Gingivitis is considered the first stage of periodontal disease, which consists of inflammation of the gums, causing changes in the tissues that support the teeth. It is usually caused by a lack of oral hygiene.
The disease can progress without showing many symptoms, such as pain. However, a visible symptom is a change in the color of the gums. With a reddish color, gingivitis can cause bleeding and intense sensitivity.
According to the Brazilian Dental Association (ABO), 90% of adults who have gingivitis are not aware of this. If you don’t want to be part of that percentage, it’s worth reading!
Contents
What is gingivitis?
Gingivitis is a common disease in the oral cavity, characterized by inflammation of the gums . If left untreated, it tends to progress and even lead to tooth loss.
Most of the time, gingivitis is caused by the accumulation of bacterial plaque (dirt and bacteria) that lodges between the tooth and the gum, which usually implies bleeding from that part of the mouth.
If not treated in time, gingivitis can evolve into a periodontal disease, known as periodontitis , one of the main causes of tooth loss in adults.
This plaque that is attached to the teeth, also called biofilm, is colorless and adheres to the tooth after meals.
If the plaque is not removed by brushing and with daily flossing, it produces toxins that interfere with the gum lining. At this stage of the disease, the damage can still be reversed, since the bone and connective tissues that hold the tooth have not yet been reached.
However, without proper treatment, gingivitis can develop into periodontitis and cause permanent damage to the dental arch.
The World Health Organization (WHO) estimates that 1 in 4 adults has some type of bacterial infection. 15% to 20% of these cases can progress to severe gingivitis.
After completing the diagnoses, it is important to start treatment immediately. Because it is reversible, it is important to see a dentist at the first symptoms.
In ICD-10, the condition is listed under the following codes:
- K05 : Acute gingivitis;
- K05.1 : Chronic gingivitis.
What is plaque?
A colorless film, formed by food debris and bacteria that accumulate on the teeth, plaque is considered the main cause of gingivitis and the appearance of cavities.
Everyone has plaque, but when it is not removed daily, it hardens and forms tartar.
Plaque produces acids that attack the tooth. When this happens with great frequency, the teeth lose their enamel, leading to the propensity to form cavities.
Another danger related to plaques is that if they are not removed, they end up irritating the areas around the teeth and the gums. This can lead to the development of gingivitis, periodontitis and in some cases, loss of teeth.
Types of Gingivitis
Gingivitis can be subdivided into some groups, differentiated according to the main cause of the problem. Check out the main types:
Plaque-related gingivitis occurs due to poor brushing or lack of flossing. It can generate a gingival infection and in the region around the teeth, aggravating the disease for a periodontitis.
Drug-influenced gingivitis
Drug-influenced gingivitis occurs due to some drug formulas that cause an accumulation of gingival tissue, which grows on the teeth.
Some blood pressure medications, immunosuppressants and anticonvulsants can have gingivitis as a side effect and are generally more common in men.
Allergic gingivitis
Some food allergies can cause an oral microbiotic imbalance. There is a direct relationship between intestinal and oral balance, because, despite being different organs, they are directly connected.
Some gum infections can cause inflammation of that part of the mouth, leading to streptococcal gingivitis. This is a rare condition and can be presented in an acute form, associated with fever , malaise and pain.
Ulcerative gingivitis
It is characterized by an acute infection of the gums, caused by bacteria and usually cause local pain and discomfort.
If not treated properly, it can develop into necrotizing ulcerative gingivitis (GUNA), in which the gingiva presents ulcerations and necrosis (tissue death).
This type of disease is often associated with smoking and stress and is considered a common pathology among young people and adults.
Stages of Gingivitis
When a patient develops gingivitis, there are some stages that the disease can go through to be considered chronic. Understand:
Acute gingivitis
Acute gingivitis can be described as short episodes of gingivitis, in which that part of the body appears inflamed for a short period of time, then disappears.
Subacute gingivitis
Sub-acute gingivitis is almost the same as acute gingivitis, being even milder and also having a short duration.
Recurrent gingivitis
Recurrent gingivitis occurs when inflammation of the gums appears, disappears and reappears spontaneously.
