Gum inflammation (gingivitis) is a bacterial inflamed dental disease of the oral cavity. The cause of this inflammation is mostly due to poor oral hygiene. Typical complaints are bleeding gums, toothache and swelling of the gums. In the course of untreated gingivitis, the gums slowly recede from the necks of the teeth, which can lead to tooth loss. So timely treatment at the dentist is advisable.
What is gingivitis?
Schematic representation of healthy gums, periodontal disease and gingivitis. Click to enlarge. Gingivitis is not something to joke about; it is an inflammation of the gums caused by bacteria in the oral cavity that, if left untreated, can quickly turn into periodontitis, which can injure or even destroy the periodontium forever. Gingivitis here refers to the redness or swelling of the gums, which are inflamed by plaque in the mouth. The gums bleed very quickly when touched, but gingivitis is usually not painful. If gingivitis becomes chronic, it can progress to periodontitis and cause tooth loosening and bone loss.
Causes
Inflammation of the gums most often results from poor oral hygiene. It is caused by bacterial plaque that adheres to the teeth and gum margins. This plaque, which can become tartar after some time, releases bacterial products from metabolic and decay processes that stimulate the body’s defenses. The immune system tries to fight the bacteria. Enzymes are therefore produced to fight the pathogens, but these enzymes also destroy the body’s own tissues, resulting in loss of connective tissue and bone. Thus, bleeding gums occur: gingival pockets form, trapping bacteria, the gums recede, and the teeth become loose in their retaining apparatus. In addition, there are a number of risk factors that promote the occurrence of gingivitis. Such factors are, for example: diabetes, pregnancy, leukemia or certain medications for high blood pressure or epilepsy. However, deficiency symptoms such as vitamin C deficiency, malnutrition or too little saliva (dry oral cavity) can also trigger gingivitis. Anabolic steroids, close spacing of teeth, caries and smoking also do not have a positive effect on oral hygiene and are equally among the risk factors.
Symptoms, complaints and signs
Gum inflammation brings the classic symptoms that characterize acute inflammation. First of all, this is the redness: while healthy gums have a pale color, inflamed gums are often easily recognizable by their highly red appearance, even by the layman. In addition, there is a swelling that often cannot be overlooked either. A bulge can often be seen at the gum line. This is characteristic because the bacteria that trigger the gingivitis can often settle particularly well here. Swelling and redness of the gums in areas where tartar can also be detected are typical. Furthermore, a throbbing pain is typical of an inflammatory reaction in the gums. In addition, there is a tendency to bleed: Inflamed gums often begin to bleed from contact with the toothbrush during normal brushing hygiene. A foul odor and unpleasant taste in the mouth are also typical of gingivitis. These come from the decomposition processes triggered by the bacteria in the mouth. The late symptoms of gingivitis are particularly serious. Due to the inflammation, a space is formed between the tooth and the gum, which further favors the settlement of bacteria. The root area can also be attacked. All of this causes the tooth to become loose in its bed and may even fall out as a late consequence of gingivitis.
Disease progression
If left untreated, gingivitis can become chronic after only a few days. Very quickly, the gums are attacked and irreparably damaged. Tooth loosening can jeopardize the tooth stock in the long term. If the gums are affected due to mechanical irritation, the inflammation heals after a few days without any major difficulties. The situation is different in the case of bacterial irritation. Such an inflammation can last for years, and since it is initially painless, it is not even noticed.Plaque and tartar inflame the gums, which slowly recede and the bacteria have free access to tooth necks. Only after years do pain or loosening of the teeth occur in this protracted process. Therefore, good dental prophylaxis is the be-all and end-all.
Complications
If gingivitis remains untreated, the inflammation can spread to the surrounding tissue. Deposits form in gum pockets, providing an ideal breeding ground for bacteria: These penetrate further and further into the jawbone and damage connective tissue and bone substance. The gums recede, the necks of the teeth are exposed and offer the bacteria room for further destruction. As a result, the teeth lose their anchorage in the jawbone and fall out. However, the complications of gingivitis are not limited to the oral cavity, but can affect the whole organism. Bacteria reach various organs via the bloodstream and can, for example, cause inflammation of the inner lining of the heart (endocarditis) or damage the kidneys. The immune system is weakened, and the risk of suffering a stroke or heart attack also increases. An already existing diabetes (diabetes mellitus) can be negatively influenced by gingivitis. Rheumatic diseases can worsen, occasionally pathogens settle on artificial joints and trigger an inflammatory process. During pregnancy, gingivitis increases the risk of miscarriage, and growth disorders in the unborn child also occur. In the elderly or immunocompromised, there is a risk of bacteria from the oral cavity entering the lungs and causing pneumonia.
