Dr Maryanne Mwikali

Gingivitis is the inflammation of the gingiva or gums and it is the commonest cause of periodontal diseases. Periodontal diseases affect the tissues supporting the teeth, which include the bone, gum and soft tissue.

The most common type of gingivitis is called plaque-induced gingivitis caused by plaque.

Plaque is a collection of food debris, saliva and a build up of bacteria on the teeth or between them and on the gum. Plaque build-up occurs in poor oral health with poor brushing habits and techniques.

Receding gum

The bacteria in the plaque invade and infect the gum, causing gum inflammation. In the absence of treatment, chronic gingivitis leads to receding gum, which pull away from the teeth and bone causing permanent damage to teeth.

Other factors that cause gingivitis are, hormonal changes, especially in pregnancy, medications like phenytoin and systemic diseases like diabetes. Bacteria, viral and fungal infections are also associated with cause of gingivitis.

The main symptoms of gingivitis are:

• Swollen, inflamed bright-red or purple gums.

• Bleeding gums: When brushing and eating or the bleeding can be spontaneous.

• Gum that is painful and tender to touch

• Gum recession: Gum pulling away from the teeth leaving exposed sensitive roots of teeth.

• Halitosis: Unpleasant bad breath.

• Shiny and stretched gum: Losing the stippling nature of normal gum also referred to as the orange peel appearance.

• Gum ulceration in severe cases.

Treatment

The main treatment for gingivitis is scaling and polishing also known as professional cleaning.

This treatment focuses on removing the causative agent, plaque. In addition to the above, root planning (cleaning of involved roots of the teeth), curettage may be done.

To augment the above treatments, antibiotics, mouthwashes with chlorhexidne or hydrogen peroxide may also be prescribed to aid in reducing the bacterial load in the mouth. Analgesics may also be given to relieve pain in painful gingivitis. Lack of treatment may lead to the progression of gingivitis to a more destructive form of periodontal disease known as periodontits.

It destroys not only the gum, but also the bone supporting the teeth and the ligaments holding the teeth to the bone leading to very weak, mobile and shaking teeth, which are sensitive and appear longer than usual. Usually their roots are exposed. Eventually, these teeth are lost due to lack of support.

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