Gingivitis(gum infection): Risk factors, symptoms, diagnosis, treatment and prevention.

Bleeding, redness, and painful or sore gums can be a symptom of gingivitis. Gingivitis is an infection of the gums. If left untreated, it can become a more severe infection known as periodontitis. The American Dental Association (ADA) states that gingivitis and periodontitis are the major causes of tooth loss in adults.


Bleeding of the gums is sometimes referred to as gingival bleeding, and it may occur during brushing or flossing. The soreness can be accompanied by swelling of the gum tissues. Most commonly, gingivitis is the result of plaque buildup on the teeth around the gum line. Plaque is a thin film of bacteria. It constantly forms on the surface of your teeth. As plaque advances, it hardens and becomes tartar. When plaque extends below the gum line, infection can occur.  Without adequate removal, the plaque hardens to become tartar, which worsens gingivitis and can, over time, lead to receding gums and even damage the bones of the jaws. Left unchecked, gingivitis can cause the gums to separate from the teeth. This can cause injury to the soft tissue and bone supporting the teeth. The tooth may become loose and unstable. If infection progresses, you may lose your tooth or need it removed by a dentist.

 Bleeding from the gums, particularly when accompanied by easy bruising and/or bleeding at other sites in the body, can also be caused by diseases that interfere with the normal blood-clotting process. Blood-thinner medications are another potential cause of bleeding gums. The hormonal changes during pregnancy can also increase the sensitivity of the gums, which may lead to increased bleeding in some cases. Those with chronic conditions that affect the function of the immune system, such as HIV infection or diabetes, may also have an increased tendency to develop gingivitis.

The Centers for Disease Control (CDC) and the National Institute of Dental and Craniofacial Research report that gingivitis is associated with an increased risk of diabetes, heart attack, stroke, and lung disease. It also increases the risk of a woman giving birth to a premature or low birth weight infant.

Gingivitis Risk Factors

The following are risk factors for gingivitis:

• smoking or chewing tobacco
• diabetes
• certain medications (oral contraceptives, steroids, anticonvulsants, calcium channel blockers, and chemotherapy)
• crooked teeth
• dental appliances that fit poorly
• broken fillings
• pregnancy
• genetic factors
• compromised immunity (e.g. HIV/AIDS)

 

Symptoms of Gingivitis

It is possible to have gum disease without any symptoms. However, the following can be symptoms of gingivitis:

• gums that are red, tender and swollen
• gums that bleed when you brush or floss your teeth
• gums that have pulled away from the teeth
• loose teeth
• a change in how your teeth fit together when you bite
• pus between teeth and gums
• pain when chewing
• sensitive teeth
• partial dentures that no longer fit
• foul-smelling breath that does not go away after you brush your teeth

Diagnosing Gingivitis

Your dentist can diagnose gingivitis based on a thorough medical history and an exam of your mouth. During a dental exam, your gums will be probed with a small ruler. This checks for inflammation. It also measures any pockets around your teeth. Normal depth is one to three millimetres. If your measurements reveal larger-than-normal gaps between your teeth and gum line, you probably have gingivitis. Your dentist may also use dental X-rays to evaluate any loss of bone tissue

Talk to your dentist about risk factors for gum disease as well as your symptoms. This can help diagnose your gingivitis. If gingivitis is present, you may be referred to a periodontist. A periodontist is a dentist who specialises in the treatment of gum diseases.

Gingivitis Treatment

To treat gingivitis you must practice proper oral hygiene. You should also cut back on any smoking and control your diabetes. Other treatments include deep cleaning your teeth, medications, and surgery.

·         Cleaning Teeth: There are several techniques that can be used to deep clean your teeth without surgery. They all remove plaque and tarter to prevent gum irritation.

Scaling removes tartar from above and below the gum line.

Root planing smoothes rough spots and removes infected tooth parts.

Lasers may cause less pain and bleeding than scaling and root planing.

·         Medications: A number of medications can be used to treat gingivitis.

Antibiotic mouthwash containing chlorhexidine can be used to disinfect the mouth.

Time-release antiseptic chips containing chlorhexidine can be inserted into pockets after root planing.

Antibiotic microspheres made with minocycline can be inserted in pockets after scaling and planing.

Oral antibiotics can be used to treat persistent areas of gum inflammation.

Doxycycline, an antibiotic, can help keep enzymes from causing tooth damage.

·         Surgery: Flap surgery is a procedure where the gums are lifted back while plaque is removed. The gums are then sutured in place to fit snugly around the tooth.

Bone and tissue grafts can be used where the teeth and jaw are too damaged to heal.      

How Can Gingivitis Be Prevented?

Gingivitis can be prevented by proper and consistent oral hygiene. Make certain to eat a balanced diet and visit the dentist regularly. Brush your teeth twice daily with fluoride toothpaste. Floss your teeth every day.

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