What Is Gingivitis? What Causes Gingivitis?

*What Is Gingivitis? What Causes Gingivitis? 
 Before and After: (Top picture) Severe gingivitis before treatment.  (Bottom picture) After mechanical debridement of teeth and surrounding gum tissues

 Gingivitis means inflammation of the gums (gingiva). It commonly occurs because of films of bacteria that accumulate on the teeth - plaque; this type is called plaque-induced gingivitis. Gingivitis is a non-destructive type of periodontal disease. If left untreated, gingivitis can progress to periodontitis, which is more serious and can eventually lead to loss of teeth.  A patient with gingivitis will have red and puffy gums, and they will most likely bleed when they brush their teeth. Generally, gingivitis resolves with good oral hygiene - longer and more frequent brushing, as well as flossing. Some people find that using an antiseptic mouthwash, alongside proper tooth brushing and flossing also helps.

In mild cases of gingivitis, patients may not even know they have it, because symptoms are mild. However, the condition should be taken seriously and addressed immediately.

What are the signs and symptoms of gingivitis?

A symptom is something the patient feels and describes, such as painful gums, while a sign is something everybody, including the doctor or nurse can see, such as swelling.

In mild cases of gingivitis there may be no discomfort or noticeable symptoms.

Signs and symptoms of gingivitis may include:

• Gums are bright red or purple
• Gums are tender, and sometimes painful to the touch
• Gums bleed easily when brushing teeth or flossing
• Halitosis (bad breath)
• Inflammation (swollen gums)
• Receding gums
• Soft gums

What are the causes of gingivitis?

The accumulation of plaque and tartar

The most common cause of gingivitis is the accumulation of bacterial plaque between and around the teeth, which triggers an immune response, which in turn can eventually lead to the destruction of gingival tissue, and eventually further complications, including the loss of teeth.

Dental plaque is a biofilm that accumulates naturally on the teeth. It is usually formed by colonizing bacteria that are trying to stick to the smooth surface of a tooth. Some experts say that they might help protect the mouth from the colonization of harmful microorganisms. However, dental plaque can also cause tooth decay, and periodontal problems such as gingivitis and chronic periodontitis.

When plaque is not removed adequately, it causes an accumulation of calculus (tartar - it has a yellow color) at the base of the teeth, near the gums. Calculus is harder to remove, and can only be removed professionally.

Plaque and tartar eventually irritate the gums.

Gingivitis may also have other causes, including:

• Changes in hormones - which may occur during puberty, menopause, the menstrual cycle and pregnancy. The gingiva may become more sensitive, raising the risk of inflammation.
• Some diseases - such as cancer, diabetes, and HIV are linked to a higher risk of developing gingivitis.
• Drugs - oral health may be affected by some medications, especially if saliva flow is reduced. Dilantin (anticonvulsant), and some anti-angina medications may also cause abnormal growth of gum tissue.
• Smoking - regular smokers more commonly develop gingivitis compared to non-smokers.
• Family history - experts say that people whose parent(s) has/had gingivitis, have a higher risk of developing it themselves.

Diagnosing gingivitis

A dentist or oral hygienist checks for gingivitis symptoms, such as plaque and tartar in the oral cavity.

Checking for signs of periodontitis may also be recommended; this may be done by X-ray or periodontal probing.

What are the treatment options for gingivitis?

If the patient is diagnosed early on, and treatment is prompt and proper, gingivitis can be successfully reversed.

Treatment involves care by a dental professional, and follow-up procedures carried out by the patient at home.

Gingivitis care with a dental professional:

• Plaque and tartar are removed. This is known as scaling. Some patients may find scaling uncomfortable, especially if tartar build-up is extensive, or the gums are very sensitive.
• The dental professional explains to the patient the importance of oral hygiene, and how to effectively brush his/her teeth, as well as flossing
• Periodically following-up on the patient, with further cleaning if necessary
• Fixing teeth so that oral hygiene can be done effectively. Some dental problems, such as crooked teeth, badly fitted crowns or bridges, may make it harder to properly remove plaque and tartar (they may also irritate the gums).

