The term “gingivitis” refers to an acute or chronic inflammation of the gums, the gingiva. It is essential that gingivitis is not understood as a single disease, but as a spectrum of diseases. These gingival diseases represent the result of various pathological processes in the gum area.
Symptoms of gingivitis are redness, swelling and an increased tendency to bleed.
There are four different types of gingivitis.
Often an optimal cleaning of the teeth is sufficient for treatment.
Gum inflammation is the most common periodontal disease. It is caused by a bacterial mixed infection, the biofilm “bacterial tooth plaque”:
This sticky plaque consists of components of saliva, metabolic products of bacteria, food residues and microorganisms and is a prerequisite for the development of various diseases of the tooth and gums.
How does gingivitis manifest itself?
Clinical symptoms of gingivitis are:
- Tendency to bleed from mechanical stimuli (brushing teeth, biting an apple).
The stages range from mild to severe.
Gingivitis does not lead to any loss of attachment – the periodontium thus remains completely intact – and can heal without lasting damage after removal of the triggering stimuli.
Which forms of gingivitis can be distinguished?
Depending on the underlying and influencing factors, different forms of the disease are classified. These forms include:
In Europe, about 80 to 95 percent of adolescents and adults are affected by this gingivitis. As the disease does not usually cause any pain, it is not noticed by the affected persons themselves and is only recognised during a visit to the dentist.
Plaque-induced gingivitis is caused exclusively by bacterial plaque, which in turn is caused by inadequate or incorrect oral hygiene (so-called dirt gingivitis). Frequent consumption of sticky carbohydrates (sugar, bananas, sweets, soft drinks etc.) favours this formation of plaque.
In addition to this most common form of gingivitis, which in many cases is associated with dental caries, hyperplasia (proliferation) of the gingiva is increasingly found. Most of these forms are hormonal or medicinal, more rarely genetic, or caused by systemic diseases:
Plaque-induced gingivitis, modified by systemic factors
The following diseases and circumstances can influence the development of gingivitis:
- Diabetes mellitus
- Blood diseases (leukaemia)
- Hormonal changes (menstrual cycle, pregnancy)
- Oral contraceptives (pill)
Plaque-induced gingivitis modified by medicaments
Among the medications that can affect the health of the gums are those that are used to treat the gum disease:
- Nifedipine, calcium channel blocker
- hydantoin, phenytoin
- Very rare gingival diseases in our habitat
Inflammation of the gums due to one-sided nutrition, malnutrition or vitamin deficiency (e.g. vitamin C deficiency)
How is gingivitis treated?
Once the diagnosis has been confirmed (periodontitis excluded) by a dentist, the teeth are professionally cleaned (PZR), which also provides patients with information and motivation for efficient oral hygiene at home. If the teeth are cleaned optimally, the symptoms will disappear completely within a maximum of one month.
Exceptions in this respect are gingival diseases influenced by drugs. In these cases, a change in medication is necessary in order to eliminate the symptoms or to weigh up which disease is more in need of treatment.
The prognosis is very good for forms of gingivitis caused exclusively by plaque. Only gingival hyperplasias require after removal of the cause in addition to optimal tooth cleaning sometimes also an operative removal of the growths.
In the case of “host susceptibility” caused by an altered immune defence, an untreated gingivitis can turn into periodontitis with bone resorption and pocket formation. Unfortunately, this often happens, especially if the affected person smokes.
Treatment of gingivitis, perfect oral hygiene at home and proper prophylaxis are therefore the best protection against periodontitis!