Gingivitis: The Earliest Stage of Gum Disease

If you have noticed your breath smelling unpleasant or your gums looking swollen and puffy or bleeding, especially after eating or brushing your teeth, it is highly likely that your gums are inflamed and you are suffering from a condition known as gingivitis. Gingivitis, usually referred to as gum disease, is typically treatable with oral hygiene improvements, and its progression can be halted with effective home care strategies in conjunction with professional treatment.

Although it might not sound very concerning, it’s crucial to note that if left untreated, it can advance into periodontitis, a debilitating disease affecting the gum tissue and the underlying bone, potentially leading to gum recession and tooth loss. 

Severe gum disease is a global health concern, affecting a staggering 1 billion people worldwide, making up 19% of the adult population. This further underscores the importance of understanding how this condition occurs and what you can do to prevent it. This article sets out to explore gingivitis in detail, shedding light on its causes, risk factors, diagnosis, treatment modalities, and prognosis.

What causes gingivitis?

Gingivitis is most commonly caused by not taking good care of your oral hygiene. When you don’t clean properly around your teeth and gums, you allow food debris to accumulate there, forming a biofilm of plaque that harbors bacteria. 

When you eat, the bacteria in your mouth feed on food debris, like sugary and starchy foods, producing acid as a byproduct. This breaks the food down into a sticky, acidic film—what we know as dental plaque, the main culprit that causes gingivitis.

How does plaque lead to gingivitis?

Plaque forms quickly and needs to be removed daily by brushing and flossing properly around your teeth and gums. If it is not cleaned, it hardens under your gum line into tartar, also called calculus, which traps more bacteria and provides a safe haven for them to thrive. This yellow-white hard layer of calculus, teeming with bacteria, irritates the gumline, causing gum inflammation.

Once hardened, you cannot remove this layer by brushing alone; you need professional dental cleaning and scaling to get rid of it effectively. The longer you delay treatment, the longer it remains on your teeth and grows under the gumline, irritating the gums and worsening inflammation. With time, your gums start to look swollen and red and bleed easily. This condition is called gingivitis, and if not treated on time, it can lead to tooth decay, tooth mobility, periodontitis, and, in severe cases, tooth loss.

What are the risk factors for gingivitis?

Gingivitis is a fairly common problem that can develop easily if you ignore oral hygiene. In addition to poor oral health, there are a few other factors you need to be mindful of that can increase your risk of gingivitis.

• Chewing or smoking tobacco or tobacco products.
• Old age.
• Dry mouth (xerostomia).
• Poor nutrition devoid of important vitamins, especially vitamin C. Vitamin D and vitamin B12 deficiencies are also linked to gingivitis. 
• Dental restorations and tooth repair treatments that don’t fit properly or are in poor condition, such as fillings, bridges, dental implants, or dental veneers.
• Crooked teeth or malaligned teeth that are hard to clean.
• Systemic health conditions that affect the immune system, for example, leukemia, HIV/AIDS, or cancer treatment, have been associated with a higher risk of gingivitis. 
• Certain medications and drugs that reduce saliva production or cause abnormal gum growth make it hard for you to clean the gums and, thus, increase the chances for your gums to get inflamed. These include phenytoin (Dilantin, Phenytek, others) for epileptic seizures and some calcium channel blockers used for angina, high blood pressure, and other health conditions.
• Hormonal changes, such as those that occur during puberty, pregnancy, or menstrual cycle, or are caused by the use of birth control pills.
• Genetic predisposition. If you have a family history of gingivitis, you might have a higher risk of developing it. 
• Certain viral and fungal infections

What are the signs and symptoms of gingivitis?

Healthy gums are firm and pale pink in color, fitting snugly around the teeth. Symptoms of gingivitis include:

• Swollen or puffy gums.
• Discolored gums, usually bright red or dark red.
• Gums that bleed easily when you brush or floss.
• Tender, painful, or soft gums.
• Bad breath (halitosis)

It is noteworthy that in the case of mild gingivitis, some patients might not develop any noticeable symptoms or experience discomfort. We encourage you to schedule regular appointments with your dentist or hygienist to keep this from going unnoticed.

Can untreated gingivitis cause complications?

Our oral health is far from being confined to toothaches and sore gums. It affects everything from your diet to your overall well-being and quality of life. This is because diseases of the oral cavity don’t always stay put and can travel to and affect other organs of the body. A close link is emerging between oral health and some of the world’s most prevalent diseases, including cardiovascular disease, diabetes and Alzheimer’s, reflecting the importance of our mouth acting as a mirror of health and disease and functioning as a sentinel for our general health and well-being.

Oral complications:

• Periodontitis. Untreated gingivitis can lead to periodontitis, a deep gum disease that spreads to the underlying soft tissue and bone. This much more serious condition can lead to gum recession and tooth loss.  
• Abscess or infection. Infection in the gums or bone can occur as a consequence of untreated gingivitis.

