Gingivitis Health Article

Definition

Gingivitis is a disorder involving inflammation of the gingiva (gum tissue). It is sometimes called gum disease.

Description

Periodontal disease is a worldwide problem. This mildest form of periodontal disease, gingivitis, is inflammation strictly limited to the gingiva and does not manifest changes in the underlying bone. When bony changes become evident, the condition is termed periodontitis.

There is commonly little or no discomfort with gingivitis. The only people who escape gingivitis are very young infants; otherwise, it affects all age groups and people of all ethnic and racial backgrounds. A bacterial infection of the gums, it causes the gum tissues to turn red and swollen. Mild gingivitis causes little pain, and may be overlooked by the dentist; however, if left unchecked, it can turn into severe gingivitis. Many people experience varying degrees of gingivitis throughout their lives, but overlook it. It commonly develops during puberty or in early adulthood, and may persist or recur frequently.

In studies cited by the American Academy of Periodontology (AAP) in Boston, Massachusetts, 1,259 patients between the ages of 13 and 65 were studied. Of those 1,259 between ages 13 and 15, 80% had some form of gingivitis, while 95% had gingivitis at age 60. Males were more frequently affected than females, with the overall average being 88% and 80%, respectively.

Causes and symptoms

The etiology of gingivitis is especially varied and has been divided into local and systemic factors.

Local factors

• microorganisms
• food impaction
• faulty or irritating restorative orthodontic appliances
• breathing through the mouth, rather than the nose
• tooth malposition
• chemical or drug application

Microorganisms are the bacteria found in plaque. The bacteria that destroy living tissue release many destructive enzymes. Specific microorganisms sometimes cause inflammatory reactions in the gingiva. Streptococcal and Staphylococcal are the bacteria known to destroy tissue and cause inflammation.

Food impaction, or general oral neglect, is the most common cause of gingivitis. The food impacts around the teeth and accumulation of debris on the teeth causes irritation of the gingiva by the toxins in the plaque. The byproducts of the toxins cause swelling of the tissue and redness to occur.

Faulty or irritating restoration, or appliances, may act as irritants to the gum tissue and thus induce gingivitis. Overhanging margins on dental fillings may directly irritate the gingiva and cause food to become impacted; this further adds to making the gum tissue even more tender. When prosthetic or orthodontic appliances encroach on the gingival tissues, gingivitis may occur—the result of the pressure and the trapping of food and bacteria. The tissue may become inflamed, redden, and become painful to the touch.

Mouth breathing (not breathing through the nose) causes drying of the oral mucous membrane and irritates the gum tissue, causing inflammation and hyperplasia of the tissue.

Tooth malposition results in repeated abnormal forces during the eating and chewing of food. Calculus may be deposited on the surface of the tooth that has no force to aid in keeping it clean. Bacteria may begin to attack the tissue around the tooth, resulting in a combination of inflammation and gum recession.

KEY TERMS

Calculus—A hard deposit that forms on the teeth, also known as hardened plaque and tartar.

Edematous—An abnormal accumulation of serous fluid in the tissues.

Gingiva—The gum tissue.

Gum recession—The gum tissue backing away from the crown of tooth towards the root.

Hyperemia—Swelling of the gum tissue.

Local—Pertaining to or being in one particular place.

Systemic—Pertaining to, or affecting the whole body.

Chemical or drug application may cause many gum tissue anomalies. A number of drugs are at least potentially capable of inducing gingivitis. Over-the-counter (OTC) drugs can be harmful to the gum tissue and act as an acid burn if used. Silver nitrate and general aspirin have acidic affects on the gum tissue, causing redness and tenderness to the touch. Dilantin sodium produces swelling of the gum tissue due to the chemicals in the drug.