Is Gum Inflammation a Curable Problem?

What Is Gingivitis?

Gingivitis refers to inflammation of the gums. Gums (or gingiva) along with the bones and ligaments form the supporting structure of the teeth. Once they get swollen, there is redness, puffiness, and bleeding of gums. But, in most cases, it is treatable and reversible.

When left untreated, it can lead to a more severe condition called periodontitis, in which there is a disease process in all the supporting structures, thereby leading to loss of teeth.

How Is Gingivitis Different From Periodontitis?

Gingivitis usually precedes periodontitis. However, gingivitis does not always result in periodontitis. It proceeds to periodontitis only when prompt treatment is not given. The formation of periodontal pockets characterizes periodontitis due to the pulling away of bones and soft tissues of the teeth. As this advances, the anchorage of the tooth is lost, and the tooth may eventually fall. On the other hand, gingivitis is reversible with proper treatment measures.

What Are the Types of Gingivitis?

• Plaque-Induced Gingivitis:

As the name suggests, this type of gingivitis occurs due to an inflammatory response caused by plaque accumulation on the tooth surfaces adjacent to the gingival margin.

• Non-Plaque Induced Gingivitis:

These are not associated with plaque deposition and can be due to several factors like genetics, allergic conditions, reactions to foreign bodies like dentures or wounds.

What Are the Causes of Gingivitis?

1. Formation of Dental Plaque: Plaque is a thin biofilm that forms on our tooth surfaces every day. It consists of several different bacteria, as well as organic and inorganic constituents. Plaque is a soft deposit that can be removed by maintaining good oral hygiene practices such as brushing, flossing, and mouthwash. But, when it is not followed correctly, it can calcify over time to form a hard deposit known as calculus or tartar, which an oral health professional can only remove through a simple procedure known as scaling. Plaque and calculus can irritate the gums causing gingival inflammation and bleeding. They can lead to tooth decay as well.

2. Hormonal Changes: During the menstrual cycle or pregnancy, hormonal changes cause the gums to become tender and cause them to swell.

3. Diseases: Certain conditions such as xerostomia, leukemia, diabetes, and HIV/AIDS cause swelling of the gums.

4. Drugs: Certain medications for epilepsy, high blood pressure, and even birth control pills cause gingival swelling.

5. Smoking: Chronic smokers tend to develop gum changes due to the effect of the heat and toxins.

6. Vitamin C Deficiency: Scurvy (vitamin C deficiency) is linked to inflammation of gums.

7. Family History: The type of bacteria we acquire during our early life determines the risk of developing gingivitis. Persons who have a family history are more prone to develop gingivitis than those who do not have a family history.

How Is Gingivitis Manifested?

1. Swollen gums.

2. Tenderness in the gums.

3. Gums appear bright red or purple.

4. Gums become soft to touch.

5. Gums bleed easily, especially when brushing or flossing.

6. Bad odor in the mouth.

7. Gum recession.

What Increases the Risk of Developing Gingivitis?

The following factors increase the risk of gingivitis:

• Poor oral hygiene habits.

• Dry mouth or xerostomia.

• Older age.

• Medications like antiepileptics, steroids, and calcium channel blockers.

• Changes in the hormone levels due to conditions like the menstrual cycle or pregnancy.

• Hormonal changes caused by contraceptive pills.

• Crooked teeth.

• Improper fitting restorations or dentures.

• Broken restorations.

• Immunocompromised patients like those affected with HIV/AIDS or leukemia and those under cancer treatment.

• Poor nutrition, in particular, vitamin C deficiency.

• Chewing or smoking tobacco.

• Mouth breathing.

How Can We Prevent Gingivitis?

Gingivitis can be prevented by:

1. Maintaining Good Oral Hygiene:

Brush your teeth (with the correct technique) twice a day, in the morning and night. Floss your teeth once a day, and flossing should be done for every single tooth. Do floss your teeth before brushing to loosen the impacted food particle that can be easily removed. Also, brush your teeth after a meal or snack if your dentist recommends. or at least rinse your mouth.

Schedule a regular dental check-up every six months to one year, depending on the risk factors involved.

2. Diet:

Eat healthy, fibrous greens that have natural cleansing actions and include lots of vitamin-C-rich foods in your diet. Do manage your blood sugar level, especially if you have diabetes.

3. Regular Dental Check-Ups:

Schedule a regular dental check-up every six months to one year, depending on the risk factors involved for routine cleaning. If needed, dental radiographs will be taken to assess your bone health and other underlying conditions that cannot be seen with the naked eye. Smoking, dry mouth, and certain medications increase the risk of progressing gingivitis to periodontitis, and hence more often, regular check-ups are advised.

How Is Gingivitis Diagnosed?

Accumulation of plaque and tartar on the gingival surfaces is checked along with the symptoms of gingivitis. In order to rule out periodontitis, dental periapical radiographs are taken, and periodontal probing is done with the help of an instrument to determine the presence of periodontal pockets.

How Can We Treat Gingivitis?

• Professional Dental Care:

Once there is a build-up of deposits on the teeth causing swelling, it can only be treated by getting a professional cleaning (scaling) done. In this procedure, tartar and plaque are removed. If there is an extensive build-up of tartar and plaque or the gums are inflamed and sensitive, scaling can be painful and uncomfortable. The frequency of follow-up cleanings depends on the individual’s condition. In case of any damaged tooth or restoration, it should be corrected to eliminate further irritation to the gums. Also, crooked teeth or improperly placed crowns or bridges should be fixed.

• Home Care Methods:

After a round of scaling, the inflammation will gradually subside, after which you can take measures to maintain oral hygiene at home every day. This includes brushing teeth twice daily, flossing teeth once daily, and using an antiseptic mouthwash recommended by your dental professional.

What Are the Complications of Gingivitis?

Untreated gingivitis leads to several complications due to the spread of infection and affects the teeth, surrounding tissues, and bones.

The following are the complications of gingivitis:

• Gingival abscess.

• A progressive condition of gingivitis called periodontitis that might result in teeth loss or bone loss.

• Abscess involving the alveolar bone.

• Trench mouth characterized by ulceration due to bacterial infection.

• Recurrent gingivitis.

How Are Gingival Diseases Associated With Other Medical Conditions?

Patients with periodontitis exhibit an increased chance of having the following diseases:

• Stroke.

• Cardiac diseases.

• Diabetes.

• Lung diseases.

• Giving birth to low-birth-weight or premature infants.

It is not clear whether gingival disease causes these medical conditions, and research is being carried out by the Centers for Disease Control and Prevention to determine it.

Conclusion:

The oral cavity harbors a wide range of microbes, imbalance of which causes gingivitis. If treated promptly, gingivitis can be reversed, and further complications like periodontitis and tooth loss can be prevented. Do follow the instructions of your dental health professional and visit him at regular intervals to avoid further issues.