Chronic gingivitis
Chronic gingivitis sets in slowly and is the most commonly found type. It is characterized by hardening of the gums, with edema (swelling), bleeding, halitosis and increased gingival fluid.
If not treated correctly, it can develop into periodontal disease, affecting ligaments and the bone that supports the teeth. It often affects school-age children, as their oral hygiene is still somewhat precarious due to their age.
Symptoms
Gingivitis can progress without pain, producing few obvious signs. According to the Brazilian Dental Association (ABO), only 10% of adults who have gingivitis are aware of this.
However, certain symptoms observed may indicate the onset of the disease, among which we can mention:
Swelling of the gums
During gingivitis it is possible that the gum becomes inflamed, more sensitive and with a reddish color than normal. In addition, due to swelling, it is possible that during brushing or flossing the gums bleed.
Teeth that look longer than they really are
During the process of gingivitis, one of the symptoms presented is the retraction of the gums. This can cause the feeling of larger and longer teeth.
Gum color change
Gingivitis can cause changes in the color of the gum, causing it to go from little to much more reddish than normal or even purplish.
Gingival bleeding
The constant bleeding of the gums can be noticed when brushing your teeth and using dental floss, when chewing hard food, or even spontaneously.
Constant presence of bad breath
Due to the accumulation of plaque, the gums start to move away from the teeth, creating small pockets. The bacteria that are trapped there release substances that cause this bad smell and the altered taste.
What are the causes?
Gingivitis is considered the first stage of periodontal disease, which consists of inflammation of the gums, causing changes in the tissues that support the teeth.
Most of it is caused by the accumulation of bacterial plaque that lodges between the tooth and the gums. Check out some of the causes:
Bad hygiene habits
The lack of brushing and the non-use of dental floss and mouthwashes facilitate the accumulation of plaque, consequently the development of gingivitis.
Genetic predisposition
This can be a factor that contributes to the development of the disease, so if there is a history of gum problems in your family, be sure to mention it to your dentist!
Risk factors
Gingivitis is common and can happen to anyone. However, there are some factors that are considered to aggravate the development of inflammation. Understand:
Smoking
Smoking makes it difficult to repair gum tissues, making the mouth more vulnerable to infections.
Vitamin C deficiency
Insufficient consumption of vitamin C can be especially harmful when it comes to the health of your gums.
Vitamin C is necessary for the synthesis of collagen in the body, essential for the formation of human body tissues. The lack of this vitamin can cause bleeding gums and periodontitis.
This is because the excessive deficiency of the vitamin in the body (scurvy), can cause severe periodontal changes, the first sign being gingivitis. The tissues become inflamed and bleed more easily.
If there is no proper medical follow-up, it can lead to bone loss around the teeth and in more severe cases, it can be fatal.
Hormonal changes
Hormonal changes can make the gums more sensitive, which facilitates the development of the disease.
Diabetes
People with diabetes are more susceptible to gum disease, as they are generally more prone to bacterial infections, in addition to having their ability to fight reduced due to this condition.
Therefore, the most important thing in these cases is to control the blood glucose level, in addition to maintaining good oral hygiene. It is also important to keep your dentist informed about your health condition or whenever you experience changes related to the disease.
Misaligned teeth
Although they are not a direct cause of gingivitis, crooked and misaligned teeth end up making oral hygiene difficult. This can favor the accumulation of plaque and, consequently, the development of gingivitis.
However, with orthodontic treatment it is possible to make this correction and facilitate brushing.
Pregnancy
Hormonal changes resulting from pregnancy, especially the increase in progesterone in the body, are associated with an increase in dental diseases, such as gingivitis and periodontitis.
This is because progesterone can cause an increase in bacteria around the teeth and gums. So be sure to inform your dentist when you discover pregnancy!
Medicines
Some medications can decrease the flow of saliva, which serves to protect your teeth and gums. In addition, some formulas such as phenytoin and antianginals (medicines used for chest pain) can cause abnormal growth of gum tissue.
How is the diagnosis made?
The professional responsible for diagnosing gingivitis is the dentist and only he can recommend the best treatments and perform diagnostic tests.
During the exam, the gums are evaluated with a small ruler, in order to check for the presence or not of inflammation. In addition, the dentist may order radiographs to check for bone loss.
