Gum Disease or Gingivitis

gingivitisGingivitis, also commonly known as periodontal disease or gum disease starts with bacterial growth in the mouth and will end with tooth loss if not treated properly. The tissue surrounding the teeth is destroyed completely leading to tooth loss.

Difference between Gingivitis and Periodontitis

Gingivitis, the gum inflammation precedes periodontitis, the gum disease. However, not all gingivitis progresses to periodontitis.

In the initial stage of gingivitis, dental plaque (bacteria, food particles, saliva and acids form plaque) builds up leading to gum inflammation. This causes easy bleeding while brushing the teeth. Though the gums are irritated, the teeth are firm in their sockets. No tissue damage occurs in this stage.

Gingivitis when left untreated, advances to periodontitis. In this stage, the inner gum layer and bone are loosened, pulling away the teeth and forming pockets.  These pockets or spaces formed in between the gums and teeth are prone to collect debris leading to teeth infections.

Toxins or poisons produced by the bacteria in dental plaque as well as the body’s good enzymes involve in combating infections. While doing so, they begin to break the bone and connective tissue which hold the teeth in position. With the disease progression, the pockets deepen resulting in more destruction of bone and tissue. The teeth are no longer anchored in position therefore becoming loose, resulting in tooth loss. Gum disease is the major cause of tooth loss in adults.

Causes of Gingivitis or Gum Disease

Plaque is the prime cause of gum disease. Other factors that cause periodontal disease include:

Hormonal changes – These changes occurring during menstruation, puberty, pregnancy and menopause, make gums highly sensitive paving a way to gingivitis development.

Illnesses – Disease conditions like HIV and cancer will interfere with the immune system, affecting the gum condition. Diabetics are at higher risk of developing cavities and periodontal diseases because of their body’s inability to use blood sugar.

Medications – Certain medications will affect oral health as they lessen the production of saliva, which has got a protective effect on gums and teeth. Some anticonvulsant and anti-angina drugs will cause abnormal growth of gum tissue.

Bad habits – Habits like smoking can also cause gum disease progression.

Poor oral hygiene – Poor Oral hygiene like not brushing or flossing regularly can make a way to gingivitis development.

Family history – Family history of teeth conditions is also a contributing factor for developing gingivitis.

Symptoms of Gum Disease

Periodontal disease progresses gradually, producing very few signs and symptoms. The signs and symptoms include:

  • Gums bleed while or after brushing
  • Tender, swollen or red gums
  • Receding gums
  • Bad taste in the mouth or bad breath
  • Loose teeth
  • Pocket formation in between gums and teeth
  • Changes in the way teeth fit together which can be felt when you bite

Some people may not experience these symptoms, yet may have some degree of gum disease. In some others, gum diseases affect only a type of teeth, like molars.

Treatment for Gingivitis or Gum Disease

The aim of gum disease treatment is to promote reattachment of gums to teeth; reduce swelling, depth of the pockets and risk of infection; and to prevent disease progression. Treatment depends on the stage of gum disease, your response to earlier treatments and your overall health. Treatment options range from nonsurgical therapies which can control bacterial growth to surgical treatments which can restore connective tissues.

Non Surgical Treatments

Non surgical treatments for gum disease include:

Professional dental cleaning – During dental checkup, your dentist will remove the tartar or the plaque built above and below the gum line of the teeth. If you have any signs of gum disorders, the dentist may recommend professional cleaning of teeth more than twice a year.

Scaling and Root planning – This is a deep cleaning procedure performed by giving a local anesthetic, where the tartar and plaque from above and below the gum line are scraped away and rough spots are made smooth. Removing the rough spots will provide a clean surface for the gums to reattach to the teeth.

Surgical Treatments

Surgical treatments are usually opted when the tissues around the teeth become unhealthy and cannot be repaired by non surgical options. Surgical treatments include:

Flap surgery (Pocket reduction surgery) – In this procedure, the gums are lifted back and the tartar is removed. The irregular surfaces of the bone if present are smoothed to limit the bacterial accumulation. The gums are then fixed back in position so that the tissue fits around the teeth. This surgical method greatly helps in reducing the space created between the gum and tooth, therefore reducing the areas of bacterial growth and reducing chance of serious health problems associated with gingivitis and periodontitis.

Bone grafts – This method uses fragments of one’s own bone, artificial bone or donated bone to replace the affected bone. These bone grafts help to prevent tooth loss by holding the tooth in place. They even serve as a platform for regrowth of bone. New technology, known as tissue engineering, is under development which encourages our own body to regenerate bone and tissue.

Soft tissue grafts – This surgical procedure is performed by removing a small amount of tissue from the palate (roof of the mouth) and attaching it to the damaged tissue site. This reduces further destruction of the gum, covers roots and provides the teeth a more pleasing appearance.

Guided tissue regeneration – This procedure is performed when the bone supporting the teeth is damaged. A small mesh like biocompatible fabric is inserted between the bone and tooth. This prevents any unwanted tissue from entering the healing area, allowing the bone and tissue to grow back.

Bone surgery – This procedure is followed by flap surgery where in the bone around the affected tooth is reshaped to decrease the irregular surfaces.

Care/Prevention for Gingivitis or Gum Disease

Gum disease can be prevented or reversed when proper plaque control is practiced. Plaque control consists of professional dental cleaning (twice a year), brushing (twice a day) and daily flossing. These habits eliminate the plaque between the teeth and from the gum line. Even antibacterial mouth rinses also help in removing bacteria that from plaque.

Certain health and lifestyle changes help in decreasing the risk, frequency and severity of gum disease. They include:

Eat a balanced diet – Intake of proper nutrition build your immune system to fight against infections. Eat foods containing antioxidant properties, for instance vitamin C foods (citrus fruits, potatoes, broccoli) and vitamin E foods (nuts, vegetable oils, green leafy vegetables).

Quit smoking – Tobacco is a major risk factor for periodontitis development. Smokers are more likely to get gum disease than non smokers. Moreover smoking lowers the chances of success of certain treatments.

Reduce stress – Stress can make it complicated for the body’s immune system to combat infection.

Avoid teeth grinding and clenching – These actions will put extra force on the tissues that support teeth and can therefore increase the rate of tissue damage.