Gingivitis

Gingivostomatitis, Ulcerative Gingivitis, Hyperplastic Gingivitis, Simple Marginal Gingivitis

What is Gingivitis?

Gingivitis is an inflammation of the gingiva, or gums. It is found in well over 60% of adults over age 45 or nearly 100%, according to some dentists and is usually the result of poor dental hygiene. It is the first stage of periodontal disease and unless corrected usually leads to periodontitis, a more serious disease that can affect both tooth and jawbone.

In most cases, gingivitis is caused by the accumulation of plaque (a soft, colorless substance composed of mucus, food particles, saliva and bacteria) on the teeth and gums. Plaque can be kept in check through regular toothbrushing and flossing but in less than two days without such care can inflame the gum tissue, causing swelling and bleeding. In some cases, gingivitis is the result of a deficiency in vitamin C, a reaction to certain prescription drugs, and open mouth breathing. It sometimes occurs during pregnancy, and can be a warning flag of more serious disease such as diabetes or leukemia.

How is it diagnosed?

Gingivitis signs and symptoms

  • Gums that are swollen, tender, red and soft around the teeth.
  • Gums that bleed easily.
  • Bad breath.
  • Fever (rarely).
  • No pain.

History: Most individuals discover gingivitis as a result of "pink toothbrush" (a toothbrush stained with blood).

Physical exam: The gums appear red or purple, are often overgrown, and bleed easily. Other signs include a build up of plaque and tartar along and under the gumline.

Tests: No tests are necessary to diagnose gingivitis.

How is Gingivitis treated?

Generally, a thorough professional cleaning, followed by proper and regular at-home brushing and flossing is sufficient. Most individuals are advised to begin using an antibacterial mouthwash on a regular basis, to use an electric toothbrush and, if they are smokers, to stop smoking. Individuals whose gingivitis has resulted from medications may need to reduce their dosage or change to another medication. Some may require minor surgery to remove the excess tissue that has grown.

Medications

  • Antibiotics to fight infection.
  • Fluoride mouthwash.
  • Vitamins, if you have a deficiency.
Information Brand Generic Label Rating
buy Metronidazole Flagyl Metronidazole Off-Label
Ilosone Erythromycin
Cleocin Clindamycin
Doryx Doxycycline

Diet

No special diet. Avoid candy, sweet drinks or sweet snacks. Sugar stimulates the production of acid, which attacks normal teeth. The best desserts are fruit and cheese, rather than ice cream or other high-sugar desserts.

What might complicate it?

Untreated gingivitis can lead to more serious dental disease. Individuals with heart conditions and gingivitis are at risk for infective endocarditis if treatment is begun without preventive antibiotic therapy.

Predicted outcome

Most individuals see a dramatic improvement in their gums within a few weeks after a professional cleaning and thorough at-home care.

Alternatives

Gingivitis can be a warning sign of diabetes, leukemia, or eating disorder.

Appropriate specialists

Dentist, periodontist, and oral surgeon.

Notify your physician if

  • You or a family member has symptoms of gingivitis.
  • The following occur after treatment:
    • Bleeding increases.
    • Pain becomes intolerable.
    • Temperature rises to 101°F (38.3° C) or higher.
    • Neck or face becomes swollen; swallowing becomes difficult.

Last updated 17 November 2011


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