Gingivitis is the medical name for gum (gingiva) inflammation. The ailment is usually caused by an acid generated by bacteria in the mouth. These bacteria live in a thin, sticky film, known as plaque, that coats the surfaces of teeth and the tongue, and they act mainly on certain carbohydrates in foods. Plaque eventually hardens into tartar, a hard mineral shell that forms around the gum line and erodes healthy gum tissue.
If you ignore proper dental care, gingivitis can quickly lead to a more serious dental problem, periodontitis (also called pyorrhea). Periodontal disease isn’t painful in itself, but it is the leading cause of tooth loss in adults. In advanced periodontal disease, gums recede and pockets form under the gum line, where bacteria move in and erode the supporting bone that anchors the teeth. Gingivitis is the mildest form and earliest stage of periodontal disease, and the only one that can be halted and even reversed with proper dental care.
Symptoms of Gingivitis
- Gum swelling, tenderness, toothache and redness. Gums may bleed easily during brushing
- Chronic bad breath; a bad taste in the mouth
- Loose teeth, deep pockets between your gums and your teeth
- Dentures do not fit properly when biting
What Causes Gingivitis?
About one-third of the population is thought to have a genetic susceptibility to gum disease, and there is now a test available to detect this. But even if your test is negative, you can still develop gum disease and still need to take the same care of your teeth. A number of lifestyle factors also promote gingivitis. The most common one is improper or poor oral hygiene. A poor diet, especially a diet high in sugar, is a factor, as is smoking, since the chemicals in tobacco smoke have harmful effects on the gums and teeth.
Hormonal changes, particularly in women, can adversely affect the gums. Oral contraceptives may increase susceptibility to gum disease, and women may also find themselves more prone to gingivitis during puberty, pregnancy, menstruation, and menopause.
Because saliva helps wash away sugars as well as bacterial toxins, anything that decreases saliva production—which includes certain medications—can make gum disease worse.
New Treatment: Topical Antibiotics
Using topical antibiotics—applied directly to the gums—is a new and promising treatment for gum disease, and your dentist may suggest it. But it is recommended only for people whose periodontal disease has not responded to conventional therapy or has recurred.
There are a number of ways to apply antibiotics directly to the gums: with floss-like cords impregnated with medication, with gels, or with liquids applied to periodontal pockets (the areas below the gumline that are most difficult to treat). Several studies have found that antibiotics can help, but no more so than scaling and planing the teeth (to remove tartar) as an initial treatment. That is, conventional treatments, including meticulous care at home, should precede the use of antibiotics.
If you are using topical antibiotics, you should be seeing your dentist frequently for scaling and planing. Topical antibiotics sidestep the potential adverse effects of antibiotics that you swallow. However, the treatment is not recommended for pregnant women, chil
What If You Do Nothing?
Though gingivitis affects only your gums, ignoring it may lead to more serious dental problems, including eventual tooth loss. If the condition worsens, you may develop chronic bad breath and more bleeding. With severe periodontal disease, teeth may loosen, and you may notice gums pulling away from teeth.
Home Remedies for Gingivitis
Once you discover symptoms of gingivitis, you should consult your dentist to determine the cause and extent of gum disease. In addition to whatever treatment your dentist recommends, good oral hygiene is crucial in halting or reversing the problem.
- Brush your teeth regularly. Using a soft nylon-bristle toothbrush, brush at least twice daily. You can use a circular brushing motion or a straight, downward one. But to focus on the gum line, a back-and-forth scrub may be needed. Brushing teeth too vigorously may lead to an erosion of the gums and, eventually, sensitive teeth.
- Brush your tongue. It collects the same amount of bacteria that stick to your teeth.
- Floss teeth and gums. Each time you brush your teeth, be sure to floss afterward. Using a gentle sawing motion, ease the floss between the teeth, forming a crescent against one side of a tooth. Use your thumbs and index fingers to stabilize the floss. Lightly scrape up and down the tooth, from just under the gum line to the chewing surface.
- Mouth Rinses. Anti bacterial mouthwashes containing the ingredient chlorhexidine (PerioGard®, Peridex®) can also help treat gum inflammation.
- Consider home dental devices. Consult your dentist about an ultrasound toothbrush, a plaque removal device such as Interplak or Sonicare, or an irrigation device such as Water Pik.
Good oral hygiene—most important, daily brushing and flossing—is the best way to protect against gingivitis. In addition, be sure to have regular dental checkups.
Beyond Home Remedies: When To Call Your Doctor
Contact your dentist if you develop symptoms of gingivitis.
What Your Doctor Will Do
Following a detailed oral examination, your dentist will determine the extent of gum disease. Depending upon the stage of periodontal disease, you may need a prescription mouth rinse, oral irrigation with an antibiotic solution, general antibiotic treatments, more thorough removal of tartar under the gum line, or surgery. Your regular dentist will probably refer you to a periodontist. A wide range of treatments, including the use of topical antibiotics, is available.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media