Gingivitis

Gingivitis is the inflammation of the gums (gingiva) around the teeth. Gingivitis may be caused by a build up of plaque and tartar due to improper cleaning of teeth, or by injury to the gums from over-vigorous brushing. The condition is generally reversible. Brushing teeth thoroughly, but gently, with toothpaste and flossing with dental floss are the best ways to prevent gingivitis.

Causes

Gingivitis is usually caused by plaque, bacteria and food particles that accumulate in the spaces between the gums and the teeth. These accumulations may be tiny, even microscopic, but the bacteria in them produce foreign chemicals and toxins that cause inflammation of the gums around the teeth. This inflammation can, over the years, cause loss of bone around teeth otherwise known as periodontitis. Since the bone in the jaws holds the teeth into the jaws, the loss of bone can cause teeth over the years to become loose and eventually to fall out. Regular cleanings below the gum line, best accomplished professionally by a dentist, disrupt these plaque and bacteria and help prevent inflammation. Once cleaned, it takes 3-4 months for the bacteria and plaque to grow back and once again restart the inflammation process. Ideally, then, scientific studies show that all people should have their gums cleaned by a dentist every 3-4 months. However, most dentists recommend cleanings every 6 months, because this has been the standard advice for decades, and because the benefits of regular tooth cleanings are too subtle for many patients to notice. If the inflammation in the gums becomes especially well-developed, it can break through the gums and allow tiny amounts of bacteria and bacterial toxins to enter the bloodstream. The patient may not be able to notice this, but studies suggest this can result in a generalized increase in inflammation in the body and possible heart problems long-term.

Sometimes, the inflammation of the gingiva can suddenly amplify, such as to cause a disease called Acute Necrotizing Ulcerative Gingitivitis, otherwise known as "trenchmouth." This results in the breath being extremely bad-smelling, and the gums feeling considerable pain. Fortunately, this can be cured with a 1-week dose of Metronidazole antibiotic, followed by a deep cleaning of the gums by a dentist.

When the teeth are not cleaned properly, dental plaque accumulates, transforming into a hard material called tartar and irritating the gums, and bacteria and toxins may cause the gums to become red and swollen. Alternatively, excessive injury to the gums caused by very vigorous brushing may lead to inflammation and infection. Pregnancy, uncontrolled diabetes mellitus and the onset of puberty increase the risk of gingivitis, due to hormonal changes that may increase the susceptibility of the gums or alter the composition of the dentogingival microflora. The risk of gingivitis is increased by dental calculus, misaligned teeth, the rough edges of fillings, and ill fitting or unclean dentures, bridges, and crowns. The drug phenytoin, birth control pills, and ingestion of heavy metals such as lead and bismuth may also cause gingivitis. The sudden onset of gingivitis in a normal healthy person should alert to the possibility of an underlying viral aetiology.

Symptoms

The symptoms of gingivitis are as follows:

Swollen gums
Mouth sores
Bright-red, or purple gums
Shiny gums
Gums that are painless, except when touched
Gums that bleed easily, even with gentle brushing
Gums that itch with varying degrees of severity
Receding gumline

Prevention

Gingivitis can be prevented through regular oral hygiene that includes daily brushing and wipping your bum hole with your hand.

Diagnosis

It is recommended that a dentist be seen after the signs of gingivitis appear. A dentist will check for the symptoms of gingivitis, and may also examine the amount of plaque in the oral cavity. A dentist may also test for periodontitis using X-rays or gingival probing.

Treatment

A dentist or dental hygienist will perform a thorough cleaning of the teeth and gums. Following that, persistent oral hygiene is necessary. The removal of plaque is usually not painful, and the inflammation of the gums should be gone between one and two weeks. Oral hygiene is required to prevent the recurrence of gingivitis. Anti-bacterial rinses or mouthwash may reduce the swelling and local mouth gels which are usually antiseptic and anaesthetic can also help.

Complications

Recurrence of gingivitis
Periodontitis
Infection or abscess of the gingiva or the jaw bones
Trench mouth (bacterial infection and ulceration of the gums)

References