Gingivitis

Introduction:

Gingivitis is a gum disease causing infection and inflammation in the gum tissues. It causes redness in the gums, bleeding, and is sometimes associated with bad breath. The gingivitis, if untreated, may lead to further weakness in gums and surrounding periodontal tissue causing periodontitis. Gingivitis is a risk factor for periodontitis.

What Are the Causes of Gingivitis?

The causes of gingivitis are the following:

• Poor oral hygiene,

• Smoking,

• Diabetes,

• Plaque accumulation,

• Improper brushing,

• Food accumulation.

How Is the Pathogenesis of Gingivitis?

The sequence of plaque to gingivitis is as follows.

Dental Plaque Formation: The sugary food intake causes the development of an environment for bacteria to produce plaque in the gingival surface near the teeth. This plaque is a sticky film composed of bacteria. This causes dental caries and gingival diseases. Dental caries are formed when plaque is associated with food accumulation in the tooth surface. The gingival disease occurs when this plaque is not removed for many days. That is, if the plaque in the gingival surface is left untreated for many days, it gradually leads to gingivitis. The plaque requires daily removal. It forms back quickly.

Dental Calculus Formation: The dental plaque, if left untreated for many days, gradually develops into dental calculus. The dental calculus is a hardened mass under the gingival line. It creates a protective cover to plaque and causes difficulties in the normal removal of dental plaque with brushing. So the dental plaque gets deposited in the tooth surface. The dental calculus also gets deposited in the teeth surface, gradually spreading the bacteria to the gingival tissues. The bacteria are spread from plaque to gingival tissues. This causes infections and inflammation in the gum tissues leading to gingivitis. The normal brushing will not remove hardened dental calculus. Dental scaling is needed to remove the dental calculus.

Gingival Inflammation Formation: The calculus, if not removed by dental scaling, gradually develops irritation to gum tissues causing inflammation of the gums. The gums become swollen and start to produce bad breath. The gums also start to bleed while brushing and spitting. If this stage of gingivitis is not treated, then it will develop into periodontitis. It can also cause tooth decay.

What Are Its Risk Factors?

Gingivitis can occur gradually. It has the following risk factors:

• Poor oral hygiene.

• Improper brushing.

• Improper flossing or inadequate flossing.

• Lack of vitamins and minerals.

• Other medical conditions like diabetes.

• Excess dental caries.

• Hormonal changes like pregnancy, puberty and menstrual cycle.

• Person taking birth control pills.

• People having immunodeficiency disorders like AIDS.

• People with dry mouth.

• Person taking numerous medications and/or certain medications like Phenytoin, certain calcium channel blockers.

• People taking tobacco in any form like smoking, chewing tobacco, and alcoholism.

• Age-related factors.

• People with poor dental restoration, sharp or crooked teeth.

• People with leukemia or cancer treatment.

• Genetic.

• Certain fungal infections can also cause gingivitis.

What Are the Symptoms of Gingivitis?

The signs and symptoms of gingivitis include the following:

• The color of the gums changes from pale pink to red or blackish-red color.

• The consistency of the gums changes from firm to puffy.

• The gums become inflamed.

• Bleeding gums.

• Bad breath.

• Gingival recession.

• Tenderness in the gums.

When to See a Dentist?

The person can visit a dentist once a year for regular check-ups and scaling. But if the person gets any of the symptoms like tenderness in the gums, bleeding gums, or bad breath associated with gum swelling can visit the dentist immediately.

What Are the Complications of Gingivitis?

The gingivitis condition has bacterial invasion, and this bacteria infection, if left untreated, can develop into periodontitis, causing tooth loss. The bacteria in the gum tissues also have the capacity to mix with the bloodstream and invade other cells, including respiratory and cardiac cells. But this theory or condition is still controversial. Respiratory infections, diabetes, cardiac infections like coronary artery disease, stroke, and rheumatoid arthritis. Acute necrotizing ulcerative gingivitis is a type of gingivitis causing pain and tenderness in the gingiva with ulceration and swelling in gums associated with bleeding. It mostly occurs due to poor nutrition.

What Are Its Diagnostic Methods?

Gingivitis can be diagnosed by the following methods:

• The basic dental and medical history of the patient.

• The clinical examination of the patient, showing symptoms of swelling in the gums.

• The clinical examination also indicates the pocket depth.

• The increase in pocket depth indicates bacterial invasion.

• The dental X-ray that is intraoral periapical radiographs and orthopantomogram indicates the calculus and level of bone loss.

How to Prevent Gingivitis?

Maintaining Oral Hygiene:

Oral hygiene should be maintained by regular brushing, regular flossing, and usage of mouthwash. Brushing should be done twice a day daily. Only a pea-size toothpaste has to be used. The tooth brushing should be done for a maximum of three minutes and not more than three minutes. Rough brushing should also be avoided. So only soft brushes with soft bristles have to be used. The dental floss can be used at night after meals. The mouthwash can also be used at night after meals. But the excess use of mouthwash has to be avoided.

Regular Dental Check-ups:

The dental check-up has to be done six months once or at least once a year. Regular dental scaling, if needed, can be done, and caries also can be prevented and restored at the initial stage, thereby preventing future gingival infections.

What Are the Treatment Methods?

Regular dental check up and dental scaling is done to prevent further gingivitis and gum infections. Basic teeth brushing, using interdental brushes, dental flossing, and using mouthwash can reverse the gingivitis condition without scaling. But it occurs only if the gingival infections are minimal. But regular oral hygiene maintenance will help to improve the condition of gingivitis. The habits of tobacco chewing or any other forms of using tobacco also should be stopped.

Medication: The antibiotic medication and painkillers are prescribed for three days. Topical antibiotic ointments are also prescribed along with medicines. These are followed for three days to one week, and then dental scaling is done.

Dental Scaling: Dental scaling is done to remove the tartar or calculus and plaque. The dental scaling is done by an ultrasonic device with scaler tips. It removes the tartar attached to the gums and around the root surfaces. The cleaning around the root surfaces is referred to as root planning.

Dental Restoration Correction: The poorly fitting crown or restoration or fractured crown or fractured restoration can cause irritation in the gums and cause infections and swelling in the gums gradually. So these restoration has to be re-restored to prevent the irritation of the gums. The sharp cusps of teeth or severely malaligned teeth should also be corrected if it involves the gum tissues and causes inflammation.

Conclusion:

Gingivitis is a basic dental condition of swelling in the gums caused by plaque and tartar. It can be generalized or localized around a particular tooth or full mouth. The treatment involves dental scaling followed by oral hygiene maintenance.