Gingivitis – causes and treatment

Gingivitis (gingivitis)

Gingivitis (gingivitis) – Recognize the precursor of a periodontal disease and treat it purposefully

A Gingivitis (med gingivitis) is much more common than you think. It manifests itself, for example, through blood spitting out after brushing your teeth and bad breath.

With such a gingivitis, the gingivitis, would have been years ago, sooner or later, the loss of the tooth inevitable. Today, dentistry is much further. Through targeted prophylactic treatment measures, the focus is more on the maintenance of teeth on a broader basis. Gingivitis can be cured in this context before it has a chance to grow into a periodontal disease.

Table of Contents

What is a gingivitis?

Gingivitis is primarily an inflammation of the marginal gum (gingiva) due to bacterial plaque. Deeper areas of the periodontium (periodontium) are not affected for the time being.

Gingivitis can lead to a periodontal disease untreated by spreading the bacteria through a periodontal pocket. The inflammatory decomposition products in the periodontal pockets lead to irreversible destruction of the entire periodontium with bone loss. In the end stage of this periodontitis loose teeth arise and it comes in the long term for tooth loss.

What causes lead to gingivitis (gingivitis)?

The causes of gingivitis are manifold. But there is no doubt that microorganisms play the main role in the development of gingivitis and periodontal disease. Gingivitis (gum inflammation) and periodontitis are the expression of the inflammatory reaction of the entire periodontium (periodontium), triggered by plaque and tartar, which can damage the gums in the immediate vicinity of the tooth neck.

If tooth decay has attacked the tooth enamel, deep niches at the transition to the gum can also form on the neck of the tooth, which then represent an excellent reservoir for bacteria and thus cause the onset of gingivitis and later periodontitis.
Gingivitis, for example, may be due to periodontal infection, pressure points of full dentures or viral diseases of the oral mucosa, and more rarely other causes such as:

  • Badly fitting dentures
  • Pregnancy gingivitis
  • Heavy metal poisoning (mercury, amalgam)
  • Blood disorders (leukemia)
  • Metabolic diseases (diabetes mellitus)
  • Vitamin C deficiency (scurvy)
  • Frequent bleeding gums
  • Alcohol and nicotine abuse
  • Immunodeficiency immune deficiency
  • Inflamed gums on breakthrough of wisdom teeth
  • Caries and xerostomia (xerostomia)

Read more about gingivitis and tooth inflammation here:

  • Plaque: guardrail for gingivitis and periodontal disease

Risk factors for gingivitis

In addition to a lack of oral hygiene and the resulting proliferation of pathogens and bacteria, there are factors that favor gingivitis and bleeding gums. Too much brushing and mechanical disturbances that injure the gums on the neck of the neck can result in gingivitis.
Risk factors for gingivitis:

  • nicotine
  • stress
  • hormonal changes
  • drugs
  • pregnancies
  • Vitamin C deficiency

Symptoms, course and consequences of gingivitis

Typical symptoms of gingivitis are swollen and reddened gums. Bleeding gums is the first sign of inflammation. Therefore, it is worth the trip to the dentist, as soon as you notice that when brushing your teeth.

Often the gums are swollen and are sensitive to pressure and pain through a blister in the mouth at this point. When touched and probing by the dentist it starts to bleed spontaneously. For the people a strong bad breath is noticeable. The gum inflammation usually disappears with the bleeding of the gums and the bad breath after more thorough dental care or after a professional tooth cleaning by a dental hygenist.

The untreated form of gingivitis passes into the clinical picture of a periodontal disease. Since the gingiva retreats via tooth enamel and cementum due to chronic gingivitis, the tooth necks are immediately exposed, which also cause the symptoms of sensitive teeth that hurt when in contact with cold, heat or acid. If the inflammation in the periodontal pocket can not be stopped, a periodontal abscess in the oral cavity can develop in the case of a heavy course and weakened defensive position of the organism.

How does gingivitis affect the gums and periodontium??

The gums are known in Latin as gingiva. A gingivitis is called gingivitis. The gum is the tissue component of the so-called periodontium apparatus.
The periodontium (periodontium), which surrounds the natural tooth, consists of the following components:

Of the Periodontal apparatus (periodontium), which surrounds the natural tooth, consists of the following components:

  • gums
  • cementum
  • Gingival fibers (desmodont)
  • Jawbone (alveolar bone)

The tooth is firmly anchored by this periodontal apparatus through the gum fibers. Damage to the periodontium (including gum inflammation) leads to a weakening of this anchorage and ultimately to tooth loosening.

