Gingivitis

Gingivitis is an inflammation of the gums surrounding the teeth. Gingivitis is one of many periodontal diseases that affect the health of the periodontium (those tissues that surround the teeth and include the gums, soft tissues, and bone).

Periodontal diseases are often classified according to their severity. They range from mild gingivitis, to more severe periodontitis, and finally acute necrotizing ulcerative gingivitis, which can be life threatening.

• Bacteria can cause inflammation of the gums. Although bacteria are normally found in our bodies and provide protective effects most of the time, bacteria can be harmful. The mouth is a great place for bacteria to live. The warm, moist environment and constant food supply are everything bacteria need to thrive. If not for a healthy immune system, bacteria in the mouth would rapidly reproduce out of control, overwhelming the body's defense system.
• An infection begins when the body's immune system is overwhelmed. Gingivitis is an infection that occurs when bacteria invade soft tissues, bone, and other places that bacteria should not be. At the moment of infection, bacteria no longer help us, they begin to harm us. Infections, like other diseases, range from mild to severe or life threatening.

Gingivitis Causes

Gingivitis is considered to be a bacterial infection of the gums. The exact reason why gingivitis develops has not been proven, but several theories exist.

• For gingivitis to develop, plaque must accumulate in the areas between the teeth. This plaque contains large numbers of bacteria thought to be responsible for gingivitis. But it is not simply plaque that causes gingivitis. Almost everyone has plaque on their teeth, but only a few develop gingivitis.
• It is usually necessary for the person to have an underlying illness or take a particular medication that renders their immune system susceptible to gingivitis. For example, people with leukemia and Wegner disease have changes in the blood vessels of their gums that allow gingivitis to develop. Other people with diabetes, Addison disease, HIV, and other immune system diseases lack the ability to fight bacteria invading the gums.
• Sometimes hormonal changes in the body during pregnancy, puberty, and steroid therapy leave the gums vulnerable to bacterial infection.
• A number of medications used for seizures, high blood pressure, and organ transplants can suppress the immune system and change the structure of the gums enough to permit bacterial infection.

Gingivitis Symptoms

• Swelling, redness, pain, and bleeding of the gums are signs of gingivitis.
  
  
• The breath begins to take on a foul odor.
  
  
• The gums begin to lose their normal structure and color. The gums, which were once strong and pink, begin to recede and take on a beefy red, inflamed color.
  
  
• Inflammation—a complex system by which bacteria-fighting cells of the body are recruited to an area of bacterial infection—plays a major role in gingivitis. It is this inflammation of the gums that accounts for most of the symptoms of gingivitis.
  
  
  • When bacteria first begin to invade the gums, proteins present in the saliva and soft tissues called antibodies coat the bacteria and weaken it, making it an easy target for the body's immune system. The cells that encounter the bacteria first attempt to kill it and, in the mean time, release chemicals into the bloodstream to call other cells to their aid.
    
    
  • One particular cell called a macrophage is responsible for ingesting the bacteria and dissolving it with chemicals. This system works nicely, but it is not terribly efficient. While the invading bacteria are destroyed, chemicals used by the immune system cells to kill them are spilled into the surrounding tissues. This not only kills the bacteria but damages the nearby connective tissues and cells of the gums as well.
    
    
  • The body sees this inflammation as a small price to pay for stopping the bacteria. This process will continue until the source of the infection is removed.

Gingivitis Treatment

Self-Care at Home

The best home care for gingivitis is prevention.

• Regular dental visits to remove plaque build-up are necessary to combat gingivitis.

• Once a dentist removes plaque, regular brushing and flossing will minimize plaque formation. Even with good dental hygiene, plaque will begin to accumulate again.

Medical Treatment

Removing the source of the infection is primarily how simple gingivitis is treated.

• By brushing teeth regularly with a toothbrush and fluoride toothpaste approved by dentists, plaque build-up can be kept to a minimum.

• Flossing is another means of removing plaque in between teeth and other areas hard to reach.

• Regular check-ups with a dentist are also important. A dentist is able to remove plaque that is too dense to be removed by a toothbrush or dental floss.

• Severe gingivitis may require antibiotics and consultation with a physician. Antibiotics are medications used to help the body's immune system fight bacterial infection and have been shown to reduce plaque. By reducing plaque, bacteria can be kept to a level manageable by the human immune system. Taking antibiotics is not without risks and should only be done after consultation with a dentist or doctor.

Prevention

Good mouth and teeth care, regular dental follow-up, and treatment of underlying illnesses are also necessary for preventing gingivitis.