Gingivitis: Causes, symptoms, and treatment || Periodontal Disease || Gum Problem

Dr Rahul Tripathi (BDS,MDS in Prosthodontics and Implantology)

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Gingivitis means inflammation of the gums, or gingiva. It commonly occurs because a film of plaque, or bacteria, accumulates on the teeth.
Gingivitis is reversible with good oral hygiene; however, without treatment, gingivitis can progress to periodontitis, in which the inflammation of the gums results in tissue destruction and bone resorption around the teeth. Periodontitis can ultimately lead to tooth loss

Signs and symptoms
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
soft gums

TYPES : There are two main categories of gingival diseases: 1) Dental plaque-induced gingival disease: This can be caused by plaque, systemic factors, medications, or malnutrition.
2) Non-plaque induced gingival lesions: This can be caused by a specific bacterium, virus, or fungus. It might also be caused by genetic factors, systemic conditions (including allergic reactions and certain illnesses), wounds, or reactions to foreign bodies, such as dentures. Sometimes, there is no specific cause.

Cause:
Plaque forms on your teeth :  Plaque is an invisible, sticky film composed mainly of bacteria that forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Plaque requires daily removal because it re-forms quickly.
Plaque turns into tartar: Plaque that stays on your teeth can harden under your gumline into tartar (calculus), which collects bacteria. Tartar makes plaque more difficult to remove, creates a protective shield for bacteria and causes irritation along the gumline. You need professional dental cleaning to remove tartar.
Gingiva become inflamed (gingivitis): The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth, causing inflammation. In time, your gums become swollen and bleed easily. Tooth decay (dental caries) also may result. If not treated, gingivitis can advance to periodontitis and eventual tooth loss.

Risk factors:
Poor oral care habits
Smoking or chewing tobacco
Older age
Dry mouth
Poor nutrition, including vitamin C deficiency
Dental restorations that don't fit properly or crooked teeth that are difficult to clean
Conditions that decrease immunity such as leukemia, HIV/AIDS or cancer treatment
Certain drugs, such as phenytoin (Dilantin, Phenytek) for epileptic seizures, and some calcium channel blockers, used for angina, high blood pressure and other conditions
Hormonal changes, such as those related to pregnancy, menstrual cycle or use of birth control pills
Genetics
Medical conditions such as certain viral and fungal infections

Diagnosis
A dentist or oral hygienist will check for symptoms, such as plaque and tartar in the oral cavity.
Checking for signs of periodontitis may also be recommended. This may be done by X-ray or periodontal probing, using an instrument that measures pocket depths around a tooth.

Treatment
Treatment for gingivitis aims to control the infection and restore healthy teeth and gums. Your dentist or periodontist will thoroughly clean your teeth to remove harmful bacteria, plaque and tartar. Additional treatments include:
Perform scaling and root planing: Scaling removes tartar and bacteria from teeth and from underneath your gums. Planing smooths the surfaces of the roots of the teeth. This step helps prevent bacteria from sticking.
Offer dental restoration: Your dentist may fix or remove crowns, fillings or bridges that stick out or don’t fit right. Smoother surfaces are easier to keep clean.
Brush thoroughly twice a day: once when you wake up and once before you go to bed.
Control diabetes if you have it.
Don’t smoke or use other tobacco products.
Floss every day to remove bacteria between the teeth.
Limit food and drinks with lots of sugar, including alcohol.
See a dentist at least once a year for checkups, and more often if you have any symptoms.

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