Gingivitis is a form of periodontal disease. Periodontal disease involves inflammation and infection that destroys the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets (alveolar bone). Gingivitis is due to the long-term effects of plaque deposits. Plaque is a sticky material made of bacteria, mucus, and food debris that develops on the exposed parts of the teeth. It is a major cause of tooth decay. If you do not remove plaque, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins produce cause the gums to become infected, swollen, and tender. Injury to the gums from any cause, including overly vigorous brushing or flossing of the teeth, can cause gingivitis. The following raise your risk for developing gingivitis:
- General illness
- Poor dental hygiene
- Pregnancy (hormonal changes increase the sensitivity of the gums)
- Uncontrolled diabetes
Misaligned teeth, rough edges of fillings, and ill-fitting or unclean mouth appliances (such as braces, dentures, bridges, and crowns) can irritate the gums and increase the risk of gingivitis.
Medications such as phenytoin and birth control pills, and heavy metals such as lead and bismuth are also associated with gingivitis.
Many people have gingivitis to a varying degree. It usually develops during puberty or earlyadulthood due to hormonal changes and may persist or recur frequently, depending on the health of your teeth and gums.
Symptoms
Bleeding gums (blood on toothbrush even with gentle brushing of the teeth)
Bright red or red-purple appearance to gums
Gums that are tender when touched, but otherwise painless
Mouth sores
Swollen gums
Shiny appearance to gums
Exams and Tests
The dentist will examine your mouth and teeth and look for soft, swollen, red-purple gums. Deposits of plaque and tartar may be seen at the base of the teeth. The gums are usually painless or mildly tender.
No further testing is usually necessary, although dental x-rays and dental bone measurements may be done to determine whether the inflammation has spread to the supporting structures of the teeth.
Treatment
The goal is to reduce inflammation. The teeth are cleaned thoroughly by the dentist or dental hygienist. This may involve various instruments or devices to loosen and remove deposits from the teeth.
Careful oral hygiene is necessary after professional tooth cleaning. The dentist or hygienist will show you how to brush and floss. Professional tooth cleaning in addition to brushing and flossing may be recommended twice per year or more frequently for severe cases. Antibacterial mouth rinses or other aids may be recommended in addition to frequent, careful, tooth brushing and flossing.
Repair of misaligned teeth or replacement of dental and orthodontic appliances may be recommended. Any other related illnesses or conditions should be treated.
Outlook (Prognosis)
The removal of plaque from inflamed gums may be uncomfortable. Bleeding and tenderness of the gums should lessen within 1 or 2 weeks after professional cleaning and careful oral hygiene. Warm salt water or antibacterial rinses can reduce the puffiness. Over-the-counter anti-inflammatory medications will ease any discomfort from a rigorouscleaning.
Healthy gums are pink and firm in appearance. Strict oral hygiene must be maintained for your whole life or gingivitis will recur.
Possible Complications
Recurrence of gingivitis
Periodontitis
Infection or abscess of the gingiva or the jaw bones