What is Gingivitis?
Gingivitis means swelling or inflammation of the gums. It is a very common condition that is present in most of our mouths to some extent.
Do your gums bleed when you brush? This is the classic complaint of someone who has gingivitis. It can occur on its own, or it can be a sign that you have more serious gum disease (periodontitis) and have irreversibly lost some of the bone that supports your teeth. It is best to see a dentist to rule this out. Gingivitis can also lead to periodontitis, so it is important that you get it under control as quickly as possible.
How is it caused?
Gingivitis is caused by a build up of dental plaque. Our body’s response to this bacteria, is to send more natural protection to the area and we do this by the process of inflammation; our blood vessels open up and our gums become swollen.
Gingivitis is mostly a chronic (long lasting) problem where a balance between our body’s defences and the bacteria occurs.
If we get rid of the plaque, we tip the balance in our favour and the gingivitis will clear up; if we don’t, it will stay as it is, or as I have mentioned, can potentially progress to periodontitis.
Anything that makes cleaning your mouth more difficult, such as braces or a partial denture, will make you more susceptible to getting gingivitis, because the plaque becomes harder to remove. Extra care and time spent cleaning is essential in these circumstances. If plaque is left on your teeth, it will over time calcify into calculus (tartar); this cannot be removed by brushing alone and requires a visit to the dentist and a professional clean to get you back to square one.
How do I know I have got Gingivitis?
Gingivitis has a classic appearance, so that once you have seen a few examples, it is easy to spot. In gingivitis, the gums are swollen and inflamed. They are much redder, particularly just round the margins (where the teeth and gum meet). They will probably bleed on brushing, or gentle probing at the dentist. Often the dentist can see the dental plaque which hasn’t been removed or disturbed by brushing; this is responsible for the gum inflammation.
To be able see gingivitis it takes about 5-7 days of plaque build up. That means you have missed brushing the gums in that area for an entire WEEK! Less obvious plaque build up can be highlighted by chewing a ‘disclosing tablet” which does as the name suggests, and shows up any plaque on your teeth.
But ‘I brush twice a day’, I hear you say- well ‘not ideally’ would be my reply… Time to get back to the basics of good oral hygiene.
We brush so often, that we commonly go into autopilot, which means we don’t watch exactly where we are brushing, or check the technique we are using. We may be watching TV, or walking around the house while we brush, or we may be being distracted in someway- so if you have gingivitis, it is certainly time for a refresher.
What do Healthy Gums look like?
Healthy gums are firm, normally pale pink (racial pigmentation may be present) and often have a sort of ‘stippled’ appearance. There is no sign of swelling or any redness and the gums fill the space in-between the teeth. If we were to probe around the gum, there would be no bleeding and the probe would only go to to a depth of about 1-3mm.
In a perfect mouth no root surface would be exposed, but healthy gums can still exist, even if some root surface has been exposed. Root surface exposure is frequently a result of over brushing, that has worn away some of the gum margin, or it may be associated with true attachment loss as in periodontitis.
With the right care, even if you have suffered previous gum disease, you can have healthy gums.
How do you treat Gingivitis?
Gingivitis alone can be reversed completely without too much difficulty. The aim, as with treating periodontitis, is the removal of the dental plaque, which is causing the problem and then preventing the plaque from returning.
A good clean from the dentist or hygienist is needed initially, to remove the tougher calculus and plaque from your mouth. Once you have a clean plaque free mouth, you need to keep it this way- so improving your oral hygiene (the way you brush and floss is essential!
The dentist may apply a disclosing solution to allow you to see the plaque more clearly and identify areas that you particularly need to target.
If you have gingivitis that is superimposed on more serious underlying gum disease (periodontitis) additional periodontal treatment will be required to help the situation.
I also often recommend my patients use a chlorhexidine mouthwash to help clear up their gingivitis that bit quicker. It is particularly useful straight after a good clean from the dentist, but certainly not a substitute for brushing.
Can you tell me more about Chlorhexidine Mouthwash
It is probably the most widely used ‘antibacterial’ and ‘antifungal’ mouthwash and my personal favourite. It is, in my humble opinion without doubt the best mouthwash for controlling plaque and gingivitis. Because it is anti-plaque it can (if used regularly), help to reduce dental caries but long term use is not advised.
It is only recommended for short-term use because of its effect on taste and the fact that using it for months at a time will cause some reversible brown staining to build up on your teeth (don’t worry your dentist can easily polish this off and if just used for a week or so, this won’t happen). One other potential side effect of long term use is the swelling of your parotid salivary gland- a swelling which again is reversible if it happens but is relatively rare.
It is available in most supermarkets such as Coles or Woollies (in Australia) and certainly in chemists.
If your gums are too sore to even brush, it can be a very useful substitute, especially following gum surgery, when it hurts to try and brush or if you have an acute painful condition such as ANUG.
To have more than just a fleeting effect, a mouthwash must hang around in the mouth and Chlorhexidine is one of the only available mouthwashes currently able to do this. It has a positive charge which means it sticks to negative proteins on tooth surfaces, gums and in your saliva; gradually seeping out over time.
All information found in this post is credited to Jamie Workman and can be found on his website www.jamiethedentist.com