Gingivitis is a general term referring to the inflammation and or irritation of the gums. In most cases, it is caused by bacterial plaque which builds up in between the gums and the teeth and by tartar which forms directly on the teeth. The resulting inflammation can cause a loss of both gum tissue and bone surrounding the teeth.
Periodontal diseases are often classified according to their severity. They range from mild gingivitis, to more severe periodontitis, and finally acute necrotizing ulcerative gingivitis, which is life threatening.
• Bacteria can cause inflammation of the gums. Although bacteria are normally found in our bodies and provide protective affects most of the time, bacteria can be harmful. The mouth is a great place for bacteria to live. The warm, moist environment and constant food supply are everything bacteria need to thrive. If not for a healthy immune system, bacteria in the mouth would rapidly reproduce out of control, overwhelming the body's defense system.
• An infection begins when the body's immune system is overwhelmed. Gingivitis is an infection that occurs when bacteria invade soft tissues, bone, and other places that bacteria should not be. At the moment of infection, bacteria no longer help us, they begin to harm us. Infections, like other diseases, range from mild to severe or life threatening.
Gingivitis is considered to be a bacterial infection of the gums. The exact reason why gingivitis develops has not been proven, but several theories exist. 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 only a few develop gingivitis.
It is usually necessary for the person to have an underlying illness or take a particular medication that renders their immune system susceptible to gingivitis. For example, people with leukemia and Wegner disease have changes in the blood vessels of their gums that allow gingivitis to develop. Other people with diabetes, Addison disease, HIV(Human Immunodeficiency Virus Infection), and other immune system diseases lack the ability to fight bacteria invading the gums.
Sometimes hormonal changes in the body during pregnancy, puberty, and steroid therapy leave the gums vulnerable to bacterial infection.
A number of medications used for seizures, high blood pressure, and organ transplants can suppress the immune system and change the structure of the gums enough to permit bacterial infection.
The symptoms of gingivitis are as follows:
• Swollen gums
• Mouth sores
• Bright-red, or purple gums
• Shiny gums
• Swollen gums that emit pus
• Severe oral odor
• Gums those are tender, or painful to the touch.
• Gums that bleed easily, even with gentle brushing, and especially when flossing.
• Gum Pockets
• Bad Breath
Exams and Tests
Gingivitis is a clinical diagnosis. This means that the physician or dentist can arrive at the diagnosis by listening to the person's medical and dental history and performing a good oral exam. The dentist will examine your mouth and teeth and look for soft, swollen, red-purple gums. Deposits of plaque and tartar may be seen at the base of the teeth. The gums are usually painless or mildly tender. Blood work, x-rays, and tissue samples are checked for cases not responding to initial therapy. The person should, however, be evaluated for underlying disease.
The goal is to reduce inflammation. The teeth are cleaned thoroughly by the dentist or dental hygienist. This may involve various instruments or devices to loosen and remove deposits from the teeth.
Careful oral hygiene is necessary after professional tooth cleaning. The dentist or hygienist will show you how to brush and floss. Professional tooth cleaning in addition to brushing and flossing may be recommended twice per year or more frequently for severe cases. Antibacterial mouth rinses or other aids may be recommended in addition to frequent, careful, tooth brushing and flossing. Removing the source of the infection is primarily how simple gingivitis is treated.
By brushing teeth regularly with a toothbrush and fluoride toothpaste approved by dentists, plaque build-up can be kept to a minimum. Flossing is another means of removing plaque in between teeth and other areas hard to reach. Regular check-ups with a dentist are also important. A dentist is able to remove plaque that is too dense to be removed by a toothbrush or dental floss.
Severe gingivitis may require antibiotics 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.
Repair of misaligned teeth or replacement of dental and orthodontic appliances may be recommended. Any other related illnesses or conditions should be treated.
Good oral hygiene is the best prevention against gingivitis because it removes the plaque that causes the disorder. The teeth should be brushed at least twice daily and flossed gently at least once per day. For people who are prone to gingivitis, brushing and flossing may be recommended after every meal and at bedtime. Consult the dentist or dental hygienist for instructions on proper brushing and flossing techniques. Mouthwash or Hydrogen Peroxide can be helpful, usually using peroxide or saline solutions (water and salt), alcohol or chlorhexidine. Rigorous plaque control programs along with periodontal scaling and curettage also have proved to be helpful, although according to the American Dental Association, periodontal scaling and root planing are considered as a treatment to periodontal disease, not as a preventive treatment for periodontal disease[
Special appliances or tools may be recommended by the dentist for use by people who are particularly prone to plaque deposits. Their use supplements, but does not replace, thorough brushing and flossing. Appliances and tools may include special toothpicks, toothbrushes, water irrigation, or other devices. Electric toothbrushes were initially recommended for persons who have problems with strength or dexterity of their hands, but are now recommended to many patients to improve their oral hygiene.
Anti-plaque or anti-tartar toothpastes or mouth rinses may be recommended by the dentist or dental hygienist.
Regular professional tooth cleaning is important to remove plaque that may develop even with careful brushing and flossing. Many dentists recommend having the teeth professionally cleaned at least every 6 months.
Institute for Good Medicine at the Pennsylvania Medical Society, http://www.myfamilywellness.org/MainMenuCategories/FamilyHealthCenter/Heart/Oralhealth.aspx