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Dental Factfiles

Gingivitis (Gum Disease)

Gingivitis means, quite literally inflammation of the gingivae or gums. Gum problems occur when there is an inflammation or infection of the support tissues of the teeth. There are two main forms of gum disease:

1. GINGIVITIS is when the gums are affected superficially.
2. PERIODONTITIS is when the deeper structures are affected.

Of the two conditions periodontitis is the more severe disease although long standing gingivitis may in some cases lead to periodontitis.

If gingivitis is present, the gums will be red in colour rather than the usual healthy pink. They will also tend to be slightly puffy or swollen. Inflamed gums also bleed, usually when tooth brushing or biting into something hard such as an apple. In severe cases of gingivitis, gums may bleed of their own accord. The major cause of gingivitis is dental plaque. Plaque is the build up of bacteria (germs) and saliva that collects on the tooth surfaces and other parts of the mouth. If the plaque is allowed to collect around the necks of the teeth (where the teeth meet the gums), the gums become inflamed and gingivitis can occur. Some of the plaque bacteria are harmful and can cause gum disease. Plaque can become hardened (mineralised) and form into a hard surface layer of tartar (calculus). The bacteria in the tartar continue to attack the tissues that support the tooth roots. Prevent plaque and tartar formation by brushing thoroughly twice a day.

Gingivitis can affect anyone at any age, although it is less likely to be seen in younger children. Mild cases may go unnoticed for some time and there may be no symptoms during the early stages of the disease. However, if left untreated, gingivitis can gradually progress resulting in the destruction of the tooth attachment and the bone around the teeth. This causes the affected tooth or teeth to become loose. It is best to visit a dentist or hygienist as soon as it is suspected that gingivitis is present so that treatment can begin promptly to prevent the condition from worsening. The dentist or hygienist will carry out a thorough examination and will treat the condition.

The first step is to make sure that the teeth are brushed regularly and effectively, and making sure that the toothbrush is applied correctly to the tooth gum margin at the neck of the tooth. First move the lower jaw until the teeth are in edge-to-edge contact and brush all the outside surfaces of the teeth and gums gently and thoroughly with a circular motion. Next open the mouth and do the same to the inside surfaces of the top teeth and the surfaces of the lower teeth next to the tongue. Finally brush all the biting surfaces and rinse the mouth out to clear away the debris. Providing that a very hard tooth brush is not being used, any bleeding that may occur is not alarming. Once you are brushing effectively, and the inflammation disappears (in about two weeks) the bleeding will stop. The dentist may also recommend a special mouthwash to help the gums return to a normal healthy condition.

The dentist or dental hygienist will also remove any other hardened deposits in your mouth (tartar or calculus) that may be helping the plaque to congregate, for example, the tartar that collects behind the bottom front teeth (incisors) and the outsides of the upper cheek teeth (molars). This tartar is plaque that has become hardened or mineralised by salts in the saliva. The process of removing these hard deposits is known as scaling and may be carried out using hand instruments or with advanced ultrasonic technology. The task is usually completed with a refreshing polish.

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