Gingivitis

Definition

Gingivitis is a disorder involving inflammation of the gums (gingiva).

Causes, incidence, and risk factors

Gingivitis is a form of periodontal disease . Periodontal disease is when inflammation and infection destroy the tissues that support the teeth, including the gingiva (gums), the periodontal ligaments, and the tooth sockets (alveolar bone).

Gingivitis is caused by the long-term effects of plaque deposits. Plaque is a sticky material that develops on the exposed portions of the teeth, consisting of bacteria, mucus, and food debris. It is a major cause of tooth decay. Unremoved plaque mineralizes into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gingiva. Bacteria, and the toxins bacteria produce, cause the gums to become infected, swollen, and tender.

Injury or trauma to the gums from any cause, including overly vigorous brushing or flossing of the teeth, can also cause gingivitis. The risks for developing gingivitis include uncontrolled diabetes, pregnancy (because of hormonal changes that increase the sensitivity of the gingiva), general illness, and poor dental hygiene.

Misaligned teeth, rough edges of fillings, and ill fitting or unclean mouth appliances (such as orthodontic appliances, dentures, bridges, and crowns) can irritate the gums and increase the risk of gingivitis. Medications such as phenytoin and birth control pills, and ingestion of heavy metals such as lead and bismuth are also associated with gingivitis.

Many people experience gingivitis to a varying degree. It usually develops during puberty or early adulthood due to hormonal changes and may persist or recur frequently, depending on how healthy your teeth and gums are.

Symptoms

• Mouth sores
  
• Swollen gums
  
• Bright red or red-purple appearance to gums
  
• Shiny appearance to gums
  
• Bleeding gums (blood on toothbrush even with gentle brushing of the teeth)
  
• Gums that are tender when touched, but otherwise painless
  

Signs and tests

Consult the dentist if signs of gingivitis are present. The dentists will examine your mouth and teeth and look for soft, swollen, red-purple gingiva. Deposits of plaque and tartar may be visible at the base of the teeth. The gums are usually painless or mildly tender.

No further testing is usually necessary, although dental x-rays and dental gingival probing (measuring the amount of bone) may be performed to determine whether periodontitis (spread of inflammation to the supporting structures of the teeth) has developed.