What is gingivitis?
Gingivitis, also called gum disease or periodontal disease,
describes the events that begin with bacterial growth in your mouth
and may end -- if not properly treated -- with tooth loss from
destruction of the tissue that surrounds and supports your teeth.
(Gingivitis and periodontitis are two distinct stages of gum
disease.)
What's the difference between gingivitis and
periodontitis?
Gingivitis usually precedes periodontitis. However, it is
important to know that not all gingivitis progresses to
periodontitis.
In the early stage of gingivitis, bacteria in plaque build up
and cause the gums to become inflamed (red and swollen) and often
bleed during tooth brushing. Although the gums may be irritated,
the teeth are still firmly planted in their sockets. No
irreversible bone or other tissue damage has occurred at this
stage.
When gingivitis is left untreated, it can advance to
periodontitis. In a person with periodontitis, the inner layer of
the gum and bone pull away from the teeth (recede) and form
pockets. These small spaces between teeth and gums collect debris
and can become infected. The body's immune system fights the
bacteria as the plaque spreads and grows below the gum line.
Toxins, or poisons, produced by the bacteria in plaque as well
as the body's "good" enzymes (involved in fighting infections),
turn against the body and actually start to break down the bone and
connective tissue that hold teeth in place. As the disease
progresses, the pockets deepen and more gum tissue and bone are
destroyed. When this happens, teeth are no longer anchored in
place, they become looser, and tooth loss occurs. Gum disease, in
fact, is the leading cause of tooth loss in adults.
What causes periodontal disease?
Plaque is the primary cause of periodontal disease. However,
other factors can contribute to gum disease. These include:
- Hormonal changes--such as those occurring during
pregnancy, puberty, menopause, and monthly menstruation--make
gums more sensitive, which makes it easier for gingivitis to
develop.
- Illnesses, which may affect the condition of your gums. This
includes diseases, such as cancer or HIV, that interfere with the
immune system. Because diabetes affects the body's ability to
use blood sugar, patients with this disease are at higher risk of
developing infections, including periodontal disease.
- Medications--can affect oral health because they lessen
the flow of saliva, which has a protective effect on teeth and
gums. Some drugs, such as the anticonvulsant medication
diphenylhydantoin (marketed as Dilantin) and the anti-angina drug
nifedipine (marketed as Procardia or Adalat), can cause abnormal
growth of gum tissue.
- Bad habits, such as smoking, make it harder for gum tissue to
repair itself.
- Poor oral hygiene habits, such as not brushing and flossing on
a daily basis, make it easier for gingivitis to develop.
- Family history of dental disease can be a contributing factor
in the development of gingivitis.