Gingivitis

What is gingivitis?

Gingivitis is a medical condition characterized by painful, swollen, red inflamed gums. Gingivitis if untreated may lead to periodontal disease damaging the gums, periodontal ligaments and tooth socket and subsequent leading to loss of teeth. Poor maintenance of oral hygiene is responsible for plaque coating on the teeth by bacteria, mucus and food debris formation. Plaque is the main cause of gingivitis. Regular tooth brushing, flossing and dental check-up can easily prevent gingivitis.

What are the symptoms?

In many cases gingivitis symptoms are mild, the condition is rarely painful and patients often fail to notice it. The common symptoms are :

  • Swelling of gums
  • Change of gum color from pink to bright red and purple
  • Tenderness on touching the gum although the itself is rarely painful
  • Unpleasant (bad) breath
  • Mouth ulcer
  • Bleeding from the gum upon touching or during brushing
  • Swollen neck glands (lymph nodes)

Gingivitis if neglected, may lead to damage to the supporting tissue of the tooth (periodontal tissue) and permanent loss of teeth.

What causes gingivitis?

Poor maintenance of oral hygiene is the main cause of gingivitis leads to plaque formation. Plaque is an invisible sticky coating consisting of bacteria, food particle and mucus. Usually plaque formation is aggravated by presence of starches and sugars present in the food.

Regular brushing and flossing can remove the plaque deposits. It has to be daily. If not removed for 2 to 3 days then the plaque becomes hard leading to tartar (calculus) formation at the junction of gum and tooth. The tartar once formed makes a protective covering around the bacteria against the effects of brushing and flossing. Usually home care is not sufficient to remove the tartar.

Tartar and plaque irritates the gum, stimulates the immune response of the host which may lead to destructive changes in the periodontal tissue. The plaque and tartar accumulate in the small gaps between teeth (plaque trap) and harbors bacterial growth. Theses bacteria produce toxins (lipopolysaccharides), enzymes which cause inflammatory changes in the gum (periodontal tissue).

Apart from periodontal tissue damage, dental loss, infection in the oral cavity (trench mouth), ulceration of gums gingivitis may lead to various other health related problems heart attack, strokes, even premature delivery of low birth-weight baby.

Risk factors

  • Poor maintenance of oral hygiene
  • Alcoholism
  • Regular use of tobacco
  • Advanced age
  • Weak immunity as in HIV, cancer and with drug intake (steroids, anticancer drugs).
  • Dryness of mouth
  • Malnutrition
  • Ill-fitted artificial dentures
  • Fluctuation in hormone levels as in pregnancy, menstruation or regular intake of oral contraceptive drugs

How is gingivitis treated?

Gingivitis can be managed easily by professional care followed by daily adequate dental care at home. Professional care includes :

  • Dental cleaning to remove plaque and tartar (scaling)
  • Informing the patient regarding correct brushing and flossing techniques
  • Regular care by the patient at home
  • Regular brushing (at least twice) and flossing
  • Use of antiseptic mouthwashes containing chlorohexidine or hydrogen peroxide

The patient should return to the dentist’s office for follow-up check ups. Most patients are aware of more common dental problems like tooth decay but education about gingivitis to prevent the problem in the future.

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