Why Do Some People Get Gingivitis Faster Than Others?
The Everyday Battle in Our Mouths
Every day, our gums face an ongoing challenge: balancing friendly bacteria and the body’s immune defense. Normally, this relationship works well white blood cells patrol the gums, keeping harmful microbes in check while allowing healthy bacteria to thrive. But when oral hygiene slips, plaque builds up, and gums can become inflamed a condition known as gingivitis.
For decades, dentists have known that some people develop gingivitis much faster than others, even under similar conditions. Until now, the biological reasons for this difference were poorly understood.
A Closer Look Through Experimental Gingivitis
To answer this question, researchers from the University of Washington and collaborators conducted a controlled human study of gingivitis. Participants stopped brushing certain teeth for three weeks, allowing natural plaque buildup. This setup provided a unique opportunity to watch in real time how gum health shifted from normal to inflamed, and then back to recovery once oral hygiene resumed
Using clinical exams, immune markers, and advanced genetic sequencing of bacteria, the team analyzed both the host (human immune system) and microbial responses.
Three Distinct Gum Response Types
The study revealed three distinct patterns of gum inflammation:
High Responders – Showed rapid and intense inflammation, with strong immune activation.
Low Responders – Had surprisingly mild inflammation, despite carrying similar amounts of plaque.
Slow Responders – Developed inflammation later than others, with unique microbial patterns dominated by Streptococcus species.
Interestingly, one well-known inflammatory molecule, interleukin-1β (IL-1β), was not strongly linked to inflammation in the “slow responder” group. This challenges the long-standing view that IL-1β is always a hallmark of gingivitis.
Protective Mechanisms in Action
The researchers also found unexpected protective responses:
A shift in immune signaling that allowed white blood cells to reach the gums without triggering tissue-damaging inflammation.
A temporary “shutdown” of certain chemical signals that normally promote bone loss, suggesting a built-in safeguard to protect teeth and bone during mild gum disease.
Together, these findings reveal that the human body has evolved multiple strategies to limit damage during episodes of gingivitis.
Why This Matters
Understanding these variations may help dentists identify individuals who are more susceptible to severe gum disease (periodontitis), which can cause irreversible tooth and bone loss. By recognizing whether a patient is a “high,” “low,” or “slow” responder, personalized preventive care could one day be developed.
Conclusion
This research highlights that gingivitis is far from “one-size-fits-all.” Instead, our gums respond in unique ways, influenced by both microbes and immune traits. Future dental care may rely not just on removing plaque but also on tailoring treatments to individual biological profiles.
Reference
Bamashmous, S., Kotsakis, G. A., Kerns, K. A., Leroux, B. G., Zenobia, C., Chen, D., Trivedi, H. M., McLean, J. S., & Darveau, R. P. (2021). Human variation in gingival inflammation. Proceedings of the National Academy of Sciences, 118(27), e2012578118. https://doi.org/10.1073/pnas.2012578118