Gingivitis is an infection of the gums. It is usually painless and most people do not realize they have it until their dentist or hygienist tells them. Bleeding of the gums during brushing or flossing is sometimes apparent to the patient, but this is not always the case. The gums do become reddened and puffy due to the infection.
The infection of gingivitis is caused by the bacteria found in dental plaque, the stuff you try to remove with brushing and flossing. It is a thin film of bacteria that forms almost as soon as you remove it. With daily oral hygiene this plaque film is disrupted enough to not be able to cause harm to your gums. If it is not removed properly once every 24 hours it begins to become more pathologic, setting up the infection of the gums. This can happen in the whole mouth but more often than not it occurs locally around certain teeth where adequate hygiene may be more difficult. Tartar buildup can irritate the gums and harbor bacteria as well.
Note that even though the gums are inflamed the bone level around the teeth is unchanged: this is what distinguishes gingivitis (no bone loss) from periodontitis (bone loss)
Certain medical conditions can aggravate gingivitis. Reduced immunity due to chemotherapy, AIDS, diabetes, and the like will worsen gingivitis. Many medications cause problems for the gums. For example, calcium channel blockers and seizure medications cause the gums to grow excess tissue. Any medication causing dry mouth will effect the gums too. Pregnancy, birth control pills, and puberty often cause a condition known as "hormonal gingivitis".
An important aspect of gingivitis to remember is that it is reversible. This reversibility is in contrast to periodontitis, a more severe gum disease which affects the bone that support the teeth. The damage to the bone in periodontitis is irreversible and can only be arrested in an attempt to control further damage to the support of the teeth.
Treatment for gingivitis is straightforward...
- Thorough professional cleaning and irrigation of gums with antibacterial mouthwash
- Personalized instruction in home care which may include brushing, flossing, special plaque removal devices, (Braun Oral B, Sonicare ,etc) and use of Listerine/prescription mouthwash and/or antibiotics.
- Timely follow up to evaluate healing and determine a recall period that suits your particular situation.