Your Dental Guide to Gum Disease (Gingivitis)

Gingivitis and periodontitis are both gum problems but the former entails gun inflammation, while the latter entails gum disease. Moreover, gingivitis usually precedes the periodontitis, but it is important to note that not all forms of gingivitis build up to periodontitis.

In the early stages, gingivitis symptoms involve a build up of bacteria, which in turn causes the gums to become inflamed. As a result, they bleed easily while brushing or flossing. However, it is important to note that the teeth themselves are still held firmly in place and there is no damage to the tissues, or the bone structure.

If this is left untreated, these early gingivitis symptoms can sometimes lead to periodontitis. This particular form of gum disease causes the inner layer of the gum as well as the bone to be separated from the teeth and subsequently form pockets. As a result, these pockets can easily become filled with food debris and thus become infected.

While the body’s immune system battles these infections, the aforementioned bacterial plaque spreads below the gum line. The emission of toxins by both sides (the bacteria as well as the enzymes involved in fighting the infection) result in the breakdown of the bone and connective tissues that hold the teeth in their place.

With the progression of this gum disease, the pockets enlarge, and further breakdown of bone and connective tissue occurs. This makes the teeth loose and can lead to tooth loss. This form of gum disease is the leading cause of tooth loss in adults.

Plaques resulting from bacterial growth are usually the primary cause of gum disease. However, the following factors can also be causative agents when it comes to periodontal disease:

• Changes in hormone levels e.g. during pregnancy or puberty etc., sometimes end up making the gums more sensitive and thus more susceptible to gingivitis.
• Diseases that compromise the immune system e.g. cancer, or diseases like diabetes which compromise the body’s blood sugar levels, can all result in the patient being more susceptible to infections from bacteria and therefore more open to gum disease such as gingivitis and periodontal disease; not to forget cavities in such cases.
• Sometimes, medications can also lead to gum disease. Some that lessen the production of saliva which is a protective agent of gums and teeth, can contribute to a gum disease like gingivitis.
• It’s no surprise that smoking also results in gum disease since it makes it difficult for gum tissue to repair itself in line with the body’s natural order of things.
• Not brushing or flossing regularly can also lead to gum disease such as gingivitis since poor hygiene is a prerequisite for the development of bacterial plaque.
• Gum disease can also be hereditary. Family history of gum disease will make a person more vulnerable to diseases such as gingivitis.

Gum disease symptoms are usually painless and subtle and, therefore, progress without the patient being aware at times. However, there may be some warning signs. There are symptoms that illustrate how it may be one form of the disease or the other, depending on the severity. Some commonplace symptoms of gum disease follow:

• Bleeding gums both during and post brushing.
• Swollen gums that may appear reddish and/or feel tender.
• Constant bad breath or a corresponding taste in the mouth.
• Gums starting to recede.
• Pockets forming between the teeth and the gums.
• Teeth feeling lose or changing positions.
• Feeling that the teeth do not fit together like they used to upon biting down.

Even if the above symptoms are not noted it does not mean that a person does not have some form of a gum disease. Some forms only affect certain teeth like the molars in the back and so might make it harder for symptoms to appear obviously visible. A periodontist or a dentist are the only people qualified to determine if a person has a gum disease or not.

Gingivitis treatment can be approached from different ways. The following are some of the options on that score:

• Scaling and Root Planning (SRP) is a non-invasive but vigorous method of deep cleaning that is sometimes handy in this particular gum disease treatment method. The scaling involves the scraping away of bacterial plaque on either side of the gum line, while root planning involves the evening out of the tooth root to prevent bacteria from making a foothold. This is usually made easier by uneven spots on the tooth root such as nooks and crannies. This also aids the gums in getting reattached to the teeth.
• Another form of gum disease treatment or, more specifically, gingivitis treatment is curettage. It involves the use of a wee handheld tool known as a curette which is used to scrape away infected/damaged gum tissue and helps the remaining structure to heal. Antibiotics are usually prescribed following this method of gum disease treatment.
• When non-invasive techniques do not work when it comes to gingivitis treatment, flap surgery is employed by your dentist. Usually comes into use in the advanced stages of periodontal disease. As the name indicates incisions around the infected area are made which allows the gum tissue to be lifted and held like a flap while the area underneath including the tooth root is cleaned. The tissue is then sowed back into place decreasing pocket sizes.
• If damage has occurred to the bone as a result of gingivitis or any other gum disease, bone grafts can be performed in which the eroded or damaged parts of the bones are replaced with grafts allowing the bone to regrow and for the teeth to stabilise.