Gingivitis

What is gingivitis?

Gingivitis is inflammation of your gums. It is the first stage of periodontal (gum) disease, but it can be cured if treated.

If gingivitis is not treated, a more serious disease called periodontitis can occur. Periodontitis affects not only the gums, as in gingivitis, but also the bone and the ligaments that attach the gums, teeth, and bone.

How does it occur?

Gingivitis is most often caused by bacteria found in plaque. Plaque is a sticky material made of mucus and saliva, food particles, and bacteria that live in the mouth. Chemicals produced by the bacteria in plaque inflame the gum tissue. The gums swell and become tender.

The most common cause of gingivitis is long-term neglect of oral health. Other causes of gingivitis are:

• injury to the tissue from improper brushing and flossing techniques
• untreated decay along the gum line
• loose fillings or crowns
• vitamin deficiency, especially vitamin C deficiency
• diseases such as diabetes, thyroid disorders, and disorders of the immune system
• medicines that cause your mouth to be dry or change the development of the gums
• blood disease.

Also, mental or physical stress can make the disease more severe and harder to fight.

What are the symptoms?

Symptoms of gingivitis may include:

• tender, swollen gums that bleed easily
• red to purple color of gums
• spongy, shiny gum tissue
• bad breath
• a bad taste in the mouth
• permanent teeth that are loose or moving apart from one another
• gums that have pulled away from your teeth
• a change in the way the teeth fit together when you bite.

How is it diagnosed?

During a dental exam, your dentist will look for signs of gingivitis, such as gums that bleed easily. The dentist will also look for plaque and tartar buildup along the gumline and under tissue in the space between a tooth and its tissue. Tartar (also called calculus) is plaque that has absorbed minerals from saliva and calcified. It is as hard as limestone and forms in layers. Tartar can eventually separate the tooth from its attachments to bone and gum tissue.

How is it treated?

Treatment begins with professional cleaning of your teeth. The dental hygienist will remove all tartar and plaque from the enamel and root surfaces of the teeth. Enamel is the outer layer of the chewing surface and sides of a tooth. In addition, the dentist or hygienist will teach you the best techniques for brushing and flossing. This may include use of specially shaped wire brushes or rubber tips to clean between teeth and stimulate circulation in gum tissue.

After the tartar and plaque are removed and the tooth and root surfaces are clean, the tissue can heal. Gum tissue can usually return to a firm, pink, and healthy condition within a few days to a few weeks.

Other treatments may include:

• Antibacterial mouth rinses, either prescribed or nonprescription
• Adjustment of medicines: Your doctor may reduce the dosage of a medicine you have been taking or prescribe another drug that does not affect the gums.
• Surgery: In the few cases of gingivitis caused by medicines, minor surgery may be necessary to correct the overgrowth of tissue.
• Multivitamin supplements.

Your dentist or healthcare provider might talk to you about ways that your diet can help you have healthier gums.

How long will the effects last?

Gingivitis affects only gum tissue and can be treated. However, if it is left untreated, bacteria causing gingivitis can eventually attack other tissues and may cause permanent damage to the supporting structures of the teeth. The teeth can become loose and eventually may need to be pulled.

How can I take care of myself?

If you develop gingivitis, rinse your mouth with warm salt water to soothe the tissue and reduce swelling. Take a mild pain medicine, such as acetaminophen or ibuprofen, to reduce the tenderness until the tissue begins to heal.

Start cleaning your teeth more thoroughly with better brushing and flossing. Be sure to massage the tissue along the gumline gently with a soft toothbrush. Never share your toothbrush with anyone. It contains bacteria that can be passed from one person to another no matter how well you clean the brush.

If the condition does not get better, call your dental office and schedule an appointment for an exam and cleaning.

How can I help prevent gingivitis?

The best prevention of gingivitis is good dental hygiene. This includes thorough home care and regular exams and professional cleanings.

If you have diabetes, you should check the health of your gums regularly. Diabetes reduces the healing ability of the body, including gum tissue.