Gingivitis and Gum Disease Basics
It afflicts as many as nine in ten adults at some point in their lives, as well as teenagers and children as young as five or six years of age. Yet, many suffer from it without even suspecting anything is wrong.
"It" is periodontal disease, or gingivitis - in the minds of most dentists, Public Enemy Number one for teeth.
Only for the last 30 years have researchers understood that gum disease is an infectious disorder, caused by many different species of bacteria. But even today, there is no cure. Fortunately, we have learned a good deal about what periodontal disease is and what can be done about it.
Behind the scenes
The culprits in gum disease are the bacteria that thrive in the crevices between gums and teeth, accumulating in the form of plaque, a hard, colorless film. Plaque produces toxins that not only irritate gums and cause bad breath, but can eventually attack connective tissue, bone and teeth.
These crevices become "pockets" where the bacteria lodge and begin to erode the tissues that connect gums with teeth. If periodontal disease isn't checked, the pockets deepen. The havoc spreads. Eventually, the bone around the teeth and roots is destroyed - and the teeth soon follow.
Sounding the alarm
How can you tell if you have a periodontal problem?
If you have bleeding gums or if you have swollen gums, gingivitis may be the reason why. But mouth disease can strike silently, without any pain or obvious signs.
Any bleeding from your gums should be a tip-off. Make sure you're doing a thorough but gentle job of brushing and flossing every day. If bleeding persists, it's time to see your periodontist. Different people have different levels of susceptibility to periodontal disease, and some forms - including those that affect children and adolescents - can develop quite rapidly.
Not everyone who has gingivitis disease goes on to develop more serious periodontal problems. Some people manage to reverse the disease or stop the progress of chronic gingivitis when it flares up.
Until there's a cure, the fundamentals of gum disease prevention - regular professional care and careful brushing and flossing at home - are still the best line of offense for good dental health.
Ways to fight back
- Periodontal disease can be checked and often reversed with simple preventive measures: brushing, flossing and professional cleaning to remove plaque and stimulate gum circulation.
- If the problem has become more serious, the dentist may do what's called scaling and planing - deep scraping of plaque from under the gum line, and smoothing of root and tooth surfaces so gum tissues have a better chance to reattach.
- Promising new gum disease treatment is already on the horizon: antiseptic or antibiotic drugs placed at the site of infection. And new chlorhexidine mouthwashes that may help prevent the formation of plaque.
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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