Understanding early and advanced gum disease
Gingivitis is the first step toward future bone loss around the teeth. Take gum redness (a sign of gingivitis) seriously and get to the dentist for treatment.
After receiving a diagnosis of gum
disease, what is the next step? Begin
by asking two questions:
Am I losing much bone around the
teeth?
Are my teeth loose?
The amount of bone loss suggests how rapidly the gum disease is progressing. Minimal bone loss at advanced age is acceptable, however, any bone loss in the young is not.
Bone loss, however, does not tell the whole story. It is possible to lose a great deal of bone and still have strong teeth. More important than bone loss is the looseness or how ‘wiggly’ your teeth are. This is a more reliable measure of how many years you will keep your teeth. If you loose bone but the teeth teeth are strong, then try to keep those teeth as long as possible and don’t rush to do extractions.
Gingivitis is the first sign of gum
disease:
Gingivitis is a mild inflammation of the gum, with redness, swelling and bleeding. It is the earliest sign of a gum problem. There is no bone loss yet. In most cases of gingivitis, if your general health is good, you will be treated with a simple cleaning and home-care instruction.
Treating gingivitis
Gingivitis serves as a warning sign that you are at great risk for worsening gum disease. Try to improve home care with better and more frequent brushing, flossing, and rinsing. Also, get a thorough dental exam and a professional cleaning at your dentist’s office.
Since gingivitis is an early form of gum disease, it often requires a professional cleaning and nothing more. Deep cleanings under anesthesia by a gum specialist are usually not necessary unless the inflammation is very severe. Sometimes gingivitis will be treated with anesthesia (a shot) to prevent discomfort when cleaning the teeth.
The red gum line is gingivitis.
The cause of gingivitis
Poor home care causes growth of bacteria on the teeth and reddening of the gums. The bone is still healthy. This is the definition of gingivitis - bad gums, healthy bone.
Gingivitis will get worse if you have metabolic changes such as diabetes, poor nutrition, mid-term (or third term) pregnancy, excessive emotional stress, or are a smoker.
‘Pregnancy gingivitis’ is gum inflammation in patients in their middle or last trimester of pregnancy. This condition occurs in 30 to 75 percent of all pregnancies and is the result of changes in the hormonal and immune system.
Many smokers develop gum disease with little outward signs of the disease. In other words, for many, while smoking worsens gum disease, the gums will appear normal to the eye even though they are unhealthy inside.
Dry mouth from medications and advancing age also play a role in gingivitis. (see under home care for information on artificial salivas). Non-alcoholic mouthwash and artificial saliva rinses can prove helpful.
One final note, gingivitis may appear in just a few limited areas of the mouth. Areas of crowded teeth are often hard to clean and are prone to gum inflammation. Dental fillings and crowns sometimes cause local irritation of the gums. These fillings and crowns may look ok, but sometimes they can catch food resulting in areas of gum bleeding. When this happens the filling or crown will have to be adjusted or replaced.
Don’t despair. Most forms of gingivitis are temporary. Whether hormonal, stress related or from inadequate home care. The gingivitis can be treated.
Improving the symptoms of gingivitis
is a team effort
You have to do your part. A dental cleaning is of no value unless you are properly brushing, flossing, and rinsing at home. Without proper home care, the inflammation will never disappear. After a dental cleaning, it only takes a few days in a dirty mouth for the inflammation of gingivitis to return. A key difference between gingivitis and the more advanced periodontal disease with bone loss, is the role that you play. Careful brushing, flossing and irrigating which will prevent the gingivitis from becoming a more advanced case of gum disease.
Act quickly
Once gingivitis worsens and bone starts to disappear, it is no longer possible to control theinfection through routine cleanings and brushing. Therefore, when you first begin to see bleeding in your gums, perhaps when you awaken in the morning or during eating or brushing, this is your chance to get to the dentist and also to take a toothbrush, floss, and Waterpik, and bring your gums back to health.
Gingivitis should not be confused with receding (lowering) gums.
Receding gums, the shrinking of gums around the roots of teeth, can be due to many causes besides gingivitis including
overly vigorous toothbrushing (just simply brushing too hard)
unusually thick bone around some of the teeth (such as the upper canines - the pointy teeth)
hormonal or other chemical reasons
infection
Pictured above, receding gums on the upper left canine. Vigorous toothbrushing and thick bone, (which is normal for canines), is the primary cause. Note in this picture that the premolar just behind also has recession. These teeth are not yet in danger of falling out. Often a desensitizing treatment (roots such as these are often sensitive to the touch) and placement of a white filling is sufficient.
To review:
Gingivitis, unlike gum recession, is a specific condition of reddening and bleeding of the gums along with swelling of the gum
edges.Thorough cleaning of the teeth and the roots by a dental professional is indicated. At times rinses such as chlorhexidine (Peridex)
may be prescribed to help control inflammation. Proper and complete home care with brushing, flossing, irrigating and mouthwash rinse is
essential.