Have you seen a bit of blood in your sink when you brush your teeth lately? That bleeding can be one of the first warning signs that you have got gingivitis.
Gingivitis, which is actually the number one cause of bleeding gums in adults, is a common and mild form of gum disease (periodontal disease) that causes irritation, redness and swelling (inflammation) of your gingiva, the part of your gum around the base of your teeth. It is important to take gingivitis seriously and treat it promptly. Whilst gingivitis is a non-destructive type of gum disease, if left untreated, gingivitis can progress to periodontitis. This is more serious and can eventually lead to loss of teeth.
In fact, one of the reasons you should brush twice a day, and floss once a day is to prevent gingivitis.
There are two main categories of gingival diseases:
Dental plaque-induced gingival disease: This can be caused by plaque, systemic factors, medications, or malnutrition.
Non-plaque induced gingival lesions: This can be caused by a specific bacterium, virus, or fungus. It might also be caused by genetic factors, systemic conditions (including allergic reactions and certain illnesses), wounds, or reactions to foreign bodies, such as dentures. Sometimes, there is no specific cause.
Signs and Symptoms
Usually, healthy gums are firm and pale pink and fitted tightly around the teeth. In mild cases of gingivitis, patients may not even know they have it, because there may be no discomfort or noticeable symptoms.
Receding gums, that is, gums that have pulled away from the teeth thereby causing loose teeth
A change in how your teeth fit together when you bite (malocclusion)
Tender gums that may be painful to the touch
Pain when chewing
When to see a dentist
If you notice any signs and symptoms of gingivitis, schedule an appointment with your dentist. The sooner you seek care, the better your chances of reversing damage from gingivitis and preventing its progression to periodontitis.
What Causes Gingivitis?
The buildup of plaque, which is a naturally-occurring sticky film containing bacteria, on the teeth and gums due to poor oral hygiene causes gingivitis. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth.
Plaque requires daily removal to prevent buildup because it re-forms quickly. Poor oral hygiene can make the buildup of plaque that stays on your teeth harden under your gum line into tartar (calculus), which collects bacteria. Tartar makes plaque more difficult to remove. The longer the plaque and tartar remain on your teeth, the more they irritate the gum due to the toxins produced by the bacteria in the plaque, causing inflammation. In time, your gums become red, swollen, puffy and bleed easily. Tooth decay (dental caries) also may result. If not treated, gingivitis can advance to periodontitis and eventual tooth loss.
Other factors that may increase your risk of gingivitis include:
Smoking or chewing tobacco
Poor nutrition, including vitamin C deficiency
Dental restorations that don't fit properly or crooked teeth that are difficult to clean
Conditions that decrease immunity such as leukaemia, HIV/AIDS or cancer treatment
Certain drugs, such as phenytoin (Dilantin, Phenytek) for epileptic seizures, and some calcium channel blockers, used for angina, high blood pressure and other conditions
Hormonal changes, such as those related to pregnancy, menstrual cycle or use of birth control pills
Medical conditions such as certain viral and fungal infections
A dentist or oral hygienist will check for symptoms, such as plaque and tartar in the oral cavity.
Checking for signs of periodontitis may also be recommended. This may be done by X-ray or periodontal probing, using an instrument that measures pocket depths around a tooth.
The goal of treatment is to reduce inflammation and remove dental plaque or tartar. Your dentist will look at what is affected to figure out where to start.
Prompt treatment after an early diagnosis usually reverses symptoms of gingivitis and prevents its progression to more serious gum disease and tooth loss. You have the best chance for successful treatment when you also adopt a daily routine of good oral care and stop tobacco use.
Treatment involves care by a dental professional, and follow-up procedures carried out by the patient at home.
Professional dental care includes:
Professional dental cleaning. A procedure known as scaling and root planing. Scaling removes tartar and bacteria from your tooth surfaces and beneath your gums. Root planing removes the bacterial products produced by inflammation, smooths the root surfaces, discouraging further buildup of tartar and bacteria, and allows proper healing. The procedure may be performed using instruments, a laser or an ultrasonic device.
Dental restoration, if needed. Misaligned teeth or poorly fitting crowns, bridges or other dental restorations may irritate your gums and make it harder to remove plaque during daily oral care. If problems with your teeth or dental restorations contribute to your gingivitis, your dentist may recommend fixing these problems.
Gingivitis usually clears up after a thorough professional dental cleaning as long as you continue good oral hygiene at home. Follow-up procedures carried out by the patient at home include:
Brush teeth at least twice a day
Use anti-gingivitis toothpaste. Your toothpaste should be able to remove plaque from both your teeth and around your gum line
Use a soft toothbrush or preferably an electric toothbrush
Floss teeth at least once a day
Regularly rinse mouth with an antiseptic mouthwash
A dentist can recommend a suitable brush and mouthwash.
If you're consistent with your home oral hygiene, you should see the return of pink, healthy gum tissue within days or weeks.
Treating gingivitis and following the dental health professional's instructions can normally prevent complications.
However, without treatment, gingivitis can spread and affect tissue, teeth, and bones.
abscess or infection in the gingiva or jaw bone
periodontitis, a more serious condition that can lead to loss of bone and teeth
trench mouth, also known as necrotizing ulcerative gingivitis (NUG), is a severe form of gingivitis that causes painful, infected, bleeding gums and ulcerations. Trench mouth is rare today in developed nations, though it's common in developing countries that have poor nutrition and poor living conditions.
Several studies have linked gum diseases, such as periodontitis, to cardiovascular diseases, including heart attack or stroke. Other reports have found an association with lung disease risk.
Some people have discomfort when plaque and tartar are removed from their teeth. Bleeding and tenderness of the gums should lessen within 1 or 2 weeks after professional cleaning and with good oral care at home.
Warm salt water or antibacterial rinses can reduce gum swelling. Over-the-counter anti-inflammatory medicines may also be helpful.
You must maintain good oral care throughout your life to keep gingivitis from returning.
Steps you can take at home to prevent and reverse gingivitis include:
Brush your teeth for at least two minutes, twice a day (in the morning and before going to bed) or, better yet, after every meal or snack.
Use a soft toothbrush and replace it at least every three to four months. Worn-out bristles remove less plaque.
Consider using an electric toothbrush, which may be more effective at removing plaque and tartar.
Floss daily. Flossing before you brush allows you to clean away the loosened food particles and bacteria.
Use a mouth rinse to help reduce plaque between your teeth.
Supplement brushing and flossing with an interdental cleaner, such as a dental pick, interdental brush or dental stick specially designed to clean between your teeth.
See your dentist or oral hygienist regularly for professional dental cleanings, usually every one to two years or on a schedule recommended by your dentist.
Don't smoke or chew tobacco.
Good health practices such as healthy eating and managing blood sugar if you have diabetes also are important to maintain gum health.
Check your gums in the mirror often for changes in colour or texture. If your gum appearance changes, see your dentist or oral hygienist.