Gingivitis

GINGIVITIS

Gingivitis is a form of periodontal disease. Periodontal disease involves an inflammation and/or infection that results in the destruction of the supporting tissues of the teeth, including the gingiva (gums), the periodontal ligaments, and the tooth sockets (alveolar bone). Gingivitis is the inflammation of the gums, and often includes redness, swelling, bleeding, exudation, and sometimes pain. Gingivitis can be chronic or acute, but is usually a chronic condition.

Factors that can cause gingivitis can be either extrinsic (localized) or systemic. The most common extrinsic factor is the long-term effect of plaque deposits. "Plaque" is the sticky material that accumulates on the exposed portions of the teeth, and is composed of mucous, food debris, and bacteria. The bacteria release destructive byproducts, and unremoved plaque may mineralize into a hard deposit called "calculus" or "tartar." Plaque, the bacterial toxins, and calculus cause irritation and inflammation of the gingiva.

Injury or any irritation to the gingiva from vigorous toothbrushing, hard food, rough fillings, and mouth appliances such as dentures, can also cause gingivitis. Breathing through the mouth can also be a contributing factor.

Systemic factors, such as diseases that affect the body's immune response, hormonal changes in puberty and pregnancy, nutritional deficiencies, and diabetes mellitus, may increase the gingiva's sensitivity to irritation. Medications such as birth control pills and antiepileptic drugs, and ingestion of heavy metals such as lead and bismuth (found in some pharmaceuticals), may also exaggerate the inflammatory response.

Because gingivitis is primarily plaque-induced, good oral hygiene, including regular brushing and flossing, is the best prevention method. Calculus deposits cannot be removed by brushing alone, however, but must be removed by a dentist or dental hygienist using proper dental instruments. Gingivitis, left uncontrolled, may lead to severe periodontal disease, resulting in the loss of gingival attachments, bone, and, subsequently, teeth.

David E. Heisel

(see also: Oral Health; Plaque )

Bibliography

Grant, D. A.; Stern, I. B.; and Listgarten, M. A. (1988). Periodontics, 6th edition. St. Louis, MO: C. V. Mosby.

U.S. Department of Health and Human Services (2000). Oral Health in America: A Report of the Surgeon General. Washington, DC: U.S. Department of Health and Human Services, Public Health Service.