Wednesday, December 12, 2012

What is Gingivitis?

In Latin, the word gingi- means gums and the word -itis means inflammation. Therefore, the word gingivitis means inflammation of the gums. In the picture above, this is fairly obvious and can be recognized with even an untrained eye. Not all cases are this obvious though.

There are numerous reasons why gums can become inflamed. The primary reason is from debris (plaque)that forms at the gum line. The gums become inflamed when we fail to remove debris during our routine oral hygiene. If you don't remove the debris, it will become inflamed and tender. In addition, there will also be some bleeding. I've heard many people state that they don't brush or floss at the gumline because it hurts and bleeds. Healthy gums do not hurt and bleed. If you have areas that hurt or bleed, the last thing you want to do is to avoid removing the debris. It must be removed. It's not much different than having a splinter in your finger. If you leave it, it will become inflamed and tender. If left for an extended period, it may become infected.

Other causes of gingivitis:
  • Calculus (Tartar)
  • Certain Hormones
  • Certain Drugs
  • Foriegn Bodies
  • Crowded/Crooked Teeth

Calculus is plaque that has mineralized. It becomes hard and attaches to the tooth surfaces. This is a bigger problem than plaque.

Women undergo many hormonal changes during pregancy. The gums become enlarged and will therefore create more difficulty in removing debris during routine oral hygiene.

Certain drugs like Dilantin (anti-epileptic medication), will cause gingival hyperplasia which means the gums will grow. Again, this makes hygiene much more challenging.

Foreign bodies also cause inflammation. The most common one that I've seen are popcorn kernel husks. They notoriously get stuck between the tooth and gums. They can be difficult to remove at home.

Crowded/crooked teeth are more difficult to keep clean. There is an increased risk of developing gingivitis.

Healthy gums should have a coral pink appearance and should not bleed readily. In addition, the texture should be stippled. In other words, it should have a texture similar to an orange. When they get somewhat glossy, it's because the gums are edematous (puffy from excess fluid). This is an early warning sign.
So you may have swollen gums. Some may ask what the big deal is. Well, there are oral and systemic complications.

Orally, if the inflammation is chronic it will lead to periodontitis. Even if the teeth are in good shape, there is an increased risk of tooth loss. Systemically, this can lead to cardiovascular sequelae which I have written about before.

The best thing anyone can do for their oral health is to meticulously brush and floss. I prefer electric toothbrushes over manual ones because the plaque is removed more thoroughly. It is also much gentler on the gums. Some people can be too aggressive with a manual toothbrush. Your dentist or hygienist can demonstrate proper flossing and brushing techniques.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit


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