What effects can gingivitis and periodontal disease have??

It can be assumed that in Germany every adult over the age of 18 is suffering from a form of gingivitis and periodontal disease.>

Both are equally responsible for the loss of natural teeth. The onset of periodontal disease is partly genetic and, above all, depends on the disposition of the patient. The type and number of bacteria in the mouth determine the clinical picture and the course.

Difference chronic and acute gingivitis

Acute gingivitis is the symptom of an immune reaction of the body on the excretions of bacteria (endotoxins), which penetrate through the oral mucosa or the gums into the bloodstream. The breeding ground for the formation of bacteria forms the plaque layer on the teeth and in the interdental spaces. It comes to the redness of the gums, increased bleeding tendency and possibly also to sensitivity to pain.

Acute gingivitis may increase to acute necrotizing ulcerative gingivitis (ANUG), where suppuration occurs and the interdental papillae are destroyed, that is, gum is missing after healing. The trigger for both acute forms of the disease, in addition to poor oral hygiene, may be the effects of mechanical stimuli such as injuries to the mouth or burns or chemical burns.

If acute gingivitis is not or only insufficiently treated, it can become chronic. 80 to 90 percent of all adults suffer from chronic gingivitis whose severity can be determined by the different bleeding tendency of the gums. Often, a tartar that has not been removed for long periods of time also plays a role, which has led to a permanent irritation of the gums due to the sharp-edged calcareous deposits.

Since the mild forms of chronic gingivitis are painless, the sufferers often know nothing about this disease and it remains untreated for a long time. Almost always the lack of oral hygiene in conjunction with a corresponding constitutional disposition is the cause.

What sequelae and diseases can arise?

When gingivitis progresses unhindered, periodontitis and halitosis develop. At this stage, the inflammation has already led to damage of the periodontium. Above all, the bones and the connective tissue are affected. The gums form back and the delicate tooth necks and root parts are exposed and provide the caries attack surface. This often results in tooth inflammation. Such inflammation of the teeth is often associated with pain, as the sensitive tooth nerves are affected. The affected teeth loosen and are thus no longer suitable as bridge abutments for the prosthetic restoration in case of tooth loss.

However, the consequential damages are not limited to the mouth and jaw area. Bacteria enter the bloodstream from the inflamed periodontal pockets and weaken the immune system. Periodontitis patients are at high risk of developing diabetes, stroke or heart attack. Pregnant women with severe periodontitis experience miscarriages 8 times more frequently.

How to prevent gingivitis?

Careful oral hygiene can prevent the development of the dangerous plaque, which is the bacterial breeding ground for gingivitis.

Proper oral hygiene – mouthwash such as Listerine and a mouthwash support

In the first place here is the tooth brushing call. An oral irrigator and a mouthwash can help to clean the gingiva. It is important to clean your teeth every morning and evening. In order not to injure the gums, attention should be paid to a suitable brush strength and not be over-cleaned. The right cleaning technique also needs to be learned. Today, the so-called sweeping technique is usually recommended, in which with little pressure and a soft medium-toothbrush from red (gums) to white (tooth) to be cleaned. In addition, tooth />

If necessary, medical and non-medical mouthwashes having an antibacterial action such as Listerine or Chlorhexamed can be administered orally (also in combination with an oral irrigator). Mouthwashes such as Listerine are now available in different flavors. However, medical mouthwashes such as Chlorhexamed are not suitable for daily use over extended periods of time. Ask us for suitable mouthwashes. A comprehensive oral hygiene is often sufficient in the early stages of gingivitis to push back. A mouthwash such as Listerine can help support daily oral hygiene. Listerine is also offered without alcohol. Mouthwashes such as Listerine can be obtained without a prescription in the well-stocked dental care department.

Professional tooth cleaning

Depending on the severity and severity of the periodontal pockets, 2 to 4 times a year the PZR (Professional Dental Cleaning) can be used by the dentist to thoroughly remove the linings in the gum pockets. This also removes the tartar, which represents a bacterial focus. Regular check-ups at the dentist are mandatory for gingivitis prophylaxis and thus effectively protect against gingivitis.

How can I avoid gingivitis??

Heavy smoking promotes the development of gingivitis and its sequelae, such as periodontitis. Excessive stress is one of the risk factors that weaken the immune system. One form of prevention in these cases would be to reduce cigarette consumption and reduce stress.

