Good health; it’s about a lot more than eating your fruits and vegetables and getting some exercise every day. Oral care is a crucial element of your healthcare regime. Perhaps more crucial than you may realize—not taking proper care of what’s inside your mouth can lead to more than just bad breath or a cavity. We’re talking gingivitis. And, unchecked, gingivitis can be the root of an even more severe issue: periodontitis.
What Is Gingivitis?
When we’re talking about oral health, we don’t just mean your teeth. Your periodontium holds and supports your teeth. It’s made up of the tooth sockets, periodontal ligament and the gingivae, a.k.a. the gums.
The role of the gums is to wrap around the base of the tooth, holding it in place and protecting it and the rest of the periodontium. So, it’s a pretty important part of the dental structure.
When the gums become inflamed and swollen, this is called gingivitis.
This is essentially the first stage of gum disease, so, if left unchecked, it can lead to a more severe form of gum disease called periodontitis. This is when the inflammation (and possible infection) affects the rest of the periodontium. Untreated periodontitis can cause loose teeth and tooth loss.
The good news is that, if you catch it in time and take the proper steps gingivitis can be reversed.
Types of Gingivitis
Gingivitis can be broken down to two types:
- Gum inflammation caused by plaque (with several mitigating factors)
- Gum inflammation due to causes other than plaque
These two types of the mild gum disease lead us directly to the potential causes behind gingivitis.
Causes of Gingivitis
Because dental plaque is simply a fact of nature, this is the most common type (and cause) of gingivitis.
So, what exactly is plaque?
It’s a collection of food debris, dead cells from the mouth, saliva and bacteria that collects as a film on your teeth. If not removed, the plaque aggravates the gums, triggering an immune response in the form of inflammation. It also creates little pockets between the gums and teeth, where more bacteria can collect and possibly also leading to tooth decay or infection.
If left too long the plaque hardens becoming that yellow substance you might see at the base of someone’s teeth, called tartar. Tartar can only be removed by your dentist or dental hygienist.
There are several underlying causes or risk factors for plaque-induced gingivitis:
Not Practising Proper Oral care: If you are not brushing your teeth and flossing at least twice a day and also getting your annual or semi-annual cleaning done by your dentist or dental hygienist, plaque will build up potentially leading to gingivitis. Conversely, brushing or flossing too hard can damage your gums and wear down your enamel leaving you vulnerable to increased plaque build-up and inflammation.
Improper Use of Mouthwash: While there are mouthwashes that your dentist might recommend specifically to reduce plaque, using mouthwash too often can be a problem. If you replace your brushing/flossing routine with mouthwash, or just use the wash too regularly, you’re killing good bacteria along with the bad and possibly creating a dry mouth environment that leads to bacterial imbalance.
Genetic Predisposition: Being at increased risk for plaque build-up, gingivitis, and periodontitis can run in your family, along with other dental issues.
Hormonal Changes: Shifts in the body’s various hormone levels, such as during puberty, the menstrual cycle and pregnancy can be a culprit behind making the gums react more acutely to plaque build-up.
Deficiency in Certain Vitamins: Although it’s not that common in our Western society, there are vitamin deficiencies that can make you more prone to plaque-caused gingivitis: pellagra (niacin deficiency) and scurvy (vitamin C deficiency), specifically.
Breathing Issues: If you breathe too much through your mouth or if you have a sleep disorder that affects your breathing, such as sleep apnea, this can impact your oral health, leading to more bacteria build-up and increased risk of plaque-caused gingivitis.
Drug Side Effects: Some medications, such as cyclosporine (immunosuppressant), nifedipine (calcium channel blocker), and phenytoin (anticonvulsant), have the side effect of causing gum tissue to experience overgrowth. Called drug-induced gingival overgrowth, this condition means that plaque can hide more easily.
Smoking/Chewing Tobacco: Using tobacco interferes with your healthy oral function, making it less likely that your gums can recover from the irritation caused by plaque. This means that periodontitis is that much closer.
Aging: As we get older, oral care can slip, we’re taking more medications, some of us are getting dentures, our overall health and immunity decline and our salivary glands are less active, leading to dry mouth (and bacteria imbalance). And, of course, plaque builds up over time. All of this means that older adults tend to experience plaque-related gingivitis more often.
