Gingivitis: Causes, symptoms, and treatment

Periodontology
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Gingivitis: Causes, symptoms, and treatment

What are gingivitis causes and treatment?

Gingivitis is a type of gum disease also known as periodontal disease where the gum tissues surrounding the teeth are inflamed which can lead to weakened teeth if not addressed in a timely manner.

There are different types of gingivitis:

  •  Plaque-related gingivitis – the most common type of gingivitis in adults and adolescents, also known as bacterial gingivitis. It is caused by a build-up of bacteria found naturally in plaque that coats your teeth. These bacteria produce toxins that are harmful and irritable to the gum tissue resulting in the swelling and inflammation of the gums.
  • Necrotizing ulcerative gingivitis (NUG) – associated with bacterial infection and stress-related conditions. In addition to stress and bacteria, other factors for gingivitis might be immunosuppression, smoking, local trauma, poor nutritional status, inadequate sleep, and recent illness.
  • Medication-influenced gingivitis – Drag-related gingival hyperplasia is an abnormal gingival tissue reaction to the use of systemic medications such as calcium channel blockers, anticonvulsant medications, oral contraceptives, and some antibiotics.
  • Allergic gingivitis – allergic reactions to food or seasonal allergy can result in gum inflammation, causing gums to become red, swollen, and even painful.
  • Specific infection-related gingivitis – Candidiasis (oral thrush) is the most common fungal infection in humans. In the mouth, candidiasis may develop white sores or just red and painful gums.
  • Certain viral infections – herpes infection in the mouth may involve any area of the oral mucosa. The symptoms may include vesicles turning into areas of ulcerations, sore throat, fever, and headache.

The most common symptoms of gingivitis or signs of gingivitis are puffiness, redness, and bleeding of the gums usually associated with oral hygiene issues. Gingivitis can be painful for some individuals, but some people might have only mild symptoms, which can go undetected if they do not regularly see a dental professional.

What cures gingivitis is having regular dental appointments to remove the plaque buildup surrounding the gums. Dental hygienists are trained to do proper gum cleaning to relieve symptoms of gingivitis and maintain gum health. If a patient has deep pockets, hygienists perform deep cleaning/ root planning to ensure that tartar and plaque are removed. Brushing with a soft toothbrush and toothpaste, rinsing with anti-bacterial mouthwash, and over-the-counter medications such as Acetaminophen and Ibuprofen also help to reduce gingivitis symptoms.

Gingivitis overview

Gingivitis is the inflammation of gum tissue surrounding the teeth. With proper oral hygiene and regular hygiene visits, gingivitis is reversible or prevented. If left untreated it can lead to an irreversible stage of gum disease – periodontitis and result in tooth loss.

What causes gingivitis? The common cause of gingivitis is a buildup of plaque which is a sticky film that adheres to the teeth and gum area. This sticky film creates the perfect environment for bacteria to grow and this bacterium creates toxins that irritate the gums. The irritated gums then become inflamed resulting in red and puffy gums which may also bleed.

What is the treatment for gingivitis? Proper oral hygiene: plaque removal, proper brushing techniques, using toothpaste and appropriate toothbrush (manual or electric toothbrush), mouthwash, and flossing. It is always best practice to visit your dental hygienist regularly, every 6 months, to prevent symptoms of gum disease and maintain your gums healthy.

Who gets gingivitis?

Some individuals may have higher risk factors of developing gingivitis if they:

  • have systemic diseases or certain infections,
  • have poor oral hygiene,
  • are pregnant (due to hormonal changes),
  • have uncontrolled diabetes,
  • smoke,
  • have misaligned or crooked teeth,
  • improperly placed fillings,
  • unclean mouth appliances (i.e., dentures, mouthguards, retainers),
  • certain medications (i.e., some birth controls, phenytoin, bismuth).

What causes gingivitis?

What causes gingivitis in humans?

Bacterial plaque causes gingivitis. Poor oral hygiene results in an accumulation of plaque on the teeth which then harden into tartar, also called calculus. This tartar fosters bacterial growth and causes gingivitis as well as weakening tooth enamel leading to tooth decay.

