Gingivitis

Inflammation of the gums, usually caused by poor oral hygiene

  • More common in females
  • Poor oral hygiene is a risk factor
  • Age and genetics are not significant factors

Mild gingivitis, also known as gum disease, is a very common disorder and occurs in about 9 in 10 adults. Healthy gums are pink or brown and firm. In gingivitis, the gums become purple-red, soft, and shiny. They also bleed easily, especially when the teeth are brushed. The condition is usually caused by a build-up of plaque (a deposit of food particles, saliva, and bacteria) where the gums meets the base of the teeth. Once plaque has formed on the teeth, it can become hardened by taking up minerals from the saliva, and it is then known as calculus (tartar). This can only be removed by a dentist or hygienist.

Gingivitis can be made worse by taking certain drugs, such as phenytoin (see Anticonvulsant drugs), immunosuppressants, and some antihypertensives. These drugs may cause overgrowth of the gums, making the removal of dental plaque difficult. Certain contraceptive drugs can also make symptoms worse. Pregnant women are more susceptible to gingivitis because of dramatic changes in hormone levels during pregnancy.

A rare but severe form of gingivitis is known as acute necrotizing ulcerative gingivitis (ANUG) or “trench mouth”. ANUG usually occurs in teenagers and young adults. The condition sometimes develops from chronic gingivitis and is caused by an abnormal growth of the bacteria that normally exist harmlessly within the mouth. ANUG is more common in people who are under stress or run down and in people with AIDS (see HIV infection and AIDS).

What are the symptoms?

The symptoms of gingivitis develop gradually and usually include:

  • Purple-red, soft, shiny, swollen gums.

  • Gums that bleed easily when the teeth are brushed.

If gingivitis is not treated, the gums become inflamed and the fibres connecting the gum to the teeth are destroyed (see Periodontitis). This can leave a pocket between the gum and teeth in which more plaque and calculus accumulate, leading to further destruction. The inflammatory process can also destroy the bone supporting the teeth. The gums may recede and leave part of the tooth roots exposed. Eventually, one or more teeth may become loose and fall out.

Symptoms of ANUG usually develop over 1–2 days and may include:

  • Bright red gums that are covered with a greyish deposit.

  • Crater-like ulcers on the gums.

  • Gums that bleed easily.

  • Bad breath and a metallic taste in the mouth.

  • Pain in the gums.

As ANUG progresses, the lymph glands in the neck may become enlarged, and a fever may develop.

Gingivitis

In gingivitis, the gums become inflamed and soft due to a build-up of plaque on the teeth. The gums also bleed easily.

What is the treatment?

If you have gingivitis, your dentist will probably scale your teeth to remove the plaque and calculus (hardened plaque). The procedure involves using an ultrasonic scaler to remove the calculus and scraping away at resistant areas with a hand tool. The teeth are then polished. Regular follow-up visits may be needed to monitor the condition of your gums. Your dentist may also recommend that you use a mouthwash that contains hydrogen peroxide, which helps to prevent plaque from building up.

If you have ANUG, your dentist will clean carefully around all the teeth. He or she will also prescribe antibiotics and an antiseptic mouthwash. Painkillers may be prescribed. Once your teeth have been thoroughly scaled and cleaned, your gums should gradually return to normal.

You can prevent gingivitis by adopting good oral hygiene (see Caring for your teeth and gums).

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.

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