What is gingivitis?
Gingivitis, the most common form of periodontal disease, is characterized by inflammation, swelling, and bleeding of the gums. The gums, or gingivae, are the visible soft tissue surrounding the teeth.
Both the gums and the underlying periodontal ligament contain many tiny blood vessels, which nourish the teeth. Thus, when the gums become inflamed, even slight pressure may produce bleeding.
What causes gingivitis?
Gingivitis occurs as a result of the buildup of plaque between the gums and the teeth. Some researchers believe that hormones may play a role, since gingivitis usually first develops during adolescence and tends to worsen during pregnancy.
- Red, swollen gums that bleed easily.
- Bad breath.
- Shrinking of the gums.
Diseases such as diabetes, thyroid disorders, anemia, and leukemia also seem to promote gingivitis. Other precipitating factors include tobacco use, habitual tooth grinding (bruxism), and crooked teeth or teeth that don't meet properly.
Dental plaque — the sticky substance that forms on your teeth — is produced by bacteria. Unless plaque is removed by regular brushing and flossing of the teeth, it hardens into tartar, the bacteria continue to multiply, and pockets develop along the gumline. As these pockets deepen, the tartar and other bacterial products irritate the surrounding tissue, causing inflammation. Without aggressive treatment, a vicious cycle develops — the deeper the pockets, the more bacteria, and the more bacteria, the greater the inflammation and loss of gum tissue, which in turn makes the pockets even deeper.
How is gingivitis diagnosed and treated?
You should suspect gingivitis if the gums are red and swollen,
Healthy gums are firm and pink.
and brushing produces a "pink toothbrush." Gingivitis is easily diagnosed during a routine dental examination.
Treatment entails removal of plaque and tartar, generally by scaling or scraping the teeth with a sharp instrument. Once the tartar and plaque are removed, the gums usually reattach themselves to the teeth.
More advanced cases may require oral surgery (gingivectomy) to remove the pockets that have formed between the tooth surface and gums. Severe gum disease may require a more extensive procedure called gingivoplasty, in which diseased gum tissue is removed and the gums are reshaped around the teeth. Alternatively, a flap procedure may be done. This entails lifting the gums away from the teeth, removing any infected tissue, reshaping the bone, and then reattaching the gums.
What can I do myself?
Good oral hygiene is the key to both the prevention and treatment of gingivitis. Proper daily brushing and flossing to remove dental plaque, coupled with regular tooth cleaning and scaling by a dental hygienist, prevents most gingivitis. Daily use of an antiseptic mouthwash or rinsing the mouth with a weak solution of a teaspoon of hydrogen peroxide in a half-cup of warm water can help control oral bacteria.
When should I see my dentist?
Regular visits (usually every 6 months) for routine cleaning and examination of the teeth are essential in maintaining healthy teeth and gums. A person should also consult a dentist promptly if gum bleeding or swelling develop.
What will the dentist do?
The gums are examined for signs of gingivitis. Teeth and gums should be thoroughly cleaned to remove plaque. In advanced cases, more extensive scaling or oral surgery may be required. If the teeth don't meet properly, the patient may be referred to an orthodontist. And if a person habitually grinds his or her teeth, a special dental appliance to wear at night can help break the habit.
The course of gingivitis
Gingivitis usually begins during adolescence and often continues in varying degrees throughout life. It can usually be controlled with good oral hygiene, but if allowed to progress, gingivitis can lead to serious periodontal disease and tooth loss. In fact, it is estimated that 70 percent of all tooth loss after the age of 40 is caused by periodontal disease, which invariably starts as gingivitis.
Is gingivitis dangerous?
It is not a major threat to health, but if allowed to progress, it can result in the loss of teeth.
What can I do to avoid gingivitis?
- Brush and floss the teeth at least daily.
- Refrain from smoking.
- Rinse the mouth after eating, especially after meals or snacks that include sweets or starchy foods.
- Have the teeth and gums cleaned regularly by a dental hygienist.