What Is Gingivitis? What Causes Gingivitis?

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 toperiodontitis, 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.

 

According to Medilexicon’s medical dictionary:

 

Gingivitis is “Inflammation of the gingiva as a response to bacterial plaque on adjacent teeth; characterized by erythema, edema, and fibrous enlargement of the gingiva without resorption of the underlying alveolar bone.”

 

There are two main categories of gingival diseases (1999 World Workshop in Clinical Periodontics):

• Dental plaque-induced gingival disease

• Gingivitis caused only by plaque

• Gingivitis caused by systemic factors

• Gingivitis caused by medications

• Gingivitis caused by malnutrition

• Non-plaque induced gingival lesions

• Gingival diseases – caused by a specific bacterium

• Gingival diseases – caused by a specific virus

• Gingival diseases – caused by a specific fungus

• Gingival diseases – caused by genetic factors

• Gum inflammations caused by systemic conditions

• Gum inflammations caused by traumatic lesions

• Gum inflammations caused by reactions to foreign bodies

• Gum inflammations without known causes

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.

 

http://www.medicalnewstoday.com/articles/241721.php

Picture courtesy of WikiHow

 

 

Social inequalities broken down by dental care in school

A new survey conducted by the University of Copenhagen and the World Health Organization (WHO) is highlighting the role of schools in work to promote health and prevent disease.

“Children in Scandinavia generally have healthy teeth and gums, largely on account of dental care in schools for all children, the arrival of fluoride toothpaste on the market, a healthy lifestyle and high living standards. But the situation in the poorest countries of the world is very different to that in Scandinavia. However, it is positive to note that the WHO’s Health Promoting Schools Initiative are gaining ground at global level, and that they are gradually wiping out the social inequities in dental health,” says Poul Erik Petersen, Professor at Department of Odontology at the University of Copenhagen, and a Global Health Specialist.

From Myanmar to Madagascar

“We have collected data based on questions about health and dental care from 61 countries that run health programmes in schools. Our findings reveal that those schools that have set up healthy school environments – and which offer all children education in dental health and disease prevention – are generally well-placed to set children on a path to a healthy lifestyle throughout their lives, with regard to issues such as diet, physical exercise, tobacco, alcohol and HIV control.”

Around 60 per cent of the countries that took part in the study run formalised teaching in how to brush teeth, but not all countries have access to clean water and the necessary sanitary conditions. This constitutes a major challenge for the health and school authorities in Asia, Latin America and Africa in particular.

“Countries in these regions are battling problems involving the sale of sugary drinks and sweets in the school playgrounds. Selling sweets is often a source of extra income for school teachers, who are poorly paid,” explains Poul Erik Petersen.

He continues: “This naturally has an adverse effect on the children’s teeth. Many children suffer from toothache and general discomfort and these children may not get the full benefit of their education.”

The biggest challenges to improved dental health in low-income countries are a lack of financial resources and trained staff. Schools in the poorest countries therefore devote little or no time to dental care, and they similarly make only very limited use of fluoride in their preventative work. Moreover, the healthy schools in low-income countries find it harder to share their experience and results.

Social inequality is a serious problem

Social inequality in dental health and care is a serious problem all over the world:

“However, inequality is greater in developing countries where people are battling with limited resources, an increasing number of children with toothache, children suffering from HIV/AIDS and infectious diseases – combined with a lack of preventive measures and trained healthcare staff,” says Poul Erik Petersen, before adding:

“Even in a rich country like Denmark, we see social inequalities to dental care, despite the fact that dental health here is much improved among both children and adults. The socially and financially disadvantaged groups of the population show a high incidence of tooth and mouth complaints compared with the more affluent groups.”

The Danish model for municipal dental care was principally built up in the 1970s and 1980s. The intention is to assure good dental health for all children and young people, irrespective of their social background. The long-term effect is now becoming apparent among adults and elderly people, who have maintained a good mouth, healthy teeth and gums, and a strong quality of life. Unfortunately, not all countries in the world are able to operate a school system of this kind.”

http://www.medicalnewstoday.com/releases/272488.php

 

 

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