Dirty appliances such as nightguards, retainers, and dentures can also contribute to gingivitis because bacteria are repeatedly reintroduced back into the mouth. These appliances often sit in the mouth for long periods of time allowing the bacteria to infiltrate the mouth. Cleaning your oral appliances with appropriate solutions can help prevent the reintroduction of bacteria into your mouth.

Nutrition also plays a role in causing gingivitis. Decreasing the consumption of sugary foods can aid in managing bacteria in your mouth.

Tobacco and/or alcohol use are other factors that are linked to some forms of gum diseases. Cessation of bad habits can aid in the prevention/management of gingivitis.

What causes gingivitis?

Signs and symptoms of gingivitis include but are not limited to:

  • red and puffy gums,
  • gums that bleed especially when brushing and/or flossing,
  • gums that feel sore and tender, and do not go away,
  • Sensitive teeth or pain, this is usually a result of the gum line pulling away exposing more of the teeth and the roots making them more sensitive,
  • Bad breath that doesn’t seem to go away, this is caused by the buildup of bacteria in the mouth from plaque and tartar sitting on your teeth,
  • Adult/permanent teeth that feel loose especially when biting down. If this occurs, it may be a sign of a progressive degree of gingivitis resulting in advanced gum disease – periodontitis.

Diagnosis and Tests

Gingivitis is diagnosed by your dental professional. You should book an appointment with your regular dentist to be diagnosed.

The dentist will probe your gums to determine whether you have gingivitis or whether it has progressed into periodontitis. X-rays are required to help diagnose whether it is periodontitis or gingivitis.

Management and Treatment

Management of gingivitis involves:

  • Visit your dentist immediately if you notice signs of gingivitis.
  • Keep brushing at least twice a day with a soft toothbrush and toothpaste to remove plaque.
  • Flossing daily to remove plaque between your teeth and below the gum line.
  • Decreasing intake of sugary foods.
  • Using an anti-bacterial mouthwash.

The dentist or hygienist removes plaque and tartar buildup decreasing the progression of gingivitis and keeping the gums and mouth healthy.
When it comes to the treatment of gingivitis, the goal is to remove all remaining plaque and tartar which was not possible to remove with regular brushing and flossing. The dentist will prescribe you a special anti-bacterial mouthwash to bring the gum inflammation down and allow it to heal.

Prevention

The best way to prevent gingivitis is to practice good oral hygiene habits:

  • Brushing twice a day using toothpaste,
  • Flossing regularly,
  • Visiting your regular dental hygienist for dental cleaning

Complications

Untreated gingivitis can result in advanced gum disease known as periodontal disease. In this stage, individuals will start having receding gums, the development of pus around the gums, chronic bad breath, and loose teeth. Successful treatment of gingivitis addressed in a timely manner can help prevent the development of an advanced stage of periodontal disease.

Here are some frequently asked questions

What questions should I ask dentist?
If you suspect that you have gingivitis, you can ask your dentist to address this concern. The dentist can then formulate a treatment plan for you to reverse or diminish the symptoms of gingivitis.
Maintaining good oral health and hygiene habits is the best way to prevent gum disease and avoid any dental issues associated with that. This could mean brushing twice daily, flossing regularly, cessation of tobacco usage, and regular dental checkups.

Gum diseases might be associated with some health conditions. When gum disease is present, the bacteria from the mouth can enter the bloodstream and travel to the heart causing direct infection of the heart valves.

Bacteria that cause periodontal disease can be inhaled into the lungs on tiny droplets of saliva. Healthy lungs have protection against this invasion, but diseased lungs are not able to defend themselves, increasing the risk of infection or worsening the existing lung disease.

Spirochete-induced gum disease is one of the risk factors for Alzheimer’s disease. The presents of spirochete bacteria in the brain of individuals with Alzheimer’s disease are significantly higher than those without the disease.

Gingivitis can be prevented with good oral habits, less stressful environment, good nutrition and regular dental visits.
If gingivitis is left untreated, it can develop into periodontitis leading to chronic bad breath, jaw bone weakening resulting in loose teeth, pus/abscess gums, bleeding, swollen gums, and potentially misalignment of your teeth.
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