Risk groups for gingivitis

The risk groups for periodontal diseases include pregnant women due to their altered hormonal status and people whose susceptibility to gingivitis is genetically motivated. If the latter is suspected, a so-called Paro-Gen test can be performed to obtain confirmation. High-risk patients are people with blood sugar fluctuations, diabetes or rheumatism. These vulnerable groups must pay particular attention to consistent dental hygiene and prophylaxis in order to prevent damage.

Treatment of gingivitis

Since no patient has the same conditions in his oral cavity and in his periodontium, in the dental practice each patient should receive an individually tailored oral hygiene program.

The status of individual oral hygiene determines the prevalence and severity of gingivitis. The control and removal of plaque and tartar, especially at the gum line and all tooth surfaces, is the most effective method for preventing these accumulations on the tooth surfaces. The most reliable way of gum prophylaxis is therefore nothing but the mechanical dental care and the mechanical cleansing of the gum sulcus (furrow on the gum line).

Specialists in the treatment of gum disease

The possibility of training as a specialist in gum treatment and refined methods (laser) in the treatment of gingivitis, this treatment is becoming more and more. Especially in the oral surgery dental practice these methods belong more frequently to the repertoire.

If the principles of modern gum treatment are already implemented in the initial phase by a pretreatment and the current microbiological and clinical diagnostic procedures are used, the treatment of gingivitis is usually successful.

What gives relief?

In any case, a dentist should be consulted as soon as possible. This will clean the affected areas and apply an anti-inflammatory ointment or gel and, optionally, e.g. in the case of an ANUG, prescribe an antibiotic.

Afterwards, a professional tooth cleaning and in many cases the practice of the optimal brushing technique and oral hygiene are indispensable, so that a lasting resolution of the complaints is guaranteed. Painless mouthwashes may be prescribed.

Homeopathy for gingivitis

It is worth considering additional complementary medical measures: homeopathic remedies, Schuessler salts or proven home remedies whose active ingredients have been proven by scientific studies.

These include mouthwashes with lukewarm cooled chamomile tea, as chamomile has a soothing, anti-inflammatory and antibacterial effect. Alternatively, sage ointments or rinsings with sea salt can be used. Clove oil with its well-known antiseptic substance eugenol is a popular home remedy.

Treat acute pain from gingivitis

Acute gum pain can be treated by medication with antibiotics and local rinses (such as hydrogen) or with a special mouth rinse. For acute treatment in the dental practice, the local application of Dontisolon in the periodontal pocket has proven excellent.

Dontisolone contains prednisolone and belongs to the group of glucocorticoids. In local application, the influx of inflammatory cells is inhibited in the pre-damaged gum tissue and acts quickly anti-inflammatory. As a home remedy, gargling with apple cider vinegar has been proven. This home remedy has anti-inflammatory and antibacterial properties. Bleeding gums locally from the gums can be controlled by a three percent hydrogen peroxide rinse by the dentist.

Mouthwashes such as Listerine or Chlorhexamed for gingivitis?

The effect of chemotherapeutic aids prevents the multiplication of gum bacteria and causes a reduction of the microorganisms by metal salts, enzyme derivatives or preparations in mouthwashes and in toothpaste.

In the last 25 years, Chlorhexamed has been able to inhibit plaque formation and eliminate and even prevent gingivitis and thus gum decline. However, this form of mouth rinse with chlorhexidine acts only on the superficial plaque because the solution can not penetrate into the deep portions of the periodontal pocket.

The mouthwashes can also cause the teeth and gums to discolour strongly. Through professional teeth cleaning and subsequent bleaching of the teeth, the dentist can restore the optimal color and dental aesthetics.

How long does it take to heal gingivitis??

Gingivitis, which has not yet had sequelae or chronicity, usually heals within 1 to 2 weeks, provided that it is followed by the dentist and the patient’s consistent involvement in oral hygiene.

However, if periodontitis has already developed and there has been damage to the jawbone and loss of teeth, a comprehensive oral restoration will take time; For example, when a bone structure must be performed in order to use implants.

Gingivitis can also spread to implants?

Gingivitis can also occur with dental implants. A healthy peri-implant cuff of the gums is a prerequisite for long-term osseointegration (implant healing) of dental implants.

If this protection is lost through gingivitis, the implant has no own defenses. In peri-implantitis, the gums retract in the initial phase of the disease. Therefore, especially with implants to ensure a thorough cleaning of the spaces between the dentures.

Would you like to know more about the possibilities of treating gingivitis in the dental practice near Berlin?

Call us now and make an appointment for a free and non-binding consultation at:

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Dr. Frank Seidel

Last update of this page on 08.10.2019 by author dr. Frank Seidel.

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