Gingivitis

Gingivitis is inflammation of the gums (gingiva) surrounding the teeth. Gingivitis affects a significant portion of the population and is the most common form of periodontal diseases (diseases of the tissues surrounding the teeth). Chronic gingivitis may lead to receding gums and can be a precursor of periodontitis. Gingivitis is a bacterial infection of the gums.

For gingivitis to develop, plaque must accumulate in the areas between the teeth. This plaque contains large numbers of bacteria thought to be responsible for gingivitis. But it is not simply plaque that causes gingivitis. Almost everyone has plaque on their teeth, but gingivitis is far less common.

In certain instances, an individual may have an underlying illness or condition that renders their immune system susceptible to gingivitis. For example, people with diabetes and other immune system diseases (such as HIV) have a weaker ability to fight bacteria invading the gums. People who smoke, chew tobacco, or have a substance abuse problem are also predisposed to develop gingivitis.

Overconsumption of alcohol can lead to gingivitis.

Sometimes hormonal changes in the body during pregnancy, puberty, and steroid therapy leave the gums vulnerable to bacterial infection.

Local factors, such as crowded teeth and poor fitting or altered tooth anatomy due to dental work increase an individual’s susceptibility to gingivitis.

A number of medications used for seizures, high blood pressure, and organ transplants have been shown to cause an enlargement of the gingiva.

For simple gingivitis, work with a dentist. A concerted effort involving good home dental hygiene, including regular and correct brushing and flossing, and regular dental visits should be all that is required to treat and prevent gingivitis. Gingivitis can usually be managed at home with good dental hygiene.

If gingivitis continues despite the effort to prevent it, contact a doctor to investigate the possibility of an underlying illness. If there are other conditions that seem to be coinciding with the signs and symptoms of gingivitis, seek medical attention. For example, chronic gingivitis and periodontitis are felt by medical scientists to be risk factors for the development of rheumatoid arthritis.

A complication of gingivitis is a so-called desquamative condition of the gums, in which ulcers, blistering, and sloughing affect the gums. This can be a sign of lichen planus, mucous membrane pemphigoid (MMP), and pemphigus vulgaris. These conditions often require a consultation and usually a biopsy from a periodontist or oral pathologist.

Gingivitis, the earliest stage of gum disease, is inflammation of the tissues surrounding and supporting the teeth and is most commonly a result of poor dental hygiene. Gingivitis is a very common condition and varies widely in severity. It is characterized by red, swollen gums that bleed easily when teeth are brushed or flossed. Gingivitis is not the same thing as periodontitis. Gingivitis always precedes and acts as a warning sign for the more serious condition of periodontitis.

Gingivitis starts when food debris mixes with saliva and bacteria which, in turn, forms dental plaque that sticks to the surfaces of teeth. If dental plaque isn’t removed by brushing with toothpaste and flossing, it can become mineralized and form tartar, or calculus. Tartar is very hard, and only a professional dental cleaning can remove it.

Both dental plaque and tartar are filled with harmful bacteria, and if they aren’t removed from teeth, they will begin to irritate the gums and cause gingivitis. If left untreated, gingivitis will often extend from the gums to the bone and lead to periodontitis.

Gums that bleed easily during flossing or brushing is a sign of gum disease (gingivitis).

While gingivitis is inflammation of the gums around the teeth, periodontitis occurs when the bone below the gums gets inflamed or infected. Periodontitis derives from the word periodontal, which means “around the tooth” and refers to the structures that surround and support teeth such as gum and bone. Periodontology is the study of the supporting structures of the teeth.

When the underlying bone gets infected, the gums will start to recede away from the teeth and form deep gum pockets. This is called attachment loss. These pockets readily collect plaque and bacteria. Because these pockets are very difficult to keep clean, more bone loss occurs. As periodontal disease progresses into later stages (early, moderate, and advanced) and more bone tissue is lost, the gum pockets are deeper and the teeth may eventually become loose and fall out.

Improper oral hygiene that allows bacteria in plaque and calculus to remain on the teeth and infect the gums is the primary cause of gum disease. But there are other factors that increase the risk of developing gingivitis. Here are some of the most common risk factors:

– Smoking or chewing tobacco prevents the gum tissue from being able to heal.

– Crooked, rotated, or overlapping teeth create more areas for plaque and calculus to accumulate and are harder to keep clean.

– Hormonal changes in puberty, pregnancy, and menopause typically correlate with a rise in gingivitis. The increase in hormones causes the blood vessels in the gums to be more susceptible to bacterial and chemical attack. At puberty, the prevalence of gingivitis ranges between 70%-90%.

– Cancer and cancer treatment can make a person more susceptible to infection and increase the risk of gum disease.

– Alcohol negatively affects oral defense mechanisms.

– Stress impairs the body’s immune response to bacterial invasion.

– Mouth breathing can be harsh on the gums when they aren’t protected by the lips, causing chronic irritation and inflammation.

– Poor nutrition, such as a diet high in sugar and carbohydrates and low in water intake, will increase the formation of plaque. Also, a deficiency of important nutrients such as vitamin C will impair healing.

– Diabetes mellitus impairs circulation and the gums ability to heal.

– Medications such as antiseizure medications increase the risk for gum disease.

– Infrequent or no dental care

– Poor saliva production

Removing the source of the infection is primarily how simple gingivitis is treated. Home treatment is key. Ultimately, these home remedies can lead to a cure for gingivitis.

– By tooth brushing regularly with a soft-bristled or electric toothbrush and fluoride toothpaste approved by dentists, plaque buildup can be kept to a minimum. – The presence of triclosan combined with fluoride has proven to significantly reduce the formation of plaque on the teeth.

– Flossing once per day is another means of removing plaque in between teeth and other areas hard to reach.

– Regular checkups with a dentist are also important. A dentist is able to remove plaque and calculus (hardened plaque) that is too dense to be removed by a toothbrush or dental floss.

– Once a dentist removes plaque, regular brushing and flossing will minimize plaque formation. Even with good dental hygiene, plaque will begin to accumulate again.

– Correct dental defects, such as over contoured or poorly fitting fillings, crowns, and other restorations.

– Avoid smoking.

– Limit sugar consumption.

– Drink plenty of water.

Severe gingivitis may require antibiotics like azithromycin and consultation with a physician. Antibiotics are medications used to help the body’s immune system fight bacterial infection and have been shown to reduce plaque. By reducing plaque, bacteria can be kept to a level manageable by the human immune system. Taking antibiotics is not without risks and should only be done after consultation with a dentist or doctor.

Some studies have shown brushing with a solution made of baking soda and peroxide will reduce the bacteria that cause gingivitis.

Mouthwashes that contain essential oils have shown the ability to reduce plaque formation and treat gingivitis when used in conjunction with professional cleanings and daily brushing. Specific ingredients include thymol, eucalyptol, methyl salicylate, and menthol.

Oil pulling is the practice of  swishing fractionated coconut oil for 20-30 minutes, then spitting it out and brushing your teeth. This will reduce inflammation and bacterial contamination of your gums.

Some have used the main ingredient in aspirin, salicylic acid, to fight gum disease; but this should be avoided as it often can lead to burns on the gums.