Today, we are going to talk about one of the common problems associated with gums. So, when talking about the gums, the first thing that comes to mind is Gingivitis. About 15 to 20% of the world’s population suffer from Gingivitis at some point in their lives.
To find out more about the subject in a more elaborated way, today we are inviting Dr. Sony Sherpa to better understand the condition, signs and symptoms, risk of not treating the condition, and difficulties associated with its treatment.
Hello, Dr. thank you so much for giving your valuable time out of your busy schedule to speak to us. So, starting with the question, what is Gingivitis, and what is the reason behind this condition?
Hello. So talking about Gingivitis, in simple terms, it is the inflammation of the Gums or Gingiva. It commonly occurs as a result of the accumulation of a film of plaque, or bacteria on the teeth. This plaque triggers an immune response that leads to the destruction of gingiva, gum, tissue. If the plaque is not removed adequately, it hardens to form calculus at the base of the teeth, near the gums, irritates the gum, and finally causes Gum inflammation which is known as Gingivitis in medical terms.
Are there any risk factors associated with the condition?
Of course, several risk factors are associated with it. Some of the common risk factors include Smoking, a Poor diet usually deficient in Vitamin C, some anticonvulsant drugs like Dilantin, a history of diabetes, HIV, and cancer, hormonal changes occurring during puberty, menopause, and pregnancy.
Several research studies have shown the increased incidence of Gingivitis among Smokers compared to Non-smokers.
Is family history relevant to this disease?
Yes, Children of those parents who had Gingivitis are at higher risk of developing the condition. That is due to the type of bacteria we acquire during our early life.
So, what are the signs and symptoms associated with the condition?
Mainly patient presents with swollen tender gums, bleeding from the gums while brushing or flushing, bright red or purple gums, receding gums, soft gums, and in many cases, Halitosis is also known as chronic bad breath.
Are there different forms of this disease?
Yes, of course. The gingival disease is divided into two main categories.
- Dental Plaque-induced gingival disease: This form is caused by plaque, systemic factors, and certain medications as well as due to malnutrition.
- Non-plaque induced gingival lesions: This is caused by certain bacteria, viruses, or fungi. It may also be associated with certain systemic conditions like Diabetes, allergic reactions, wound, or reaction to foreign bodies, such as dentures.
How is Gingivitis diagnosed?
As soon as the patient visits the clinic, the dentist checks for symptoms like plaque and tartar in the oral cavity. X-ray or periodontal probing using an instrument to measure pocket depths around a tooth can be done if signs of periodontitis are present.
Is it a treatable condition?
Of course, if an early diagnosis is made gingivitis can be reversed. Treatment mainly focused on the removal of plaque. The therapy mainly focuses on reducing the number of oral bacteria and may require several clinic visits. Regular scaling is done to remove the plaques. Follow up appointments may be required. Any damaged teeth if present should also be well treated. The patient also needs to take care of his teeth at home.
How can someone do at home?
Hmm, so the patient needs to brush their teeth at least twice a day. Flossing teeth at least once a day is recommended. The mouth should be rinsed regularly with an antiseptic mouthwash. Hydrogen peroxide, saline, alcohol, or chlorhexidine mouth wash may also be used.
So, what if someone does not get proper treatment for Gingivitis?
Several complications can develop if left untreated. Some of the common complications are a collection of pus in gingiva or jaw bone, Periodontitis, recurrence of the disease, trench mouth, where bacterial infection can cause ulceration of gums.
As you talked about Periodontitis, is it the same or different conditions?
No, they are completely different conditions. Periodontitis occurs as a late feature of untreated Gingivitis. Periodontitis is an inflammation of the periodontium which comprises four tissues (Gingiva, cementum- the outer layer of roots of teeth, Alveolar bone or the bone socket, and periodontal ligament which are the connective tissue fibers running in between cementum and alveolar bone.)
In this condition, the inner layer of gum and bone pull away from the teeth and leads to pocket formation. These act as a site for the accumulation of debris and get infected. Toxins start to break down the bone and connective tissues which hold the teeth in place. Eventually, teeth are no longer held in position, and teeth loss occurs. Also one can have changes in bite and pain while chewing or biting.
What can be done to prevent Periodontal disease?
Usually, preventive measures for periodontal disease are more or less the same as those for Gingivitis. It also includes regular brushing of teeth, regular flossing, using antiseptic mouthwash and regular follow up.
So, what if despite preventive measures someone develops this condition?
If someone develops periodontitis, scaling and rooting is done. Usually, it is successful. Follow up after four to six weeks with an evaluation of pockets and bleeding on probing is done.
Is it completely treatable by non-surgical means?
No, despite the non-surgical treatment, cases have been found where they are unsuccessful. In such a case, a surgical approach may be required.
What are the surgical approaches for the condition?
Several forms of periodontal surgeries are available which aim to stop progressive bone loss and regenerate lost bone where possible. Some surgeries done are open flap debridement and osseous surgery as well as guided tissue regeneration and bone grafting.
So why is it so difficult to treat it?
As we have already explained earlier, various risk factors are associated with it. Also, regular dental follow-up and home care are required for it which is usually not done by patients. Initially neglecting the condition makes it complicated and difficult to treat.
Now, many of us got to learn so much about Gingivitis and its complications. Thank you so much for your valuable time.
If you have any questions on Gingivitis, use the comments area below!