Gingivitis

What is gingivitis?

Gingivitis is inflammation of gum tissue. Another name for gum tissue is gingiva. It is the first stage of periodontal disease, but it can be cured if treated.

If gingivitis is not treated, a more serious disease called periodontitis will 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 the sticky material made of mucus and saliva, food particles, and bacteria that live in the mouth. Chemicals and enzymes produced by the bacteria in plaque inflame the gum tissue. The gums swell and become tender.

Other causes of gingivitis include:

• injury to the tissue from improper brushing and flossing techniques
• vitamin deficiency, especially vitamin C deficiency
• dry mouth, as a side effect of medications
• overgrowth of gum tissue due to long-term use of some medications, such as Dilantin
• glandular disorders, including thyroid disorders
• blood disease.

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

What are the symptoms?

Symptoms of gingivitis may include:

• tender, swollen gums that bleed easily ("pink toothbrush")
• red to purple color of gums
• spongy, shiny gum tissue
• infection of gums
• a bad taste or bad breath.

How is it diagnosed?

During a dental exam, your dentist will look for these signs that indicate gingivitis:

• red to purple gum tissue
• spongy, swollen, overgrown gum tissue
• gums that bleed easily
• plaque and tartar buildup along the gumline and under tissue in the space between a tooth and its tissue.

Tartar (called calculus by dentists) is plaque that has absorbed minerals from saliva and calcified. It is as hard as limestone and forms in layers, eventually separating the tooth structure from its attachments to bone and gum tissue.

How is it treated?

Treatment begins with a professional cleaning. 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 surfaces 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 forms of treatment may include:

• Antibacterial mouth rinses: Your dentist may recommend a prescription rinse such as Peridex or a nonprescription rinse such as Listerine.
• Adjustment of medications: Your doctor may reduce the dosage of a medication you have been taking or prescribe another medication that does not affect the gums.
• Surgery: In the few cases of gingivitis caused by medications, minor surgery may be necessary to correct the overgrowth of tissue.

How long will the effects last?

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

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 medication, such as aspirin or acetaminophen, 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.

If the condition doesn't 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.