Pathogenesis (development of disease)
Gingivitis is caused by pathogens that can spread, usually due to inadequate tooth cleaning, and then damage the gums (gingiva). This is how inflammation is triggered. As a result, gingival pockets may develop, in which bacterial plaque accumulates. If not treated, this plaque solidifies and leads to tartar. This, in turn, promotes the maintenance of the inflammatory process.
Etiology (causes)
Biographic causes
- Hormonal factors – during puberty or pregnancy.
Behavioral causes
- Nutrition
- Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
- Consumption of stimulants
- Alcohol
- Tobacco (smoking)
- Drug use
- Amphetamines (indirect sympathomimetic): ecstasy (3,4-methylenedioxy-N-methylamphetamine, MDMA), crystal meth (methamphetamine) or methylphenidate.
- Psycho-social situation
- Stress
- Lack of oral hygiene: plaque not removed regularly.
Causes related to disease
- Diabetes mellitus (diabetes)
- Infection with bacteria such as β-hemolytic streptococci (streptococcal infections).
- Leukemia (blood cancer)
- Fungal infections, especially with Candida albicans.
- Viruses such as herpes viruses, Epstein-Barr virus (EBV; trigger of Pfeiffer’s glandular fever) or the cytomegalovirus (CMV).
- Vitamin C deficiency
Medication
- Anabolic steroids – drugs often used as doping agents that promote muscle growth.
- Calcium antagonists – drugs used for hypertension (high blood pressure) such as amlodipine or nifedipine.
- Hydantoins – drugs that used to be used for epilepsy; today, only phenytoin from this group is used
- Immunosuppressants – drugs such as ciclosporin (cyclosporin A), which are used to suppress the body’s immune system.
