GINGIVITIS

General Information

DEFINITION--Inflammation or infection of the gums.

BODY PARTS INVOLVED--Gum tissue around teeth.

SEX OR AGE MOST AFFECTED--All ages, but most common in adults.

SIGNS & SYMPTOMS

• Gums that are swollen, tender, red and soft around the teeth.
• Gums that bleed easily.
• Bad breath.
• Fever (rarely).
• No pain.

CAUSES

• Poor nutrition, especially vitamin deficiencies that cause diseases such as scurvy or pellagra.
• Plaque (food particles, germs and mucus at the base of the teeth).
• Blood disorders, including leukemia.
• Adverse reactions to drugs, such as anticonvulsants (primarily phenytoin and barbiturates).
• Exposure to lead and bismuth.

RISK INCREASES WITH

• Diabetes.
• Poor nutrition, especially vitamin deficiency.
• Infections.
• Pregnancy.
• Poor dental hygiene.

HOW TO PREVENT

• Practice good oral hygiene (see General Measures) to prevent plaque formation.
• Have regular dental checkups twice a year.
• Eat a well-balanced diet. Take vitamin supplements if you cannot eat well-balanced meals.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor or dentist.
• Laboratory culture of the plaque to identify the bacteria responsible for the infection.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's or dentist's treatment.
• Surgery to remove infected gum tissue, if other treatment fails.

POSSIBLE COMPLICATIONS

• Extensive involvement may require gum surgery.
• Untreated gingivitis may lead to periodontitis, an advanced stage of gum disease that can lead to bone loss and loosening of teeth.
• Acute necrotizing gingivitis (trench mouth) that can causes destruction of gum tissue. Treatment is with antibiotics.

PROBABLE OUTCOME--Prognosis is generally favorable with appropriate treatment.

How To Treat

GENERAL MEASURES--

• Brush your teeth properly. Scrub clear, sticky plaque off the teeth daily with a soft toothbrush. Place the brush at the gum line and gently rotate it, pointing bristles toward the gum. Brush one section of teeth at a time. A soft brush is less likely to damage teeth and gums than a hard brush.
• Floss your teeth at least once a day. Use waxed or unwaxed dental floss. Wind most of it around the middle finger of each hand. Use index fingers as guides to force the floss between the teeth gently. Gently clean adjacent tooth surfaces with a back-and-forth, sawing motion at the gum line. Floss between all lower teeth. Loosen floss and place it on the tops of the thumbs. Floss between all upper teeth, using the thumbs as guides.
• Use a fluoride toothpaste.
• Make regular appointments with your dentist for cleaning and treatment of cavities.
• Avoid smoking.

MEDICATION--Your doctor or dentist may prescribe:

• Antibiotics to fight infection.
• Fluoride mouthwash.
• Vitamins, if you have a deficiency.

ACTIVITY--No restrictions.

DIET--No special diet. Avoid candy, sweet drinks or sweet snacks. Sugar stimulates the production of acid, which attacks normal teeth. The best desserts are fruit and cheese rather than ice cream or other high-sugar desserts.