Gingivitis or gum disease is the mildest form of periodontal disease, in which only the gums are affected.
Gum disease is common in our society and those who suffer from it usually decide to ignore the symptoms, considering them harmless, but this is a serious mistake.
Gingivitis is a reversible periodontal disease and can be managed with a simple treatment plan, but untreated gingivitis can easily become periodontitis.
Gum disease causes
The main cause is the accumulation of dental plaque (bacteria) in the gum line, usually due to poor oral hygiene, but there are many other causes.
The causes of gingivitis are:
- Inappropriate oral hygiene (incorrect brushing technique, misuse of dental floss).
- Hormonal changes (gingivitis associated with the menstrual cycle or pregnancy).
- Orthodontics.
- Vitamin C deficiency.
- Stress.
- Anxiety.
- Xerostomia (Dry mouth due to low saliva production).
- Diabetes.
- AIDS.
- smoking.
- Trauma (wounds).
- Impacted teeth (pericoronitis).
- Viral or fungal infections.
Types of gingivitis
Gum disease can be classified into four types:
- Acute gingivitis.
- Desquamative gingivitis.
- Ulcerative gingivitis.
- Hemorrhagic gingivitis.
Acute gingivitis
It is the most common type of gingivitis, it does not cause any pain and usually goes unnoticed, although the gums may bleed easily.
Desquamative gingivitis
This type is characterized by gingival erythema (severe redness) that causes pain, bleeding, peeling of the gums, and a burning sensation in the gingival mucosa, sometimes ulcers can appear on the gums.
Desquamative gingivitis does NOT occur due to the accumulation of dental plaque, but rather due to an exaggerated immunological reaction of the gums to irritating agents.
The main cause is usually stress, whether it is physical or emotional stress, and can appear along with dermatological diseases such as dermatitis or psoriasis.
Ulcerative gingivitis
Also called ANUG (acute necrotizing ulcerative gingivitis), it is a type of severe gum disease that appears suddenly causing pain in the gums, bleeding, sialorrhea (excessive salivation), and bad breath.
The gums present sores similar to perforation and are covered by a layer of grayish tissue, this makes eating and talking painful for the patient, ulcerative gingivitis produces moderate to intense fever.
This is a very unusual type and only manifests itself in people with diseases that affect the immune system, such as HIV/AIDS.
Hemorrhagic gingivitis
It is characterized by profuse bleeding, usually caused by the chronic accumulation of dental calculus (calcified dental plaque).
It can also originate due to trauma or physical injuries to the gums, such as aggressive brushing or a blow, or it can appear as a consequence of a systemic disease that affects blood coagulation mechanisms.
Gum disease symptoms
The reason why many people are not aware that they have gingivitis is that its symptoms are, at first, very inconspicuous. Mainly because in most cases gingivitis does not cause any pain.
These are the early signs of gum disease that you should be aware of:
- Inflammation and redness of the gums (infected gum).
- Bleeding gums.
- Halitosis (bad breath).
- Receding gums (this makes the teeth appear longer than normal)
- Tooth sensitivity.
Treatment for gingivitis
The basic treatment is professional deep cleaning for gum disease (scaling and root planing). Professional cleaning removes dental plaque and calculus that irritate the gums.
In most cases, a deep cleaning is enough to reverse gum disease and it will be a matter of time before the gums heal completely.
As a general rule, it is advisable to have a professional cleaning at least every 6 months, to avoid plaque accumulation and prevent gum disease.
It is also necessary to adopt a correct oral hygiene routine at home, this includes using a suitable toothbrush, mouthwash, and dental floss.
A correct brushing technique also makes a difference, in case you have trouble making the right movements, an electric toothbrush could help.
Severe gum disease treatment, on the other hand, might include surgical procedures such as gum grafts to restore gum recession and gingivectomy to remove infected tissue.
Advanced gum disease will require various follow-up appointments since it will need maintenance deep cleaning to ensure the gums are healing properly.
Gum disease treatment cost
The cost of gum disease treatment will depend on the severity of the disease, as an estimation, the treatment for mild gum disease costs around 200$, and moderate and advanced gum disease can go up to 1.500$-3.000$.
Gum disease treatment cost is usually covered by health insurance companies.
Antibiotics for gum disease
Although almost all cases of gingivitis can be reversed with professional dental cleaning, some require supportive antibiotic therapy so that the gums can heal properly.
This usually involves the use of mouthwashes or gels that contain antibiotics such as doxycycline but remember that you should only use medicated mouthwashes under the supervision of a dentist.
It is also important to highlight that the use of these mouthwashes is temporary and their prolonged use can have adverse effects on oral health.
