Gingivitis

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Periodontal disease is the name for bacterial infections of the gums in the mouth. In most cases this disease is linked to poor oral hygiene. Some people however can have a genetic pre-disposition to the disease. The disease once initiated can progress more rapidly in people who have diabetes, especially if the diabetes is poorly controlled. Smoking is a strong risk factor for periodontal disease.

Symptoms
• Occasional redness or bleeding of gums while brushing or using dental floss teeth or • Biting into hard food (e.g. apples)
• Occasional swellings that recur
• Halitosis or bad breath
• Persistent bad taste in the mouth
• Shaky teeth in later stages
• Recession of gums resulting in apparent lengthening of teeth (also caused by heavy handed brushing using a hard tooth brush)
• Pockets between the teeth and the gums (Pockets are sites where the jaw bone has been destroyed gradually or by repeated swellings. Teeth become loose or shaky when sufficient jaw bone has been destroyed. The unfortunate thing is that the bone destruction is largely painless.)
• Lack of pain when bleeding happens after cleaning is NOT a sign of health.

Treatment
• Regular brushing and flossing and using an interdental brush at least daily.
• Treatment by a Periodontist, which includes professional cleaning to remove calculus (tartar, tooth stone)and may include drugs (infrequently), and/or surgery occasionally.

Prevention
• Brushing properly on a regular basis (2 times a day)
• Flossing daily and using interdental brushes if there is sufficient space between teeth and behind the last tooth in each quarter.
• Regular dental checkups and professional teeth cleaning as required. This serves to monitor the person's oral hygiene methods and how the condition has responded to treatment. Professional tooth cleaning will not prevent or control the disease because the bacterial plaque (biofilm) returns on the tooth surfaces every 24 hours.


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Gingivitis is the inflammation of the gums (gingiva) around the teeth due to improper cleaning of teeth. The condition is generally reversible. Brushing teeth with toothpaste and flossing with dental floss are the best ways to prevent gingivitis.

Causes
Gingivitis is usually caused by improper cleaning of teeth. When the teeth are not cleaned properly, the plaque irritates the gums. Bacteria and toxins may cause the gums to become red and swollen. Contributing factors include pregnancy and uncontrolled diabetes, due to hormonal changes that may increase the susceptibility of the gums or alter the composition of the dentogingival microflora. Hormonal changes during puberty also may put one at risk for gingivitis. The risk of gingivitis is increased by dental calculus, misaligned teeth, the rough edges of fillings, and ill fitting or unclean dentures, bridges, and crowns. The drug phenytoin, birth control pills, and ingestion of heavy metals such as lead and bismuth may also cause gingivitis.

Symptoms
• Swollen gums
• Mouth sores
• Bright-red, or purple gums
• Shiny gums
• Gums that are painless, except when touched
• Gums that bleed easily, even with gentle brushing

Prevention
Gingivitis can be prevented through regular oral hygiene, including the brushing and flossing of the teeth.

Diagnosis
It is recommended that a dentist be seen after the signs of gingivitis appear. A dentist will check for the symptoms of gingivitis, and may also examine the amount of plaque in the oral cavity. A dentist may also test for periodontitis, by the use of X-rays, or by gingival probing.

Treatment
A dentist or dental hygienist will perform a thorough cleaning of the teeth and gums. Following that, persistent oral hygiene is necessary. The removal of plaque is usually not painful, and the inflammation of the gums should be gone between one and two weeks. Oral hygiene is required to prevent the recurrence of gingivitis. Anti-bacterial rinses or mouthwash may reduce the swelling.


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