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What is Gingivitis?

Gingivitis, also generally 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 due to destruction of the tissue that surrounds your teeth.
Actually, 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, causing the gums to become
inflamed (red and swollen) and often easily 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 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 – 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 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 some lessen the flow of saliva, which has a
protective effect on teeth and gums. Some drugs, such as the anticonvulsant medication
Dilantin and the anti-angina drug Procardia and 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 for the development of
gingivitis.
Is Periodontal Disease Linked to Other Health Problems?
According to the CDC, researchers have uncovered potential links between periodontal
disease and other serious health conditions. In people with healthy immune systems, the
bacteria in the mouth that makes its way into the bloodstream is usually harmless. But
under certain circumstances, the CDC says these microorganisms are associated with
health problems such as stroke and heart disease. Diabetes is not only a risk factor for
periodontal disease, but periodontal disease may make diabetes worse.
What are the Symptoms of Periodontal Disease?
Periodontal disease may progress painlessly, producing few obvious signs, even in the
late stages of the disease. Although the symptoms of periodontal disease often are subtle,
the condition is not entirely without warning signs. Certain symptoms may point to some
form of the disease. They include:
Gums that bleed during and after tooth brushing
Red, swollen, or tender gums
Persistent bad breath or bad taste in the mouth
Receding gums
Formation of deep pockets between teeth and gums
Loose or shifting teeth
Changes in the way teeth fit together upon biting down, or in the fit of partial dentures.
Even if you don't notice any symptoms, you may still have some degree of gum disease.
In some people, gum disease may affect only certain teeth, such as the molars. Only a
dentist or a periodontist can recognize and determine the progression of gum disease.
How Does My Dentist Diagnose Periodontal Disease?
During a periodontal exam, your dentist or periodontist typically checks for these things: Gum bleeding, swelling, firmness, and pockets (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease) Teeth movement and sensitivity and proper teeth alignment Your jawbone to help detect the breakdown of bone surrounding your teeth How is Periodontal Disease Treated? The goals of periodontal treatment are to promote reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues. A full description of the various treatment options is provided in Gum Disease Treatments.

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