Gingivitis treatment at home
Home treatment of gingivitis consists of adopting stricter hygiene habits, brushing your teeth at least twice a day is generally recommended, but if you are trying to recover from gingivitis, we suggest that you brush after each meal or appetizer.
Using toothpaste for sensitive gums could also improve healing by being gentler than common toothpaste, a good option recommended by dentists is ensodyne for gingivitis and sensitive gums.
Purchasing an electric toothbrush can help you get rid of gum disease as these can be more effective at removing plaque while being gentle enough to not injure the gums, plus, getting a water flosser could be a good addition to your oral health routine.
Some natural treatments for gum disease can relieve your discomfort, but we suggest you do not try anything you read on the internet as not all of them are effective and can even cause more problems.
An effective and safe home remedy is to use Aloe Vera to massage the gums gently, this will reduce inflammation and stimulate healing, making the healing process of your gums faster.
How to prevent gum disease
The foundation is oral hygiene:
- Brush at least twice a day, especially before going to sleep.
- Floss your teeth at least once a day.
- Use a mouthwash.
- Visit the dentist for a professional cleaning at least 2 times a year (every 6 months).
- Maintain a healthy diet.
- If you are a smoker, quitting cigarettes is the best way to take care of your oral health.
Gingivitis and Pregnancy
Gum disease is frequent in pregnancy due to hormonal changes experienced by women, these changes produce an increase in the blood supply to the gums, making them more prone to bleeding as well as a hyperreactivity of the immune system, causing the gums to react with inflammation to small stimuli.
Frequently asked questions about gingivitis
What is the difference between periodontitis and gingivitis?
Gingivitis is the initial phase of periodontal disease and affects only the gums, periodontitis is an advanced stage of periodontal disease and affects the gums, the periodontal ligament, and the bone that surrounds the teeth.
Is gingivitis contagious?
No, gingivitis is not contagious, bacteria that causes gum disease is normally present in everyone’s oral cavity, for a person to develop gingivitis they must be susceptible to infections.
It is possible to cure gum disease without a dentist?
It is possible in very mild cases of gingivitis since improving their oral hygiene routine will be enough, but remember most people don’t realize they have gum disease until symptoms get worse and they visit a dental clinic.
What is the best Waterpik for gum disease?
The Waterpik Aquarius is the dentist’s favorite choice for complementing the oral hygiene routine in patients with gum disease.
You can also try the Philips Sonicare Power Flosser 5000.
Does gingivitis cause fever?
Usually not, since gum disease does not cause any symptoms at first, but in some cases, gum infection can cause a fever.
What is a gum disease specialist?
A dentist specializing in gum disease is called a periodontist, they are oral health professionals trained to cure diseases that affect the supporting tissues of the teeth, such as gums and bones and they are qualified to perform a series of advanced procedures to rehabilitate the oral cavity, including surgeries and tissue grafts.
Can gingivitis cause bad breath?
Yes, when gums bleed, the blood is metabolized by the mouth’s bacteria and it produces a strong smell that causes bad breath.
Gingivitis and orthodontics
Orthodontics makes oral hygiene difficult and therefore can contribute to the accumulation of bacteria that cause gum disease, but in addition to this, in poorly planned orthodontic treatments, tooth movements done by braces can cause gingivitis and gingival recession.
Is gingivitis hereditary?
No, no periodontal disease is hereditary.
Can I have gingivitis around one tooth?
Yes, that’s called localized gingivitis and usually occurs due to a physical lesion, e.g. when you repeatedly hurt certain areas of your gums while brushing.
Gingivitis and dental implants
Sometimes, the placement of a dental implant can cause mucositis, which is the inflammation, redness, and bleeding of the gums that surround the dental implant.
It is also caused by dental plaque. It is usually problematic but it is reversible and therefore it is possible to save the dental implant.
What does gingivitis look like?
A person with gingivitis will have reddened gums, will experience gum bleeding when brushing or eating, and will probably feel discomfort when eating too hot or too cold foods due to increased sensitivity in the gums.
What should a healthy gum look like?
Healthy gums are pale pink, thin in appearance, should fit perfectly to the shape of the teeth, and, most importantly, healthy gums do not bleed, neither when eating nor brushing.
References
- Bamashmous, S., Kotsakis, G. A., Kerns, K. A., Leroux, B. G., Zenobia, C., Chen, D., Trivedi, H. M., McLean, J. S., & Darveau, R. P. (2021). Human variation in gingival inflammation. Proceedings of the National Academy of Sciences of the United States of America, 118(27). https://doi.org/10.1073/pnas.2012578118
- Rathee M, Jain P. Gingivitis. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557422/
- InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Gingivitis and periodontitis: Overview. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279593/
