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Gingivitis
or Gum Disease

 
 
 

Gingivitis, also known as inflammation of the gums, is a disease of the soft tissues surrounding and supporting the teeth. The gum immediately surrounding the teeth is called Gingiva.

Gingivitis is a bacterial infection caused by microbes in plaque that is allowed to settle and grow around the gingiva. One of the most significant signs of gingivitis is bleeding from the gums.

This is not normal, and is an inevitable indication of disease. It might be noticed on the toothbrush following brushing, in the toothpaste on spitting out, or even on biting into some fibrous foods, eg. apples. In severe cases, the gums might bleed spontaneously, particularly during the night when blood may be found on the pillow.

Most gingivitis is of the chronic type: it is generally painless, has slow onset and is most easily detected by bleeding. Most gums are pink in colour, although they are sometimes pigmented, especially in dark-skinned people. When diseased, the gums look red and may be swollen and loose at the margin where the tooth emerges. There may even be some tenderness if the inflammation is severe.

Who is susceptible to gingivitis? Almost anyone – particularly if their cleaning is inadequate. In between the teeth is a very common area for gingivitis to occur if dental floss is not used daily, and also on the tongue side of the teeth because this is a harder area to reach with the toothbrush. Some people are unusually susceptible: e.g. during hormonal changes as in young people during puberty – the so-called “puberty gingivitis”, and during pregnancy.
Smoking makes people more prone to gum infection from plaque. Other risk factors include stress and general disease, particularly poorly-controlled diabetes. Gingivitis can occur in acute form. The best known is ANUG (Acute Necrotising Ulcerative Gingivitis) formerly known as “Vincent's Infection” or “Trench Mouth”. This condition is extremely painful and is identified by ulcers at the gingival margin, mostly in the peak of the gum between teeth. There is a strong, characteristic smell from the mouth.

ANUG happens because of poor oral hygiene, smoking, stress, poor eating habits or a combination of a number of these factors. It is most commonly seen today in association with HIV (AIDS) infection. ANUG can be effectively treated with mouthwashes and/or antibiotics, but is likely to return if the same causative conditions continue.

The other acute form of gingivitis that is reasonably common is Acute Herpetic Gingivo Stomatitis. This is a primary form of infection by the Herpes Simplex virus, which will probably return in the form of Cold Sores.

If any of the forms of Gingivitis is left untreated, the infection in the gingiva will spread to the underlying bone, and the Periodontal Membrane – the fibrous membrane which supports the tooth in the bone. Once this area has been invaded by infection, the membrane and the bone start to break down. This more advanced form of the infection is called Periodontitis.

 

 

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