See a dentist and explain what symptoms you are experiencing. This facilitates the diagnostic process.
Gingivitis has a cure?
Yea! Gingivitis is considered a reversible pathology, so if it is treated right it has a cure.
First of all it is important to consult a doctor to make the correct diagnosis. Based on the cause of your gingivitis, the dentist will establish a treatment to treat the problem, in addition to encouraging and explaining the importance of changing habits for your oral health .
Treatment
The main purpose of gingivitis treatment is to reverse symptoms and prevent inflammation from progressing to a more severe level.
At the first moment, the dentist may recommend cleaning the teeth (scaling), in order to eliminate tartar and plaque present in the teeth and gums.
In addition, it may be necessary to expand the treatment in more severe cases or in cases of advanced gingivitis. In this case, the dentist will prescribe some medications according to each specific case, with the prescription of antibiotics or anti-inflammatory drugs as a resource.
When consulting a dentist, the first procedure is the oral evaluation and cleaning of the teeth. This cleaning procedure is called prophylaxis, which we will explain below.
Dental cleaning
This is the first step towards oral re-education, that is, hygiene practices that improve the health of your teeth. In the consultation, the specialist will remove all the plaque accumulated on the surface of the teeth and all the tartar deposited on the base.
In this process, a dental surgeon cleans each tooth individually, in the inner and deep parts of the gums, with specific products that leave the mouth clean and healthy.
The frequency of this procedure should be discussed with your dentist, however, it is recommended that it be done every six months. But don’t forget, the best person to know the best option for you is your dentist.
In addition, there are some daily hygiene tips that can assist in the prevention process, such as the habit of mouthwashing.
Mouthwashes
The mouthwash is a great help in the treatment of the disease. Be sure to use one that is specific, such as anti-gingivitis, antibacterial or antiseptic. These types of rinses have antimicrobial agents that help in the process of eliminating bacteria.
Remedies for gingivitis
It is important to highlight the relevance of consulting a doctor before self-medicating. Only a specialized person can tell you the best treatment, duration and dosage indicated for each specific case of the disease.
Medicines to treat the disease can include:
Anti-inflammatory for gingivitis
The treatment of gingivitis aims to reduce or fight local inflammation and should be continued until the symptoms disappear. In more severe cases, the dentist may recommend the use of prescription drugs, such as:
- Ibuprofeno Algy-Flanderil Comprimido, Ibufran, Neurofen, Buprovil, Ibuprofan, Ibuprotrat, Ibupril).
- Nimesulida ( Cimelide , Nimesilam , Wheat , Mesalgin, Inflalid , Uciton ).
- Cloridrato de Benzidamina (Benzitrat, Benflogin, Fonergoral).
Antibiotics for Gingivitis
In more severe cases of gingivitis, the use of antibiotics may be recommended by the dentist. These drugs need a prescription and cannot be stopped.
- Amoxicillin ( Amoxil , Sulbamox, Amoxicillin EMS , Amoximed , Novoxil , Polimoxil , Nemoxil ).
- Cloridrato de Minociclina (Ranbaxy, Minociclina).
- Cloridrato de Clindamicina (Dalacin C, Anaerocid, Doxicilina).
Read more: Misuse of antibiotics creates superbugs that can kill
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Home remedy for gingivitis
The best natural way to care for and prevent gingivitis is through good oral hygiene and regular consultations with your dentist.
Given the risks of gingivitis, never self-medicate or do home treatments. According to the Brazilian Dentistry Association (ABO), home treatment with hydrogen peroxide (one of the most well-known home treatments) is not recommended.
This procedure can lead to additional injuries, aggravating the existing problem.
Toothpaste and mouthwash for gingivitis
According to the Regional Council of Dentistry of São Paulo (CRO), mouthwashes are indicated for postoperative periods or for periodontal diseases, such as gingivitis.
The best options will always be those recommended by your dentist, so it is best to consult a specialist who can recommend an ideal product for you. In addition, CRO-SP states that rinses are not a substitute for brushing and flossing.