Leukemia: The blood and bone marrow cancer can make someone more prone to plaque-caused gingivitis and can also make the gum disease worse, because the person suffering from it has a compromised immune system. Plus, leukemia interferes with the body’s natural clotting process, so the bleeding from gingivitis can last longer in someone with this disease.
Gingivitis Due to Other Causes
Though dental plaque is the most common trigger, there are other potential causes behind the gum inflammation that is gingivitis.
Impacted Tooth: If you have a tooth that hasn’t fully broken through the gumline, you have an impacted tooth. You’re left with a gum flap where debris and bacteria can become trapped, leading to gingivitis. Called pericoronitis, this mostly occurs with wisdom teeth.
Viral Infection: An infection by some viruses can cause inflammation in your gums. For example, the common herpes virus can infect the gums; this is called acute herpetic gingivostomatitis. In addition to gum inflammation, someone with this infection may also have little yellow or white sores on the inside of their mouth.
Fungal Infection: A fungal infection is another potential cause of gingivitis. We naturally have fungi in our mouths, but sometimes a health condition or overuse of antibiotics can lead to overgrowth of those fungi. Thrush is one example. In addition to gum swelling, there may be visible patches on the gums or elsewhere.
Illnesses: Certain diseases can interfere with your immune system and increase inflammation in your body, including gingivitis. These include diabetes, cancer, thyroid conditions, osteoporosis, and HIV/AIDS.
Symptoms of Gingivitis
The problem with gingivitis is that it can be so mild that you have no symptoms. That’s one reason why it’s so essential to see your dentist regularly.
As it progresses, you can develop some or all of the following symptoms:
- Swollen, red or purple-looking gums
- Gums that are tender to the touch
- Bleeding gums (usually when you brush or floss)
- Gums that feel softer than usual
- Gums shrinking back from the teeth
- Bad breath
If you have a lot of pain or any loose teeth, your gingivitis may have progressed to periodontitis, so you need to see your dentist right away.
While you do need to visit your dental every six to 12 months to prevent and treat gingivitis, there’s a lot you can do at home to reduce your risk.
- Use a soft toothbrush and don’t brush your teeth or gums too aggressively
- Consider getting an electric toothbrush, for more thorough cleaning
- Brush your teeth a minimum of two times a day
- Floss at least one a day
- If you have dentures, make sure you clean them regularly
- Replace your toothbrush every three months (to avoid spreading bacteria)
- Also replace your toothbrush after you’ve been ill
- Avoid food and drink with a lot of sugar
- Get on a program to quit smoking/chewing tobacco
- Check your prescriptions to see if they can cause gum overgrowth
- Talk to your dentist about what mouthwash to use and how often, to avoid overuse
- Talk to your doctor about any concerns about illness that may make you at higher risk for gingivitis
- Let your dentist know if your family has a history of dental health problems; they will let you know if you need to get professional cleaning done more often
What Is the Treatment for Gingivitis?
You should be seeing your dentist or hygienist at least once at year, at which point they’ll check for signs of oral disease, including the plaque, tartar and inflammation that can indicate gingivitis. They will also recommend the frequency of appointments you need to prevent gingivitis.
Your dental professional will perform dental scaling, using an instrument to remove plaque and tartar at and below the gumline. You may feel some discomfort if you have a lot of build-up or if your gums are inflamed. Depending on the condition of your teeth and the extent of your scaling needs, you may need to book a follow-up appointment. It’s important to get this done, in order to prevent even more serious gum disease.
Nip Gingivitis in the Bud with Princeview Dental
Because gingivitis can lead to the even more serious periodontitis (and possible tooth loss), it’s essential that you practise proper oral care at home. It’s also crucial that you don’t let it go too long before seeing your dentist or dental hygienist, if you think you have gingivitis.
If you’re experiencing inflamed or bleeding gums, contact the dental health professionals at Princeview Dental Group for a dental assessment and treatment plan or for more guidance on how to treat or prevent gingivitis. Located in the heart of The Kingsway neighbourhood, we provide dental emergency care, routine oral care, periodontal maintenance and cleaning services and more.