Gingivitis is also commonly called periodontal disease or gum disease. When the gingivae (gums) become red and swollen and start to bleed, the disease is called gingivitis. Sometimes, the gums exudate or their normal contours change. When not infected, the gums or gingivae are firm and adapt themselves tightly to the teeth.
Keratinized gingiva, found near the crown of the teeth is pink stippled tissue. This tissue must cover the space found between the crowns. Non-keratinized gingivae found away from the crowns are red, movable, and highly vascular and form a continuous layer with the inner lining of the cheeks (buccal mucosa). When a tongue depressor presses on the gums, normal gums will not bleed.
Gingivitis is the most common problem that affects the gums and if left untreated can cause periodontitis.
Causes and who are at Risk
Poor dental hygiene is the main cause for gingivitis symptoms to occur. When we eat or drink, food gets deposited in the teeth. If the teeth are not regularly and properly brushed, this causes plaque to build up. Plaque is sticky and contains bacteria. When this is not removed, it hardens into tartar that sticks to the teeth and can only be removed by a dentist. The bacteria found in plaque and tartar, irritate the gums, make them sore and inflamed and gingivitis occurs. When untreated, gingivitis causes periodontal disease that result in the teeth loosening and falling out.
Apart from those who practice poor oral hygiene, smokers, diabetics and those with a weak immune system due to illnesses like AIDS or treatment like chemotherapy, those under constant stress or are malnourished are all susceptible to contracting gingivitis.
Others at risk include those who follow poor brushing techniques that cause injury to the gums, hormonal changes during pregnancy increase gum sensitivity, those who wear ill-fitting or dirty mouth appliances (dentures, bridges, braces or crowns) can all suffer from gingivitis. Certain medications like birth control pills or phenytoin and contact with metals like bismuth or lead all makes a person vulnerable to gingivitis.
Symptoms of Gingivitis
Gingivitis symptoms occur in varying degrees depending on age, hormonal changes or health of gums and teeth. Common symptoms include:
Bleeding gums: This is a classic gingivitis symptom and is a sign that you suffer from gum disease. This occurs due to plaque and tartar build-up in the teeth. Improper flossing and brushing techniques can traumatize the gums causing inflammation and bleeding. If the bleeding persists, it can be due to more serious illnesses like leukemia and must be referred to a doctor at once.
Appearance of gums: The gums turn a reddish-purplish hue or bright red. They feel tender when you touch them but otherwise, you will not experience any pain. They are shiny in appearance.
Mouth sores: Mouth sores are also called aphthous stomatitis and they occur in the gums, inner cheeks, lips, tongue or palate. They are caused due to various reasons, but for those with gingivitis, mouth sores occur due to irritation of the gums.
Swollen gums: Swollen gums are a common symptom of gingivitis. The gums appear abnormally enlarged, protruding or bulge out. Sometimes the swelling can be so abnormal that they can block out most of the teeth. It happens when the papillae get irritated due to gingivitis. Papillae are bits of gum that are triangular and found between teeth.
Pain in the cheekbones: Bacteria from infected gums can get between the spaces found behind the cheekbones. This causes a condition called maxillary sinusitis that causes shooting or aching pain and requires antibiotics to treat it.
When gingivitis is not treated it can develop into periodontitis, symptoms of which are:
- Foul taste in the mouth
- Loose teeth that can fall out and make chewing difficult
- Gum abscesses that cause pus to collect under the gums or teeth
A rare condition called acute necrotizing ulcerative gingivitis is more severe than even periodontitis and causes symptoms such as:
- Halitosis or bad breath
- Very painful and bleeding gums
- Painful ulcers
- Receding gums especially between the teeth
- Excessive saliva and a metallic taste in the mouth
- Difficulty in speaking or swallowing
- High temperature (> 100.4F) and general malaise
What to do?
Regular dental checkups can prevent any dental problems from worsening. Anyone with the above gingivitis symptoms must visit a dentist before they get worse.
Treatment of Gingivitis
Once the dentist identifies that you have gingivitis, he will recommend any of the following procedures depending on the severity of the symptoms. The dentist will first aim to reduce the inflammation by thoroughly cleaning the teeth using various instruments. Some of the dental procedures that can be used include scaling and polishing teeth and gums and root planing.
If the gingivitis is caused due to poor orthodontic appliances, they will be replaced. Misaligned teeth can be corrected using simple procedures. Once the plaque and tartar build-up has been reduced, gingivitis symptoms will improve. The dentist will suggest various good oral hygiene practices that you will need to follow diligently.
Antibacterial mouthwashes or warm salt water rinses can reduce the inflammation. Patients can experience discomfort after the teeth, gums have been cleaned, and for this, the doctor will prescribe some over-the-counter anti-inflammatory pills. Severe infections maybe treated with appropriate antibiotics. Extraction of affected teeth maybe recommended when gingivitis symptoms recur or when the patient has a severe infection.
Gingivitis : Prevention and Precaution
Homecare helps in the prevention and recurrence of gingivitis symptoms. The patient must get regular dental cleaning done as recommended by the dentist. Always use a soft toothbrush and replace it every 3-4 months. If you can afford it, get an electric toothbrush that can remove plaque and tartar more effectively. Brush teeth twice a day and if possible after every snack or meal. Floss at least once a day. Ask your doctor for a good antiseptic mouthwash and use it regularly. Tartar control toothpastes alone are not sufficient to remove tartar build-up. Instead, ensure you follow proper brushing and flossing techniques. An inter-dental cleaner like a dental pick can help to clean between the teeth.
Other tools that a dentist may recommend for those with chronic gingivitis are special toothbrushes or water irrigation. These are supplements to regular brushing and flossing and not as a replacement. Some dentists will suggest the patient uses special anti-tartar or anti-plaque toothpaste.
All these good dental practices can prevent gingivitis from occurring or recurring. Professional cleaning must be done at least once a year and more often if you are at risk of contracting gingivitis.