Gingivitis involves inflammation of the gums surrounding the teeth. Due to this, the gums become soft and
swollen and usually red instead of a healthy pink. The inflammation of the gums is a defense mechanism put up by the body's immune system to prevent the growth of bacteria which along with the remnant food particles and plaque form tartar. This cannot be removed by simple brushing or flossing.
What Causes Gingivitis Disease?
The primary cause of gum disease is plaque. However, there are various other reasons why gingivitis disease develops.
- Gums become sensitive when there are hormonal changes in the body, such as during puberty, pregnancy, menopause and monthly menstruation. During pregnancy, hormonal changes and tartar induce excessive growth of gum tissues resulting in the formation of lumps commonly referred to as pregnancy tumors. These tumors prevent bacteria from being removed effectively during brushing, thus resulting in gingivitis disease.
- In post-menopausal women, a painful condition called desquamative gingivitis may develop, for reasons yet unknown. In this condition, the outer layers of the gums come away from the teeth and lose their solidity, resulting in the exposure of nerve-endings which causes acute pain.
- Long-term use of contraceptive pills can also result in gingivitis.
- Diseases that affect the immune system such as HIV or cancer may also affect the gums. Diabetes when uncontrolled, can affect the gums. On the other hand, gingivitis disease may also be a pointer to systemic disorders.
- Some medications can also cause gum disease as they restrict production of saliva which prevent the formation of tartar. Some medications used in the treatment of angina and seizures can cause abnormal growth of the tissues in the gums.
- Habits, such as smoking, do not facilitate the easy self-repair of the gums. A severe form of gingivitis, known as Trench mouth or ANUG (Acute necrotizing ulcerative gingivitis) is mostly found in the case of smokers. ANUG is also reported in the case of incapacitated persons under severe stress. Acute pain, swelling, bleeding and bad breath develop very quickly in this condition and also the gums turn grey.
- If gingivitis runs in the family, then there is a greater chance of a person getting it. Poor oral hygiene is a major contributor to gingivitis.
- Dental appliances not properly fitted or improper alignment of teeth may also cause gingivitis.
- Dietary imbalances, vitamin deficiencies, and drug reactions can also result in gingivitis.
- Gingivitis disease is also often caused by fungal and viral infections.
Symptoms of gingivitis
There is usually no pain associated with mild form of gingivitis. Hence it may go unnoticed. However, there
are certain symptoms that warn that treatment for gingivitis is needed:
- When the gums are swollen, soft, or red.
- When gums bleed during, or after brushing.
- When bad breath or bad taste in the mouth persists even after brushing and flossing.
- When the gums recede.
- Deep pockets are formed between teeth and gums.
- Visible deposits of tartar.
Can Gingivitis be prevented?
Good oral hygiene would help prevent the disease of gingivitis. Regular brushing and flossing and use of mouthwashes containing chlorhexidine would help prevent gum disease. In addition to this, a balanced diet with proper eating habits would also help. Avoiding smoking and use of tobacco products would also help in the prevention of gingivitis.
Treatment for Gingivitis
The first step on noticing any of the symptoms would be to seek the help of a dentist or dental hygienist. The
dentist would use several instruments for loosening and removing the tartar that has formed and thus ensure that the teeth are thoroughly cleaned.
The dentist would then instruct you on how to carefully brush and floss to prevent plaque from accumulating. The
dentist would probably recommend professional cleaning, once or twice a year or more frequently, in more advanced cases, to treat gingivitis. In addition, the dentist could also recommend use of anti-plaque, anti-tartar toothpaste or mouthwash containing chemicals which would prevent the growth of bacteria. Besides, proper oral hygiene to prevent gingivitis would also be recommended.
If the dentist finds that misaligned teeth or improper dental appliances are causing gingivitis, he may
recommend corrective procedures. This would help cure gingivitis. If the dentist finds that someone is particularly prone to formation of plaque, she may recommend use of special implements to remove plaque, such as toothpicks,
electric toothbrushes etc. This treatment for gingivitis would suffice when the gingivitis disease is in the early stages.
For reducing the pocket depth between teeth and gums, which can also cause gingivitis, dentists use the procedures of root-planing and scaling. In addition dentists may also administer minocycline microspheres. However, in the case of pregnant women, minocycline microspheres can harm the fetus. Hence, in their case, this drug has to be administered only if the benefits outweigh the risks.
For women who have desquamatic gingivitis, hormone replacement therapy could be beneficial. However, adverse
effects of the therapy could prevent their recommendation. Instead, corticosteroid rinses and pastes which can be directly applied on gums may be more commonly recommended.
Pericoronitis is acute, painful inflammation of the gingival tissue over a partly erupted tooth (as in the case
of a wisdom tooth). The treatment for this would include removal of the debris beneath the gingival flap and irrigation with saline. This may be followed up with extraction, particularly when there is recurrence of the episode.
To treat gingivitis as in the case of Trench mouth, gentle debridement sometimes lasting over a period of
several days, mouth rinses and enhanced oral hygiene are essential. To relieve the pain, when debridement cannot be done immediately, antibiotics may be recommended.
Proper care must be taken to prevent gingivitis even at the initial stages. It is much easier to treat
gingivitis when it is mild than to find a cure for gingivitis at an advanced stage. Gingivitis disease, when neglected, could lead to more acute periodontal conditions which may even result in tooth loss.
When the gingivitis disease is a secondary development of any of the systemic disorders (such as diabetes or HIV
or cancer) the underlying cause needs to be attended to as well.