Cu toate că este mult tartru, gingia nu sângerează.

It means although / even though.

It introduces a concession: one fact is true, but the result is different from what you might expect.

• Cu toate că este mult tartru... = Although there is a lot of tartar...

Literally, cu toate că is something like with all that, but you should learn it as a fixed expression meaning although.

Yes, este literally means is, but in Romanian it can also work like English there is in sentences about existence or presence.

So:

• este mult tartru = there is a lot of tartar

Romanian often uses e / este in this kind of structure instead of adding a separate word for there.

Because tartru is being treated as a mass noun here, like water, sand, or plaque in English.

With a singular mass noun, Romanian uses the singular form of mult:

• mult tartru = a lot of tartar

The form mult agrees with tartru, which is masculine/neuter singular here.

Compare:

• mult lapte = a lot of milk
• mult zahăr = a lot of sugar
• mult tartru = a lot of tartar

If the noun were feminine singular, you would get multă instead:

• multă apă = a lot of water

In this context, tartru means dental tartar or calculus: the hardened deposit that forms on teeth.

So this is dental/medical vocabulary, not something general you hear every day in all contexts.

Gingia is the definite singular form of gingie.

Romanian usually puts the definite article at the end of the noun, not before it.

• gingie = gum / a gum
• gingia = the gum

So the -a is the equivalent of English the.

Romanian often uses the singular where English prefers the plural, especially with body parts or tissue when speaking generally.

So:

• gingia nu sângerează literally = the gum does not bleed
• natural English meaning = the gums do not bleed or the gum tissue does not bleed

Romanian singular here sounds normal and idiomatic.

It is:

• nu = not
• sângerează = bleeds / is bleeding

So:

• gingia nu sângerează = the gum does not bleed

Unlike English, Romanian does not use an extra auxiliary like does for this kind of negation. You simply put nu before the verb.

Compare:

• sângerează = bleeds
• nu sângerează = does not bleed

It is the 3rd person singular present of a sângera = to bleed.

That matches the subject gingia:

• eu sângerez = I bleed
• tu sângerezi = you bleed
• el/ea sângerează = he/she/it bleeds

So in this sentence, gingia takes sângerează.

Yes. In many cases, deși is a very natural alternative.

So you could also say:

• Deși este mult tartru, gingia nu sângerează.

Both mean Although there is a lot of tartar, the gum does not bleed.

A rough difference:

• deși = shorter, very common
• cu toate că = a little fuller/emphatic, sometimes slightly more formal in tone

Not completely. Romanian word order is fairly flexible.

The original sentence:

• Cu toate că este mult tartru, gingia nu sângerează.

puts the although clause first, which highlights the contrast right away.

You could also place the main clause first:

• Gingia nu sângerează, cu toate că este mult tartru.

That is still understandable, but the original order is very natural because it sets up the unexpected contrast first.

Because the speaker is stating a real fact:

• este mult tartru = there is a lot of tartar

After cu toate că and deși, Romanian normally uses the indicative when talking about something presented as true or real.

So este is exactly what you would expect here.