Gingivitis – Why you should know what this word means.

What is Gingivitis?

Gingivitis is a very common but mild form of gum disease that causes swelling of the gums.

Mild gum disease occurs due to the presence of plaque in the mouth especially near the margin between the gum and the tooth. Plaque is a sticky material made of bacteria, mucus, and food debris that develops on the exposed parts of the teeth.

If plaque is not removed effectively by brushing or cleaning your teeth and gums at least once every 24 hours, the bacteria it produces release toxins that cause the gums to become inflamed. The gums become swollen and tender and will bleed if brushed; these are the signs of gingivitis (mild gum disease).

Because gingivitis is mostly a mild condition, it can often go undetected. In its early stages it is a completely reversible condition that can be treated simply by cleaning the gums and teeth properly.

However, if left untreated, gingivitis can lead to more harmful gum disease in individuals who are susceptible to the more serious form of gum disease called periodontitis. For this reason, it is important to know what gingivitis is and how to treat it.

How can you tell if you have it?

The most common signs of gingivitis are red, swollen or bleeding gums that are sore to touch. If you have gingivitis, you may experience little or no pain so watching for the early warning signs is essential. For example, if your gums bleed when you brush your teeth, you should never ignore it. This is a good time to check out your oral hygiene skills because gingivitis in the early stages can be completely reversed by good self care.

Can I do anything myself to make gingivitis better?

Yes, you can brush your teeth and gums for at least three minutes daily using a soft bristle brush and a recommended brushing technique.

Use dental floss for cleaning in between your teeth. You can supplement your brushing and flossing if necessary with a recommended mouth rinse. You will notice an improvement after three days using this regime and after one week the symptoms of gingivitis including redness, swelling and bleeding should disappear completely.

When should I go to a dentist for help?

If the symptoms do not subside, you may have some periodontal (gum) disease and you will need to make an appointment with your dentist who will be able to investigate your condition and make a diagnosis and treatment plan. This may involve scaling of your teeth and a number of visits to the hygienist who will also review your oral hygiene skills. Your gums may bleed more when you are pregnant, but this tendency disappears once your baby is born.

What is periodontal (gum) disease?

Periodontal (gum) disease occurs when inflammation in the gingiva spreads further into the tissues that support the tooth in the bone. The tissues attaching the tooth to the bone and the bone itself are gradually eroded. This can take place at one site in the mouth (localised) or it can affect some or all of the teeth in the mouth (generalised).

What is the cause of periodontal (gum) disease?

The primary cause is unknown, but the disease almost always occurs in the presence of a bacterial plaque biofilm. Certain factors are known to aggravate the condition. Factors which are known to make periodontal disease worse are smoking, poorly controlled or untreated diabetes and hereditary factors.

Trauma from over vigorous tooth brushing may cause the gums to recede. This is a form of periodontal disease which can be arrested but not reversed by a change in tooth brushing technique.

How can you prevent it?

Good oral hygiene and plaque control using a combination of a good brushing technique, interdental flossing and sometimes a recommended mouthwash is understood to slow down the progress of most forms of periodontal disease.  All of these should be carried out under the general supervision of a dentist who will monitor the progress of the disease.

How can you treat periodontal (gum) disease?

If you have developed periodontal (gum) disease the first step is to reduce the level of inflammation by having your teeth and gums cleaned professionally by a dentist often with  the help of a hygienist. When the swelling and bleeding have subsided,   the dentist will then be able to do a full periodontal examination and assessment of each tooth and surrounding bone.

A deep scaling is then carried out on each segment of the mouth over three to four visits. This will be accompanied by extensive education in oral hygiene and plaque control and regular maintenance visits. The aim of treatment is to slow down progress of the disease, so that the teeth can be retained in a functional condition for as long as possible. This is a realistic goal for most people with moderate to severe periodontal disease. Occasionally, it may be necessary for your own dentist to refer you to a periodontal (gum) specialist if you are a complicated case.

Can periodontal (gum) disease affect my general health?

Recently, there has been discussion about possible links between periodontal (gum) disease and general health. Some researchers have found evidence that people who have periodontal (gum) disease have increased risk of heart disease or stroke. Elevated levels of certain polypeptides (proteins) have been found in people who have severe gum disease. This may be caused by the inflammatory process itself or it may be caused by oral bacteria getting in to the bloodstream from the inflamed gums and releasing the protein. This protein can cause clotting at remote sites in the body including in small blood vessels in the heart or brain. Measuring this effect at a population level is proving more difficult. However, it would be wise to take this information on board as you resolve to improve your own oral hygiene and to make a regular checkup with your dentist part of your annual routine to maintain your oral health and your general wellbeing.

Sources: 1. Clinical Periodontology and Implant Dentistry, Jan Lindhe, Thorkild Karring, Niklaus P. Lang. Editors 4th edition 2006

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