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
The Lowdown on Gum Disease
Dentistry has surely shifted its focus from cavity control, thanks to fluoride and early dental care. Now we are learning more about periodontal disease, and for good reason. These days, tooth loss is the likely result of gum disease.
Q. I used to come in twice a year for cleanings. Now the dental hygienist says I need more attention, more often. My insurer limits coverage to six-month visits. What's up?
A. First, we know more about diagnosing the disease and have come upon some very dangerous systemic relationships to other conditions. That is, if you have heart problems, diabetes, or you're expecting a baby, we'll have to watch you closer than the next patient. Ongoing treatment for advanced mouth disease (periodontitis), too, should be scheduled more often.
Q. OK. What will periodontal treatment cost? I want to keep all the teeth I have.
A. You'll have to contact your periodontist's office for specific pricing but to treat a light case of gingivitis - the very first stages of disease - is the least expensive. Deep pockets around teeth and apparent bone loss - a complex case - will cost more. Periodontitis that requires surgery, and maybe the services of a specialist, costs much, much more. A good argument for early gum disease treatment and prevention.
Q. When you're done with me, am I cured?
A. Periodontal and gum disease prevention is the best defense because nobody walks away from it. Unfortunately, periodontal disease is incurable. But with your help, we can keep it under control. So much of your tissue health depends on how much work you're willing to put in. There's nothing magical about brushing and flossing. You just have to do it.
+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.