Causes and treatment of gingivitis

Gingivitis means inflammation of the gums, or gingiva, and occurs when a film of plaque, or bacteria, accumulates on the teeth.

Gingivitis is the most mild and commonly found type of periodontal disease, but when untreated, can progress to periodontontis, which is more serious because it involves the bone and gum being destroyed, and can eventually lead to loss of teeth.

Signs of gingivitis include red and puffy gums, that bleed easily when the person brushes their teeth. It is often resolved with good oral hygiene, with longer and more frequent brushing, and flossing.  People may not even know they have it, because symptoms are mild but the condition should be taken seriously and addressed immediately.

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 gum tissue.

Dental plaque is a biofilm that accumulates naturally on the teeth, and is formed by colonies of bacteria that are trying to stick to the smooth surface of a tooth. These bacteria might help protect the mouth from colonies of harmful microorganisms, but dental plaque can also cause tooth decay, and periodontal problems such as gum disease and bone disease around the teeth. When plaque is not removed adequately, it can harden into calculus, or tartar, at the base of the teeth, near the gums, which has a yellow colour, which can only be removed professionally.

Plaque and tartar eventually irritate the gums, causing gum inflammation around the base of the teeth, which means that the gums might easily bleed.

Other causes and risk factors

Changes in hormones: This may occur during hormonal cycles and changes, and pregnancy. The gums may become more sensitive, raising the risk of inflammation.

Some diseases: Diabetes and HIV are linked with a higher incidence of gum diseases

Drugs: Oral health may be affected by some medications, especially if saliva flow is reduced. Dilantin, an anticonvulsant is known to cause abnormal growth of gum tissue.

Smoking: Regular smokers more commonly develop gum disease, compared with non-smokers.

Poor diet: A vitamin-C deficiency, for example, is known to be linked to gum disease.

Family history: Those with parents who have had gum disease have a greater risk of developing gum issues, which is is thought to be due to the type of bacteria we acquire during our early life.

Signs and symptoms of gingivitis may include:

• bright red or purple gums

• tender gums that may be painful to the touch

• bleeding from the gums when brushing or flossing

• halitosis or bad breath

• inflammation, or swollen gums

• receding gums

Diagnosis

A dentist or oral hygienist will check for symptoms, such as plaque and tartar in the oral cavity, and bleeding of the gums. This is done by X-ray evaluation and periodontal probing, using an instrument that measures pocket depths around a tooth, and allows your dental professional to form a periodontal index to monitor your gum health over time. 

Treatment

If diagnosis happens early, and if treatment is prompt and done correctly and thoroughly, gingivitis can be reversible.

Treatment involves care by a dental professional, and follow-up procedures carried out by the patient at home

Plaque and tartar are removed in a process, known as scaling. It may be uncomfortable, if tartar build-up is extensive, or the gums are very sensitive.

Your dental professional will explain the importance of oral hygiene and how to brush and floss effectively, to prevent the bacterial buildup.

Follow-up appointments will be recommended, with more frequent cleanings if necessary.

Fixing any damaged teeth also contributes to oral hygiene by enabling correct cleaning. Some dental problems, such as crooked teeth, poorly fitted crowns or bridges, may make it harder to properly remove plaque and tartar, and may also irritate the gums.

Care at home

People are advised to:

• brush teeth at least twice a day.

• use an electric toothbrush

• floss teeth at least once a day

Complications

Treating gingivitis and following a dental health professional's instructions can usually prevent complications.

However, without treatment, gum disease can spread and affect tissue, teeth, and bones.

Complications include:

• abscess or infection in the gingiva or jaw bone

• periodontitis, a more serious condition that can lead to loss of bone and teeth

• recurrent gingivitis.

Several studies have linked gum diseases, such as periodontitis, to cardiovascular diseases, including heart attack or stroke.