Gingivitis - Everything You Need To Know
Gingivitis is the most common periodontal disease, affecting 90% of the population. It is an infection of the gums caused by bacteria that form plaque.
In small amounts (when it is newly formed), plaque is invisible and relatively harmless. But when left to accumulate, it increases in volume and the proportion of harmful bacteria grows. These gingivitis bacteria release toxins that result in inflammation of the gum tissue and bad breath.
Eventually, the plaque hardens and forms hard deposits called calculus or tartar. If not properly treated, gingivitis may progress to periodontitis, a periodontal disease in which there is loss of the bone that supports the teeth.
Signs of Gingivitis
Gingivitis can be identified by red or swollen gums. In some circumstances, the gingivitis can cause bleeding gums when brushing or eating, and there may be bad breath. To diagnose gingivitis, a dentist may probe gently under the gums. In healthy gums, there should not be any bleeding with this gentle probing. A bleeding gum indicates that there is gum inflammation or gingivitis.
Who's At Risk for Gingivitis?
Certain people are more susceptible to gingivitis. Stress, smoking and poor nutrition can contribute to the development of gingivitis. Certain medications such as steroids, heart medications, cancer therapy drugs, anti-epilepsy drugs, and anti-depressants also increase the risk for gingivitis.
In the presence of plaque, these medications can lead to gum overgrowth. The enlarged gums can further interfere with oral hygiene, precipitating a vicious cycle of further gum enlargement.
Changes in female hormones can also increase the vulnerability to gingivitis. Adolescent women, pregnant women and women who take hormone replacement or birth control pills also have a greater risk of developing gingivitis.
There are several systemic illnesses that are associated with gingivitis. These include
- acute leukemia
- Addison's disease
- diabetes
- hemophilia
- immunodeficiency diseases (including HIV)
The swelling and redness of the gums may be disproportional to the amount of plaque present. To prevent further complications, meticulous plaque control is critical for people with these illnesses.
Gingivitis Treatment
For gingivitis treatment, the bacterial plaque and tartar have to be removed from the surfaces of the teeth by a dentist or hygienist. Then, the factors that contribute to plaque retention have to be altered in order to facilitate oral hygiene procedures.
This can involve re-shaping existing restorations or even moving teeth with braces so that they are not crowded. Essential to the success of the gingivitis treatment is the person's ability to control plaque build-up after initial treatment. Daily brushing and flossing are key to gingivitis prevention and helps prevent bad breath.
If there is a lot of gum inflammation, if the gums are very sensitive, or if there is a lot of tartar buildup, it may be necessary to numb the gums in order to remove the buildup of bacteria underneath the gum margins. If the gum is very inflamed and swollen, it may be necessary to remove some of the excess gum tissue surgically.
Gingivitis is reversible, and with proper gingivitis treatment and maintenance, it can be controlled. However, untreated gingivitis can result in gum defects, bone loss around the teeth, and eventual tooth loss and systemic complications. The best way to prevent gingivitis is by brushing and flossing daily, and by visiting the dentist for a routine cleaning and an examination at least every six months.
By Laura Minsk, DMD
Gum Disease and Early Diabetes Detection
In many cases it's the dentist - and not the physician - who has the first opportunity to detect diabetes early, because diabetics are especially prone to dental health problems.
Swollen, tender, receding and bleeding gums, loose teeth, and a sore tongue may not just be signs of poor dental hygiene. They may be danger signals for diabetes, too.
If you have any of these symptoms, you may be one of the estimated 11 million people in North America who already have diabetes, or you may be one of the 600,000 who will be diagnosed this year.
Diabetes occurs when a gland called the pancreas fails to produce sufficient amounts of the hormone, insulin, to regulate blood sugar levels. In other words: Diabetics have too little insulin and too much sugar in their blood.
When this happens, the body tissue can't convert the sugar it needs into energy. The blood stream then fills with this unused sugar and the result is diabetes - a disease medical journals often describe as the "forever" disease.
A serious illness which respects neither age, sex, race nor income level, diabetes is the leading cause of blindness in people 20 to 65 years old and can lead to kidney failure, heart attacks and even death.
But outside the dental community, few people realize that diabetics have more than their share of tooth and periodontal (gum) problems. This fact is especially true for undiagnosed diabetics or those who have failed to control their disease adequately with insulin and/or diet and exercise.
Periodontal disease among diabetics progresses rapidly, recurs frequently, and heals slowly. The resistance to treatment can lead to loosened teeth and premature tooth loss.
Your regular dental office visits provide the best chance for early detection of many health problems, including diabetes. If you have a diabetic tendency, your dentist may very well refer you to your physician - another good reason to keep your prescribed dental recall and dental cleaning appointments faithfully!
If you are diabetic, it's important that you keep your dental health history up-to-date, exercise regularly, and eat a diet that provides good nutrition:
- Have regular meals and snack times. Don't skip meals.
- Avoid sweets (cake, candy, pie, ice cream).
- Limit use of animal fats and trim fat off meats. Avoid butter, cream, egg yolks.
- Bake and broil rather than fry foods.
- Don't use alcohol, wine, or beer without your doctor's permission.
- See your dentist regularly so small dental problems can be taken care of with a local anesthetic.
Teeth don't heal themselves, so small problems turn into big ones if left untreated. Major oral surgery requires a general anesthetic which means "no food prior to surgery" - a problem for diabetics.
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.