When should you go to the doctor?
In the case of inflammation of the gums, a doctor is not needed in a large number of cases. In most cases, the inflammations heal completely after a few days without further complications or sequelae. Medical care is not necessary in these situations, as the body’s own immune system initiates the processes of regeneration. If there is freedom from symptoms within a few days, no further visit to a doctor is necessary. Consultation of a doctor is indicated if the gum inflammations progress continuously as well as show an increasing intensity. If redness around the mouth increases, there is swelling or a purulent taste in the mouth, a doctor should be consulted. If there is a loss of appetite, pain when eating, inner restlessness or irritability, the cause should be clarified. If teeth become loose and irregularities occur with an existing denture or braces, an examination should be initiated. If redness around the mouth appears over several days or weeks, consultation with a physician is also recommended. If there is an increase in body temperature, headaches, fatigue, as well as a persistent feeling of malaise, the affected person should consult a doctor. Help and support is also needed if aphthae form in the mouth or if the health condition deteriorates significantly within a short period of time.
Treatment and prevention
Prevention and treatment of gingivitis include regular visits to the dentist and good oral hygiene (brushing teeth two to three times a day, flossing or brushing between teeth, using a supportive mouthwash now and then) are the simplest and most effective things that can be done to prevent gingivitis. Once or twice a year, a thorough dental cleaning may also be appropriate to really remove all plaque as completely as possible. If the dentist has diagnosed gingivitis or even periodontitis, plaque and tartar must be removed so that the inflammatory condition can improve. After a comprehensive diagnosis by means of X-rays and analysis of the progress of the disease, the next step is cleaning, which involves mechanical cleaning by the dentist, renewal of fillings, possible tooth extraction and rinsing fluids. The patient is also given tips on what good dental care should look like.
Aftercare
Gum inflammation can often be traced back to poor oral hygiene. If food remains in the oral cavity as a result, bacteria can multiply rapidly and trigger the painful inflammation. Thorough and regular dental care should therefore be part of daily personal hygiene.However, care should also be taken not to brush the teeth too vigorously in order to prevent injuries, which can also trigger inflammation of the gums. A strong immune system is needed to prevent pathogens from spreading. A balanced diet, adequate exercise and avoiding excess weight help to strengthen the body’s defenses. Restful sleep and stress-free rest periods also promote the health of the organism. In the case of gingivitis, the patient must pay particular attention to the composition of his diet. Spicy, acidic foods should be avoided, as well as alcohol and nicotine, as they can aggravate the discomfort in the mouth area. The inflamed areas in the mouth should be spared when chewing. Despite the discomfort, however, a thorough cleaning of the teeth should not be omitted under any circumstances, so that bacteria are not hindered to multiply. Toothbrushes with soft bristles and medicated mouthwashes help sufferers to contain the spread of germs and gradually minimize discomfort.
Here’s what you can do yourself
In the case of inflammation, the body’s own defense system should basically be supported. In order to prevent the pathogens from spreading as quickly as possible or to kill them, the organism needs a stable and healthy immune system. This is influenced by the daily diet as well as the behavior of the person concerned. A healthy and balanced food intake, the avoidance of overweight, regular oxygen supply and sufficient exercise promote the general health of the organism. Attention should also be paid to adequate rest periods and restful sleep. In order not to aggravate the complaints in the mouth and throat area, the components of the food should be controlled. Spicy foods, acidic products or harmful substances such as alcohol and nicotine should not be consumed, as they can lead to an increase in existing complaints. Chewing should be shifted to areas of the mouth that are not affected by the inflammation, if possible. Daily tooth cleaning should be performed despite existing discomfort. Otherwise, germs can multiply more quickly and further weaken the general state of health. However, cleaning should be modified in order not to trigger further damage to the gums. The bristles of a toothbrush can otherwise damage the mucous membranes and further. Mouth rinses and cleaning of the interdental spaces can contain the spread of germs and thus lead to relief of existing symptoms.
