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Medical Specializations

Dentistry => Gingivitis


Gingivitis, painless inflammation or degeneration of the gum tissue, or gingiva, considered the first stage of gum disease (see Dentistry). Healthy gums are firm and uniformly pink, with the gum tissue evenly filling the spaces in between the teeth. In gingivitis, the gum tissue between the teeth becomes swollen and uneven; the tissue at the gum line (where the teeth meet the gums) becomes darker; and gums bleed easily. In advanced cases, the mouth will develop a noticeably unpleasant odor.
Gingivitis can begin at puberty but most often appears in adults, generally as a result of poor dental hygiene. According to the American Dental Association, some form of gum disease affects three out of four adults over age 35. People who have certain medical conditions, including diabetes mellitus and acquired immune deficiency syndrome (AIDS), are more apt to develop this disorder. Hormonal changes, such as those occurring during pregnancy, can also make a person more susceptible to gingivitis.
Gingivitis is caused by the buildup of plaque, a film of bacteria that sticks to the teeth at the gum line. Toxins released from the bacteria irritate the gums, causing the gums to swell and bleed. This enables the bacteria to penetrate just below the gum line into an area known as the gingival sulcus. Warm, moist, and protected from the tongue and the chewing movement of the teeth, the gingival sulcus provides the perfect environment for bacteria to breed. Moreover, the delicate tissues of the sulcus are particularly vulnerable to the strong toxins produced by the bacteria. As the bacteria grow and continue to release toxins, they create a solid pocket of plaque beneath the gum line. This bacteria-filled pocket causes the gums to become more inflamed, which weakens the tissue, allowing even more plaque to be trapped in the expanding pocket.
Left untreated, gingivitis progresses to the next stage of gum disease known as periodontitis. In periodontitis, the inflammation from plaque not only damages the gums but also destroys the bones and ligaments that support the teeth. Eventually, the gums detach from the teeth and the teeth may begin to fall out.
The first step in treating gingivitis is scaling-a thorough professional cleaning of the teeth to remove any plaque. This is particularly important because plaque can harden into a mineral form called calculus or tartar, which can be removed only by professional instruments. In addition, dental structures that can interfere with plaque removal, such as broken fillings or bridges, may be fixed during regular dental cleanings. Most important, the patient will be instructed in proper home care, including regular brushing and effective flossing.
Dentists recommend brushing with a very soft nylon brush twice a day for two to three minutes each session (according to the Academy of General Dentistry, the average American brushes for only 45 to 60 seconds). Daily flossing is also important, using the correct technique that includes cleaning the root surfaces of the teeth just below the gum line. Finally, regular visits to the dentist for checkups and professional cleaning are essential.