What the patient can do at home:

• Brush your teeth at least twice a day
• Bear in mind that in most cases, electric toothbrushes do a better job than we can do on our own
• Floss your teeth at least once a day
• Regularly rinse your mouth with an antiseptic mouthwash. Ask your dentist to recommend one.

What are the possible complications from gingivitis?

In the vast majority of cases, if gingivitis is treated and the patient follows the dental health professional's instructions, there are no complications. However, if the condition is left untreated, gum disease can spread and affect tissue, teeth and bones, leading to periodontitis.

Possible complications from gingivitis may include:

• Abscess in the gingiva
• Abscess in the jaw bones
• Infection in the jaw bone or gingiva
• Periodontitis - this is a more serious condition that can lead to loss of teeth
• Recurrent gingivitis
• Trench mouth - ulceration of the gums caused by bacterial infection

Several studies have linked gum diseases, such as periodontitis, to cardiovascular diseases, including heart attack or stroke. Other reports have found an association with lung disease risk.

*Source: Nordqvist      , C. (2012, February 15). "What Is Gingivitis? What Causes Gingivitis?." Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/241721.php.

Oral health: Why is it so important?

Oral health is defined as the health of all oral structures and while the usual focus lies on teeth, it is important to not neglect other oral structures such as the lips, tongue, inside lining of the mouth, roof of mouth or palate, soft palate, throat, and tonsils. Periodontal health should also be taken into consideration, as they are the supporting structures of the teeth which is crucial for adequate retention of teeth. All these play an important role in the functioning of the mouth hence need to be maintained at a satisfactory level in order to prevent problems.

The public perception of oral health

Oral health has been an important focus in recent years due to the shift for better smile and healthier lifestyle. Peer pressure force people to maintain their mouths at a socially acceptable standard and depending on the group, these ‘standards’ are very subjective and may have great variations inter-group. Some people may place an important focus on simply being able to function with their mouths while others may have greater emphasis on the appearance and impressions they give of their mouths. Besides social background, other factors such as employment can also influence their perception towards oral health. For example an individual who has never been concerned about the appearance of their smile may start becoming self conscious of their poor oral health if they landed work in public relations or similar jobs that requires professional level of client interactions.

Why is it so important to maintain good oral health? Good oral health is as important as it is in direct relationship with function and the state of its health influences our ability to perform such tasks with our mouths. These include speaking, eating, swallowing, smiling and others. Deterioration of oral health will cause impairment in at least one of those areas. The impact of this, again can be subjective depending on the individual perception towards the importance of affected function.  There is a close link between oral and general health, which cannot be refuted. Sudden oral health deterioration in individuals practicing reasonable oral hygiene can often be the first signs of underlying systemic diseases. Very often, oral changes precede medical diagnosis and the mouth is usually the first to show signs of the disease. This is especially true for conditions that affect the immune system such as diabetes and leukemia. This is because impaired healing is frequently reflected in the mouth where even the tiniest amount of plaque can cause significant gum diseases due to exaggerated inflammatory response. Such oral manifestations are hard to treat and usually behave aggressively until the underlying condition is managed. There have also been numerous evidences suggesting the link between poor periodontal health and cardiovascular diseases where the bacterium involved in periodontal diseases can be found on the plaque lining of affected blood vessels. Recent study has also shown people with poorer oral health tend to have higher mortality rates and greater risks of acquiring cardiovascular diseases than their healthier counterparts who have more teeth.  Oral health being able to influence our daily functioning and general health plays a key factor behind our social health. Most people fail to recognize this important relationship which leads to poor care of oral health. Being able to masticate and swallow properly is a form of basic need which is important to all of us. The ability to speak properly and smile comfortably is a form of interaction that molds our social life. Impairment of this can often lead to isolation and poor self esteem, sometimes causing more significant problems such as depression. Other aspects such as simply being in a pain free state is also crucial as toothaches are often rated highly when it comes to people’s inability to tolerate pain. It often creates more disturbance to daily life and affects people’s ability to work more so than other common sickness such as fever or cold.

Source: intelligentdental.com