Gingivitis is the inflammation of the gum tissue surrounding dental arcade which is most commonly caused by bacterial accumulation in the form of plaque around teeth. It is one of the most common dental complain, a dentist came across in his life. If this problem is not properly addressed then infection may spread to the area around the gums and ultimately can involve all of the oral mucosa.

Unhygienic and improper cleaning can lead to accumulation of plaques in several areas in the oral cavity especially spaces between teeth and gums. Bacteria feel very happy to live and proliferate in these crevices. These bacteria then make their colonies there and then start spreading to the surrounding mucosa. Surrounding mucosa provide excellent place for their multiplication and ultimately mucosa appear reddish, irregular, hot and painful. In the primary stages of inflammation neutrophils, which are considered as the first line of defense in the body against microorganisms, starts migrating towards the inflammation site and release substances which are called chemotactic factors which attract other defensive cells of the body to eliminate bacteria from the place and additionally cause release of excessive amount of fluid around the inflammatory site. Lymphocytes then dominate other cells such as monocytes and plasma cells. These cells then fight against the inflammatory process and kill the bacteria and repair the tissue if the immune system of the individual is strong otherwise if not treated, it can become ulcerative which can spread to the internal tissues such as roots of the teeth. And finally extremely painful episodes may have to be experienced. Occasionally, tooth removal remains the only option to contain the inflammation.

Appearance of Gingivities

Clinical appearance of gingivitis can be used for its classification such as if the inflammatory patch has turned into an appearance of ulcer (whitish rounded/ sometimes irregular appearance) than it is termed as ulcerative gingivitis. If there is profuse bleeding from the gums then it is called as hemorrhagic gingivitis. If there is abscess formation in the inflammatory tissue then it is called as purulent gingivitis and if the inflamed area is necrosed then it is called as necrotizing gingivitis.  Moreover, etiology of the disease can also be used to classify gingivitis such as gingivitis caused by drugs is called drug induced gingivitis; gingivitis caused by alteration in the production of different hormones is termed as hormonal gingivitis; gingivitis caused by microorganisms is termed as infectious gingivitis and gingivitis caused by nutritional factors is termed as nutritional gingivitis.

There are several factors predispose this condition such as regular use of tobacco, alcohol, fizzy drinks, chocolates and sweets. These provide excellent media for the growth of bacteria. Immune compromised individuals are more prone to gingivitis such as HIV infected individuals especially kids. Diabetic patients are also very receptive for gingivitis and other periodontal diseases. There are several drugs which cause bleeding of the gums and gingivitis such as anticoagulants, protease inhibitors, misoprostol, phenytoin and methotrexate. Exposures to large amount of metals are also responsible for many gingival diseases such as arsenic, zinc, lead, nickel and bismuth. Allergic reaction, inadequate nutrition, debilitating diseases and improper plaque removal can also lead to gingivitis.

Patients most commonly are presented with complain of bleeding gums and pain. Gums may also be presented with noticeable swellings with a tender and painful feeling when being touched. Halitosis or bad breath is also very common in these patients. People visiting the dentist clinics with loose teeth may also be the effect of chronic gingivitis. Complete dental examination is necessary to find out the exact cause of this dental condition. Complete blood chemistry and radiographic diagnostics should be followed to figure out the extent of damage this condition may cause. Evaluation of the diet for the presence of essential nutrients is also one of the ways to root out the cause of the disease.

Preventing Gingivitis

There are several ways to prevent gingivitis. Adequate hygiene of the oral cavity should minimally be achieved by regular brushing and flossing. Brushing ensures the removal of plaques from the surface of the teeth and flossing do the same in between the teeth. Antibacterial rinse can be an extra advantage. Tobacco use should be minimized and after every cigarette brushing should be done. Stress predisposes gingivitis and should be avoided. Try to maintain proper and balanced diet which should be fully equipped with vitamins and minerals.

Conclusively, I may say that gingivitis is one of the introductory diseases of the oral cavity to bring many disastrous dental conditions and if not treated timely can lead to severe complications and consequences. Adequate hygiene along with abstinence from the predisposing factors can save us from gingivitis.


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