary Medical Association, 2009). That is an association, not proof that the gums caused it.
Keeping gingivitis reversed at home
After a vet cleaning, plaque starts sticking to the teeth again within 24 hours (Gawor and colleagues, Journal of Veterinary Dentistry, 2025). The gum stays healthy only while that plaque keeps getting cleared.
Brushing is the most effective way to do that, and how often matters for the gums. In beagles that already had some gingivitis, brushing every day or every other day reduced it more than brushing once a week (Harvey and colleagues, Journal of Veterinary Dentistry, 2015). When 22 beagles were brushed daily, their gum scores had improved after one week, and two weeks after brushing stopped they were back where they began (Enlund and colleagues, Journal of Veterinary Dentistry, 2024).
Use a soft brush and a toothpaste made for dogs, and work along the gumline where the redness is. Never use human toothpaste, because some contain xylitol, which is dangerous to dogs. Our page on getting plaque off your dog's teeth covers brushing technique and a coating that has already built up. If your dog won't accept a brush, products with the Veterinary Oral Health Council (VOHC) seal have passed trials for slowing plaque or tartar, and our guide to cleaning dog teeth without brushing compares them.
No home method lifts tartar that has already hardened, and none reaches under the gumline. If the gum is still red after a few weeks of daily brushing, something under the gumline may be keeping it inflamed, and that needs a vet.
When to see a vet
- The same day for gums that bleed on their own and don't stop, a swollen face, or a dog that has stopped eating
- Within a few days for pus at the gumline, a loose tooth, or chewing on one side and dropping food
- Within a week or two for gums that bleed easily, receding gums, bad breath with red gums, or a red line that hasn't settled after two or three weeks of daily brushing
- At every routine check, ask your vet to look at the gums, even if your dog seems fine
Questions owners ask
Is gingivitis painful for dogs?
Inflamed gums are tender, and bleeding when they're touched is part of that. Most dogs keep eating anyway and hide the discomfort, so a normal appetite doesn't rule it out. Periodontitis with loose teeth or infection is more painful.
How long does it take for gingivitis to go away in a dog?
In the beagle trial above, gum scores were better after one week of daily brushing. If there's tartar, the gum won't settle until a vet has cleaned it off, and the gains last only while the brushing does.
Can I treat my dog's gingivitis at home naturally?
Daily brushing with a dog toothpaste can settle very early gingivitis on teeth with no tartar. If there's tartar, or the gums are still red after a few weeks, your dog needs a vet cleaning first. Home care then keeps the result.
What should I feed a dog with gingivitis?
No food reverses gingivitis. Ordinary kibble doesn't clean teeth on its own, since dogs in dental trials eat their usual dry food and still build up plaque. A dental diet with the VOHC seal can help slow plaque or tartar. If your dog's mouth is sore, ask your vet whether soft food is better until after treatment.
References
- American Veterinary Dental College. Nomenclature (periodontal disease stages), avdc.org/avdc-nomenclature. Position statement on dental scaling without anesthesia, avdc.org/wp-content/uploads/2019/AVDC-pos-stmts/Dental_Scaling_Without_Anesthesia.pdf.
- Cunha E, Tavares L, Oliveira M. Revisiting periodontal disease in dogs, how to manage this new old problem? Antibiotics (Basel). 2022;11(12), 1729.
- Enlund KB, Rahunen N, Thelander S, Olsén L. Evaluation of a thiol-detection test to assess tooth brushing efficacy in dogs. J Vet Dent. 2024;41(3), 183-191.
- Gawor J, Jank M, Harvey CE, Nicolas CS. Effectiveness of dental homecare protocols in unscaled dogs. J Vet Dent. 2025;42(3), 176-181.
- Glickman LT, Glickman NW, Moore GE, Goldstein GS, Lewis HB. Evaluation of the risk of endocarditis and other cardiovascular events on the basis of the severity of periodontal disease in dogs. J Am Vet Med Assoc. 2009;234(4), 486-494.
- Harvey C, Serfilippi L, Barnvos D. Effect of frequency of brushing teeth on plaque and calculus accumulation, and gingivitis in dogs. J Vet Dent. 2015;32(1), 16-21.
- Lowe C, Anthony J. Pilot study of the effectiveness of a xylitol-based drinking water additive to reduce plaque and calculus accumulation in dogs. Can Vet J. 2020;61(1), 63-68.
- Marshall MD, Wallis CV, Milella L, Colyer A, Tweedie AD, Harris S. A longitudinal assessment of periodontal disease in 52 miniature schnauzers. BMC Vet Res. 2014;10, 166.
- Merck Veterinary Manual. Xylitol toxicosis in dogs. Updated June 2025. merckvetmanual.com.
- Niemiec B, Gawor J, Nemec A, et al. World Small Animal Veterinary Association global dental guidelines. J Small Anim Pract. 2026;67(10), 859-987. doi:10.1111/jsap.70057.
- Stepaniuk KS, Gingerich W, Ziche AM. Oral examination in a random anesthetized canine population for the prevalence of periodontal disease and fractured teeth. J Vet Dent. 2026, online ahead of print. doi:10.1177/08987564261447381.
- Veterinary Oral Health Council. vohc.org.