Gingivitis: causes, symptoms, treatment

Gingivitis: causes, symptoms, treatment

, Gingivitis: causes, symptoms, treatment

Gingivitis is an acute or chronic infection of the gums. It is mostly caused by bacteria, less often by viruses or fungi. Inflamed gums are almost always due to poor dental hygiene. But an injury to the gums can also cause inflammation. Typical symptoms are swollen, reddened gums and bleeding gums. Read more about causes, symptoms, treatment and prognosis of gingivitis here!

Brief overview:

  • Description: acute or chronic infection of the gums
  • Cause: mostly lack of oral hygiene (with reproduction of bacteria in the oral cavity), sometimes mechanical irritation/injury in the oral cavity
  • Symptoms: Swelling, bleeding, bad breath
  • Examination: usually the dentist only needs a visual inspection, possibly also a probe and, if necessary, an X-ray examination
  • Treatment: careful oral hygiene, cleaning by dentist if necessary
  • Prognosis: Gingivitis usually heals within a few days. If untreated, periodontitis and tooth loss can occur.

Gum inflammation: Causes and risk factors

If the teeth are not cleaned thoroughly on a regular basis, gingivitis can quickly develop. If oral hygiene is inadequate, pathogens can multiply in the oral cavity. The most common are bacteria. There are several hundred different types in the mouth. They belong to the natural oral flora and are normally harmless.

However, if the teeth are not regularly cleaned of food residues, the bacteria literally have a field day – they multiply strongly. The germs, together with food residues, metabolic products and saliva, form a soft biofilm on the teeth, which is called bacterial plaque. In this dental plaque, the bacteria are largely protected from the immune system’s defensive forces.

But that’s not all: When metabolizing food residues, the bacteria produce aggressive acids and toxins. These penetrate into the fine gap between the tooth and the gum and attack the latter. The immune system reacts to this with an inflammatory reaction – gum inflammation has developed.

If plaque is not brushed off regularly, calcium and other minerals are deposited in it. The plaque becomes firmer and develops into tartar. In its rough structure, the bacteria can settle even more easily. Small gum pockets (periodontitis) can also form.

Besides a lack of oral hygiene, brushing teeth too intensively can also cause gingivitis: This can cause damage to the gums. Bacteria can settle in the wound and cause inflammation.

Various risk factors make people particularly susceptible to gingivitis: these include metabolic disorders, diabetes mellitus (diabetes), alcohol and nicotine consumption, stress, hormonal changes (puberty, pregnancy, etc.) or a vitamin C deficiency. Certain drugs against cramping (hydantoin preparations) and high blood pressure (nifedipine preparations) also promote inflammation of the gums. The same applies to the active substance cyclosporine A. It inhibits the immune system and is therefore used after organ transplants (to prevent rejection reactions) and autoimmune diseases.

Gingivitis: Symptoms

Dentists distinguish between acute and chronic gingivitis. The former usually occurs suddenly and at the gumline. It doesn’t usually hurt. It is estimated that around 80 percent of adults in this country have gingivitis, but they don’t know it.

If the inflammation does not subside over a longer period of time (about a week), it is called chronic. If it spreads to the periodontal apparatus and causes so-called periodontitis there, the affected persons can even lose their teeth in severe cases.

Gingivitis does not cause any pain. However, there are other signs of gingivitis: while healthy gums are pink, firmly attached to the tooth and do not bleed, inflamed gums typically manifest themselves as the following symptoms:

  • Redness and swelling
  • Bleeding gums: Gingivitis is initially noticeable in those affected by bleeding gums. If untreated, it can lead to periodontitis and even tooth loss.
  • soft gums
  • Bad breath

A special form of gingivitis is the acute necrotizing ulcerative gingivitis (ANUG). In this form the bacteria attack the gums between the teeth. Ulcers form and the gums die. Alarm signals here are sudden strong fever, pain, bad breath and fatigue.

Gingivitis: Treatment

Gingivitis usually subsides after a few days if you clean your teeth carefully and regularly. If it is going to last for a long time, you should have your dentist treat the gingivitis.