Check out some brands that you can find on the market and on online sites:
- Oral Solution Listerine Defense of Teeth and Gums
- Listerine Tartar Control Oral Solution
- Periotrat Oral Solution
- Noplak Max Oral Solution
- Parodontax Fluoride Toothpaste
- Colgate Total 12 Professional Gum Healthy Toothpaste
- Oral-B Pro-Health Toothpaste Healthy Gums
- Fio Dental Oral-B Super Floss
- Fio Dental Colgate Total Professional Expand
Living together
Despite the possible discomfort that gingivitis causes, there are some measures that can help to ease the discomfort. Among them we can mention:
- Look for toothbrushes that are soft and change them every three months;
- Prefer electric brushes. They facilitate the removal of dental plaque;
- Keep the habit of brushing your teeth always after a meal;
- Use dental floss daily;
- Use mouthwashes, they control the proliferation of plaque.
Prognosis
Gingivitis is a reversible condition. However, without proper treatment, it can develop into periodontitis and cause permanent damage to the dental arch.
The World Health Organization estimates that one in four adults has some type of bacterial infection. 15% to 20% of them can progress to severe gingivitis.
Complications
If plaque is not removed by brushing and flossing daily, it produces toxins that affect the gum lining.
At this stage of the disease, the damage can still be reversed, since the bone and connective tissues that hold the tooth have not yet been reached.
However, without proper treatment, gingivitis can develop into periodontitis and cause permanent damage to the dental arch.
This is because an important change that can occur is the reduction in the production of collagen, a fundamental component of the tissues that support the tooth.
In addition, periodontal diseases can affect the health of the body as a whole as well, increasing the risk of problems such as heart attack , stroke, lung disease and even problems in pregnancy, causing the baby to be born prematurely or underweight.
Periodontitis
This stage of the disease is characterized by local inflammation and irreversible wear on the bone, gums and fibers supporting the tooth.
It is possible to perceive the formation of a pocket inside the gum, where food residues and bacterial plaque are stored. It must be accompanied and treated by a specialist doctor, in order to avoid further damage and prevent the disease from advancing.
Acute Necrotizing Ulcerative Gingivitis (GUNA)
Acute necrotizing ulcerative gingivitis, or GUNA as it is known, is considered a condition of rapid evolution, causing necrosis of periodontal tissues.
It is considered a specific bacterial infection (fusiform bacilli) and presents with an area of acute inflammation and local redness.
If not treated early on, GUNA can cause gum destruction, bleeding, fever, malaise and pain.
Prevention
Some daily oral hygiene habits can prevent the development of gingivitis even in its early stages.
Below are some customs that can prevent the appearance, among them:
- Brush your teeth daily right after your meal with a soft brush or electric brush.
- Use anti-gingivitis and anti-plaque toothpaste to reduce the damage caused by plaque bacteria.
- After brushing, rinse thoroughly with an antibacterial mouthwash to help fight plaque, gingivitis and bad breath. Floss at least once a day to remove food particles and plaque from between your teeth.
- Scheduling regular check ups at the dentist, specifically every six months, is also a way of prevention, in addition to keeping your mouth always clean and healthy.
How to brush your teeth correctly?
The brushing of the teeth should be smooth, with circular movements and special attention to the posterior teeth. Also, hold the toothbrush at a 45-degree angle over your gums (don’t rub hard, as it can hurt them).
Another habit that complements oral hygiene is brushing the tongue. This practice will eliminate many bacteria that cause bad breath and plaque build-up. Using an antiseptic mouthwash can also prevent oral diseases, such as gingivitis.
Common questions
Ask questions about gingivitis, inflammations, care and preventions!
Does food cause gingivitis?
No. The important thing is to maintain a routine of oral hygiene always after meals.
Is it worth using specific toothpaste and antiseptics?
There is no evidence of the benefits of antiseptics in controlling gingivitis. However, with regard to the choice of toothpaste, give preference to white products, since they facilitate the visualization of possible bleeding.
Is gingivitis contagious?
It is not possible to say that gingivitis is contagious. However, because it is an oral disease, it is necessary to redouble the care in contact situations, such as kissing.
Oral health is just as important as that of any part of the body. Maintaining a daily hygiene routine is necessary to prevent diseases such as gingivitis.
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