  

• ANUG (Acute Necrotizing Ulcerative Gingivitis). Although rare, untreated gingivitis can lead to ANUG, or trench mouth, in which the bacterial infection causes gross ulceration of the gums.

Systemic complications:

Your teeth and gums have a great influence on your health, from your risk of Alzheimer’s to diabetes and cardiovascular disease. Untreated gingivitis can lead to periodontitis, whose damaging effects are not merely localized to the mouth but can spread to other organs in the body. Studies show that chronic periodontitis can affect various other systems in your body, including the cardiovascular, respiratory, musculoskeletal, reproductive, endocrine, renal, and even the central nervous systems, either directly or indirectly, negatively impacting overall well-being.

How can you prevent gum disease?

Prevention strategies for gum disease predominantly revolve around maintaining meticulous oral hygiene to keep plaque and calculus from developing around your teeth and gums. 

How is gum disease diagnosed?

Dentists usually diagnose gingivitis based on the following:

• Medical and dental history
  Reviewing your dental and medical history and conditions that may contribute to your symptoms.
• Dental examination
  Examining your teeth, gums, mouth, and tongue for signs of plaque, irritation, or swelling.
• Measurement of pocket depths
  Measuring the pocket depth of the sulcus (groove) between your gums and teeth. A dental probe is inserted beside your tooth beneath your gumline, usually at several sites in your mouth. In a healthy mouth, the pocket depth is between 1 and 3 millimeters (mm). Pocket depths deeper than 4 mm may indicate gum disease.
• Dental x-rays
  Dental x-rays to check for bone loss in areas where your dentist sees deeper pockets.
• Supplementary tests
  If it’s unclear what has caused your gingivitis, your dentist may recommend you get a general medical evaluation to check for other health conditions. If your gum disease has progressed, they may refer you to a gum disease specialist (periodontist).

What is the treatment for gum disease?

Prompt treatment usually reverses symptoms of gingivitis and prevents it from leading to more severe gum disease (periodontal disease) and tooth loss. To get the most out of your treatment, it is imperative that you follow a rigorous oral hygiene routine and completely eliminate tobacco use.

The treatment for gingivitis includes:

• Professional dental cleaning. Professional cleaning entails the removal of all traces of plaque, tartar, and bacterial products from all the surfaces of your teeth and under the gums. This procedure is known as scaling and root planing. Scaling removes tartar and bacteria from your teeth and below your gums, and root planing rids the root surfaces of the bacterial products produced by swelling and irritation, smoothening the root surfaces. This prevents further buildup of tartar and bacteria and allows for proper healing to take place. 

  

  Your dentist or hygienist may use special instruments, a laser, or an ultrasonic device to do these procedures. If you have large calculus deposits that have rendered your gums sensitive, you may experience some discomfort during deep cleaning. However, our team will try their best to make the procedure as comfortable and painless for you as possible. 

• Dental repairs (if needed). Crooked teeth or ill-fitting crowns, bridges, or other types of dental repairs with overhangs of sharp corners may irritate your gums and make it harder for you to remove plaque during daily oral care. If problems with your teeth or dental repairs contribute to your gingivitis, your dentist may recommend fixing these problems.
• Professional advice. Gingivitis usually clears up after a thorough professional cleaning, provided you continue good oral care at home. At Blanc Dentaire, we take the time to sit down with our patients and talk to them in detail about everything related to their dental care. This helps them get the most out of their treatment and maximize its efficacy. After your treatment is complete, your dentist will explain to you the importance of good oral hygiene and teach you how to brush and floss your teeth properly to prevent problems in the future. They will also help you plan an effective at-home program and a schedule of regular checkups and professional cleaning appointments. 
• Follow-up appointments. Your doctor will recommend follow-up appointments at intervals that depend on your oral health condition to monitor the state of your mouth after treatment efficiently. This will allow them to keep an eye on and catch any recurrences quickly if they occur.

If you adhere to your dentist’s recommendations and diligently brush and floss your teeth, you can expect your gums to be healthy within days or weeks. To learn more about gingivitis or discuss your dental needs with a professional, please do not hesitate to contact our dental office and let our doctors provide you with the best care and advice you deserve. Our compassionate and experienced dental team is always looking to help you care for your oral health in any way possible! 

The Takeaway

Gingivitis is the earliest stage of gum disease. It is caused by bacteria accumulating on teeth if they are not kept clean. This bacterial buildup releases toxins that cause irritation of the surrounding gum tissue, resulting in inflammation, discoloration, and sensitivity.

As gingivitis is only mild inflammation of the gums, it is entirely treatable and reversible with good oral hygiene practices. Regular dental checkups are crucial for detecting early signs of gum disease and ensuring prompt intervention.

To schedule a checkup at Blanc Dentaire, click here or call (514)-933-3368 or (514)-564-4554. Let us help you care for your oral health and provide you with expert guidance on how to keep your choppers looking and functioning well for years to come.