What to do in case of gingivitis? Tips to do at home

The most important remedy against gingivitis is daily oral hygiene. Especially the bacterial coatings must be removed regularly.

Normally it is sufficient to brush your teeth thoroughly twice a day. This can prevent gingivitis or allow it to heal. You must thoroughly clean all tooth surfaces and remove plaque. Use a toothbrush with softer bristles. This reduces the risk of the inflamed gums being injured or additionally irritated when brushing teeth.

To clean the interdental spaces, you should use dental floss or so-called interdental brushes. Finally, you can gargle with antibacterial mouthwash solutions or apply a special ointment. Both curb the growth of bacteria. What also helps are prescriptions based on hydrogen peroxide prescribed by the dentist.

Note: As a preventive measure, it is also advisable to have your teeth professionally cleaned by your dentist at least once a year. Because this also reaches the places in the mouth where you cannot reach with a toothbrush.

Gingivitis: Home remedies & homeopathy

Some people use home remedies for gingivitis to relieve the symptoms and let the inflammation subside more quickly. For example, you can gargle with chamomile tea. The medicinal plant has anti-inflammatory and mucous membrane protecting properties. Sage, thyme or myrrh are also often used for their anti-inflammatory and disinfectant effects.

Apple cider vinegar as household remedy: A good household remedy for gingivitis should also be apple cider vinegar. It is recommended to gargle with a mixture of two tablespoons of apple vinegar and a glass of water at least half an hour before brushing your teeth every day. This is said to stimulate salivation and have anti-inflammatory and antibacterial effects.

Some people who are prone to recurrent gingivitis use homeopathy for gingivitis to help healing. However, their effectiveness has not yet been scientifically proven.

Alternative healing methods do not replace classical oral hygiene!

Gingivitis: Treatment by the dentist

If thorough tooth brushing and possible home remedies and homeopathy do not cure the gingivitis, you should go to the dentist. He will first clean all tooth surfaces and remove stubborn plaque that is not accessible to the patient. Using hand instruments and ultrasound equipment, he can also reach deep-seated plaque and remove it gently. He will then gently polish the tooth surfaces. This makes it more difficult for the bacteria to reattach themselves there.

If the gums are severely damaged or if gum pockets have formed, the doctor will decide on the appropriate therapy in each individual case.

Gingivitis: examinations and diagnosis

Gingivitis is usually visible to the naked eye. With the help of a probe, he tests the condition of the gums and checks to see if any pockets have formed. Bacteria are particularly fond of settling there. Depending on the severity of the inflammation, the gums bleed to varying degrees after being touched by the probe. The dentist uses these examinations to determine the periodontal screening index (PSI). It is used for early detection of diseases of the periodontium.

If the gum inflammation has existed for a long time, an additional X-ray examination of the jaw is often advisable. This helps in the search for the cause and possible consequences. By examining saliva, the doctor can also determine the types of bacteria in the oral cavity.

Gingivitis: course and prognosis

The prognosis for gingivitis is generally good. With careful dental care and oral hygiene it usually heals after a few days. Untreated, however, gum inflammation can become chronic. In the worst case, periodontitis, i.e. an inflammation of the entire periodontium, can develop. Over time, the gums recede, the teeth loosen and may fall out.

To prevent this from happening in the first place, you should ensure thorough oral hygiene and go to the dentist for regular check-ups. In this way, gum inflammation can be prevented or detected and treated early.

About this text

This text complies with the requirements of medical literature, medical guidelines and current studies and has been reviewed by medical experts.

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Sandra Eades
Hello I am Sandra Eades, physician, researcher and author from Australia. I am working currently as researcher for a private institution. I have studied in Britain and Australia, where I currently reside. I write about research topics in the organization of the public health government agencies. For the iMS I write about general medical conditions. I also research scholar sources to provide information to writers of other articles. I also check the citations of scholar papers. Finally, I read other articles before they are published. I am also a mother of three children!