Causes and treatment of gingivitis

Inflammation of the gums, or gingiva, means gingivitis. It typically happens because a plaque film, or bacteria, accumulates on the teeth.

Gingivitis is a non-destructive form of periodontal disease, but periodontitis may progress via untreated gingivitis. This is more serious and can lead to the loss of teeth eventually.

Gingivitis is a prevalent type of periodontal disease
Gingivitis is a prevalent type of periodontal disease

Red and puffy gums, which bleed quickly when the person brushes his teeth, are symptoms of gingivitis.

With good oral hygiene, such as longer and more regular brushing and flossing, gingivitis is often resolved. Additionally, an antiseptic mouthwash can assist.

In mild cases of gingivitis, as the symptoms are mild, patients may not even know they have it. The disorder should, however, be taken seriously and treated immediately.

Types

Two key types of gingival diseases exist:

Gingival disease caused by dental plaque: This may be due to plaque, systemic causes, drugs, or malnutrition.

Non-plaque induced gingival lesions: It can be caused by a specific bacterium, virus, or fungus. Genetic causes, systemic disorders (including allergic reactions and certain illnesses), wounds, or reactions to foreign bodies, such as dentures, may also be triggered. Sometimes, there is no specific cause.

Causes

The accumulation of bacterial plaque between and around the teeth is the most common cause of gingivitis. The plaque activates an immune response, which in turn will potentially lead to tissue damage of the gingival or gum. Eventually, it may also lead to additional problems, including the loss of teeth.

Dental plaque is a biofilm which naturally accumulates on the teeth. Typically, it is produced by colonizing bacteria trying to adhere to a tooth’s smooth surface.

These bacteria can help protect the mouth from harmful microorganism invasion, but dental plaque may also cause tooth decay, gum infection, and periodontal problems such as gingivitis and chronic periodontitis.

If plaque is not properly removed, it may harden into calculus, or tartar, near the gums at the base of the teeth. This has a yellow color. The calculus can only be professionally removed.

The gums are gradually irritated by plaque and tartar, causing gum inflammation at the base of the teeth. This means that the gums can bleed easily.

Other causes and risk factors

Hormone changes: This can occur during puberty, during menopause, during the menstrual cycle, and during pregnancy. The gingiva could become more responsive, increasing the risk of inflammation.

Some diseases: A higher risk of gingivitis is associated with cancer, diabetes, and HIV.

Drugs: Some medications can affect oral health, especially if the flow of saliva is reduced. Abnormal growth of gum tissue may be caused by dilantin, an anticonvulsant, and certain anti-angina drugs.

Smoking: In comparison to non-smokers, frequent smokers experience gingivitis more frequently.

Age: With age, the risk of gingivitis increases.

Bad diet: For instance, a deficiency of vitamin C is associated with gum disease.

Family history: Those whose parents have had gingivitis are also at greater risk of developing it. This is assumed to be due to the type of bacteria that we develop early in life.

Symptoms and signs

There may be no pain or noticeable signs in mild cases of gingivitis.

Gingivitis signs and symptoms may include:

  • bright red or purple gums
  • tender gums that may be painful to the touch
  • bleeding from the gums when brushing or flossing
  • halitosis, or bad breath
  • inflammation, or swollen gums
  • receding gums
  • soft gums

Diagnosis

Symptoms, such as plaque and tartar in the oral cavity, are examined by a dentist or oral hygienist.

It is also possible to recommend testing for symptoms of periodontitis. Using an instrument that measures pocket depths around a tooth, this can be achieved by X-ray or periodontal probing.

Treatment

Gingivitis may be effectively reversed if diagnosis occurs early, and if treatment is timely and proper.

Treatment includes care by a dental practitioner, and follow-up treatments done at home by the patient.

Professional dental treatment

Teeth after  scaling

Plaque and tartar are removed. This is referred to as scaling. This can be painful, particularly if there is substantial tartar build-up, or the gums are very sensitive.

The dental professional will explain the value of oral hygiene and how to efficiently brush and floss.

Follow-up appointments, with more regular cleanings if needed, could be recommended.

The fixing of any damaged teeth also leads to oral hygiene.

Some dental issues can make it more difficult to remove plaque and tartar properly, such as crooked teeth, poorly fitting crowns or bridges. The gums can even become irritated by them.

Home treatments

People are advised to:

  • brush teeth at least 2 times a day.
  • use an electric toothbrush
  • floss teeth at least once per day
  • Rinse the mouth daily with antiseptic mouthwash.

A dentist can suggest a suitable brush and mouthwash.

Complications

Complications can typically be prevented by treating gingivitis and following the directions of the dental health practitioner.

Nevertheless, gum disease can spread and damage tissue, teeth, and bones without treatment.

Complications include:

  • abscess or infection in the gingiva or jaw bone
  • periodontitis, a more serious condition that can lead to loss of bone and teeth
  • recurrent gingivitis.
  • trench mouth, where bacterial infection leads to ulceration of the gums

Several studies have linked cardiovascular disorders, including heart attack or stroke, to gum diseases, such as periodontitis. An association with lung disease risk has been identified in other studies.

Sources

  • Corliss, J. (2014, July 23). Treating gum disease may lessen the burden of heart disease, diabetes, other conditions
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  • Gingivitis. (n.d.)
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  • Koh, R. U., Ko, E., Oh, T. J., & Edwards, P. C. (2015, March). Foreign Body Gingivitis. The Journal of the Michigan Dental Association, 97(3), 44-47
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  • Causes and treatment of gingivitis (LINK)
  • Periodontal disease. (2015, March 10)
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  • Saini, R., Saini, S., & Sharma, S. (2010, July-Sept). Periodontitis: A risk factor to respiratory diseases. Lung India, 27(3), 189
    (LINK)

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