Inflammation of the gums – detecting and treating gingivitis
If you notice blood when brushing your teeth every day, this could be a sign of gum inflammation. You are not alone: almost every adult occasionally suffers from so-called gingivitis – which often goes unnoticed, as the inflammation is not always associated with pain. The reason for swollen gums and bleeding is bacteria, which build up on the gingival margin (gum edge). If these bacteria are not removed by brushing, they can cause inflammation.
In the case of ongoing inflammation of the gums, bacteria can travel to the periodontium (the tissues supporting a tooth) and cause long-term damage. This would be a case of periodontitis (also commonly known as gum disease). Left untreated, teeth can become loose and fall out prematurely. Consequently, thorough and regular oral hygiene is also the best prevention and treatment for gingivitis!
In this article you will learn how gingivitis occurs, how to quickly detect it, how good oral hygiene promotes healing and when you should see a dentist.
Causes of gingivitis
Bacteria are the most common cause of acute or chronic gingivitis. It is perfectly natural for bacteria to be present in the mouth: there are actually several thousand varieties in the oral cavity. These are part of the oral microbiome and are beneficial, inter alia, for digestion or in defending the body against pathogens.
However, together with the components of saliva and the remains of food, bacteria can form a viscous substance on the surface of the teeth and the gingival margin – known as biofilm. This biofilm provides excellent protection of the bacteria from external influences. If it is not thoroughly and regularly removed, plaque is formed.
Poor oral hygiene means that not only is this plaque not removed, the remains of food are also left in the mouth. This helps bacteria to proliferate rapidly, as the optimal conditions are present. The food remains are a source of nutrition for the bacteria. During metabolisation, acids are produced which attack the enamel and the gums.
A large number of bacteria accumulate at the point where the tooth meets the gums in particular. This area is referred to by experts as a sulcus and is a furrow measuring a few millimetres only. It offers the ideal place for bacteria, acids and food to collect and to enter the gums. The immune system reacts with an inflammatory response: gingivitis.
Symptoms of gingivitis
But how exactly would you know if you have gingivitis? Here, experts differentiate between acute and chronic inflammation of the gums.
Acute gingivitis often goes unnoticed as it is usually not painful. According to estimates, around 80% of all adults have gingivitis without realising it. However, if gingivitis does not heal after a longer period (more than seven days), it becomes chronic and can then also cause pain. Subsequently, gum recession can also occur, exposing the necks of the teeth and making the teeth appear longer.
To prevent gingivitis from becoming chronic in the first place you can look out for specific signs and quickly determine whether your gums are inflamed:
- The colour of the gums: healthy gums are light pink and smooth. Inflammation, on the other hand, is characterised by redness and swelling.
- Do your gums bleed when you brush your teeth or bite into an apple? This can also be a sign of inflammation.
- Chronic gingivitis is characterised by pain.
- Bad breath is another sign of chronic gum inflammation.
- In particularly severe cases, pus can also form and other physical reactions such as fever can occur.
If you are uncertain about these signs, please ask your dentist for medical consultation.
Gingivitis or periodontosis – what is the difference between these gum diseases?
But how is gingivitis different from periodontitis? Bleeding from the gums is usually dismissed as harmless and ignored, especially as it is only rarely associated with pain. However, harmless gingivitis can quickly progress to periodontitis.
Inflammation of the gums (gingivitis) is caused by inadequate oral hygiene: bacteria in the mouth are not removed correctly and cause an inflammatory reaction at the gum line. The problem is usually quickly resolved by thorough and regular oral hygiene.
With periodontitis, it gets much more complicated: unlike inflammation of the gums, periodontitis is often irreversible and can occur due to untreated gingivitis. Regular oral hygiene is also vital here to halt the progress of the disease. However, treatment will be unsuccessful without a dentist, as the bacteria has penetrated deep into the tooth socket and can no longer be removed using a toothbrush or oral floss.
Whilst gingivitis rarely has serious consequences and bacterial colonisation is mainly limited to the gums, in periodontitis, the entire peridontium is infected with bacteria. This can also cause teeth to become loose or even to fall out.
Treating inflammation of the gums – when should you see a dentist?
In many cases, gingivitis clears itself within a few weeks with thorough and careful oral hygiene. General oral care, consisting of brushing the teeth twice a day (morning and evening) and daily cleaning of the interdental spaces using oral floss or an interdental brush, is indispensable.
There are also other measures that can support the healing process and which are easy to perform:
- Use a toothbrush with soft bristles to avoid further damage or injury to the gums.
- Special ointments which are applied to the gums are also formulated to contain the bacterial load.
- A household remedy for gum inflammation is chamomile tea. Other herbs and substances that contain essential oils and have an anti-inflammatory action such as sage, myrrh or thyme can help to relieve inflammation.
- Use a mouthwash to minimise bacteria in the oral cavity and to clean hard-to-reach areas.
However, if there is still no improvement in the gingivitis, you should see a dentist. A dentist will use the so-called Parodontal Screening Index – PSI for short – to check whether there is already an increased risk of periodontitis as a result of the gingivitis. The expert will also remove plaque and tartar from the teeth and gums and gently polish the teeth to make it harder for bacteria to adhere to the surface.
Risk factors for gingivitis
Even if the biggest risk factor is poor oral hygiene, there are other factors that increase the risk of getting gingivitis:
- The likelihood of getting gingivitis is twice as high for smokers as it is for non-smokers.
- The risk also rises with age, as natural saliva production is lower. This also means that less food residue and bacteria are naturally washed away.
- The same is true for breathing through the mouth. This also dries out the mouth and increases the risk of gingivitis.
- A vitamin C deficiency also increases the likelihood of gum inflammation, as do a number of pre-existing diseases such as Diabetes mellitus, leukaemia or HIV.
- Major hormonal changes such as those that take place during pregnancy or puberty, can often lead to problems with inflamed gums.
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Periodontitis – also known as gum disease – is inflammation of the tooth socket. In many patients, this disease goes unnoticed for some time, as there are only a few symptoms during the initial stages. In this article you will find out how to recognise periodontitis and how to treat it.
Whether you discover your gums bleeding between meals, during mealtime or when brushing your teeth, you need to clarify the cause. It is not usual for healthy gums to bleed.