Gingivitis, inflammation of the gum tissue or gum disease, is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. In most cases, gingivitis is caused by poor oral hygiene. This allows bacteria to nestle in the spaces between teeth and multiply, causing the gums to become inflamed and infected.
The health risks of gingivitis
Gingivitis is very common. Most adults in the UK have gum disease to some degree and most people experience it at least once. In many cases, people aren’t aware that their gums are affected because they don’t have any symptoms. However, when gingivitis is not treated, it can advance to a condition called ‘periodontitis’. In periodontitis, gums pull away from the teeth and form spaces (pockets) that become infected. The teeth can become loose and may eventually fall out. The infection may also circulate throughout the body via the bloodstream. Research has shown that periodontitis increases the risk of infections in other parts of the body, and has also been linked to heart and vascular disease and pregnancy complications. Therefore, it’s very important to recognise gingivitis at an early stage so that the infection can be treated.
What causes gingivitis?
Gingivitis is caused by a build-up of plaque on the teeth.
Gingivitis due to plaque
Plaque is a sticky, colourless substance that builds up on your teeth. It contains salivary deposits, bacteria and their acidic waste products, and food particles. Plaque is constantly growing in your mouth. Plaque that is not removed can harden and form tartar that brushing doesn’t clean. Like plaque, tartar irritates the gums and may cause them to become infected. It can also cause bad breath , tooth erosion and decay.
Other causes of gingivitis:
- Malnutrition. Chronic deficiency of Vitamin C will cause the gums to become weak and therefore more likely to become infected.
- Candida infection . Candida infection of the mouth, oral thrush, can make the gums more sensitive and make it easier for gingivitis to develop.
- Medication. There are certain prescription and over-the-counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to bacteria. Also, some medicines can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep teeth and gums clean. Phenytoin, an anti-epileptic medicine, and nifedipine, a medicine used to treat high blood pressure and cardiac arrhythmia, are known to reduce saliva.
- A partially erupted tooth. Inflammation of the soft tissue surrounding the crown of a partially erupted tooth, usually molars, is a form of gingivitis known as ‘pericoronitis’. Pericoronitis is caused by an accumulation of bacteria, moisture and debris beneath the tissue covering a partially erupted tooth, causing the area to become infected.
- Herpes infection . Herpetic gingivostomatitis is a combination of gingivitis and stomatitis, an inflammation of the oral mucosa. This very painful type of gum disease is caused by herpes simplex infection.
- Pregnancy. Hormonal changes during pregnancy can make gums more sensitive and make it easier for gum irritation to worsen and develop into gingivitis.
- Menopause. A condition called ‘desquamative gingivitis’ can occur in older women after they go through menopause. This type of gingivitis can be extremely painful.
- Diabetes . People with diabetes are at higher risk for developing infections, including gingivitis, due to high blood sugar levels and reduced saliva production.
- Leukaemia. In leukaemia patients, gingivitis occurs when leukaemia cells infiltrate the gums, and gingivitis can become severe because leukaemia reduces the body’s ability to fight the infection.
What are the symptoms of gingivitis?
Gingivitis isn’t always painful and therefore you may be unaware you have it. But there are signs that you can watch out for. The colour of your gums is one of them. Healthy gums should be pink. If your gums are red, this could be a sign of early stage gingivitis. At this early stage in gum disease, damage can be reversed by practising good oral hygiene.
Other symptoms of gingivitis include:
- Receding or ‘flappy’ gums. Healthy gums are firm and fit snugly around the teeth. Inflamed gums are flappy and slightly detached from the teeth. The gum tissue may also recede.
- Swollen gums. Healthy gums fit snugly around the teeth and are not swollen. Inflamed gums look puffy. Mouth ulcers may develop at the base of the gums.
- Bleeding from gums. Inflamed gums bleed when you brush or floss your teeth.
- Bad breath. Foul-smelling breath or a bad taste in your mouth can be an indication that your gums are inflamed.
How is gingivitis treated?
To treat gingivitis, the dentist or dental hygienist will first deep clean your teeth to remove plaque and tarter. The techniques used can be a little painful.
You will then receive instructions on how to practise proper oral hygiene. This involves regularly brushing your teeth and flossing.
Good oral hygiene
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- Brush your teeth. Brush your teeth twice a day for about five minutes. Use a soft toothbrush with a small brush head to get in hard-to-reach spots. An electric toothbrush can rotate at a far higher speed, making it an easy and effective option. Also pay attention to your gums and gently massage them with your toothbrush as part of your brushing routine.
- Floss. Flossing is an essential part of taking care of your teeth and gums. Proper flossing removes plaque and food particles in places where a toothbrush cannot easily reach, like between your teeth.
- Clean your tongue. Use a tongue scraper to remove food particles or bacteria trapped on the tongue, especially at the back.
- Mouthwash. Rinsing your mouth with mouthwash after brushing your teeth and flossing helps to remove any leftover debris and flush away bacteria.
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Last updated on July 14, 2016.