Gingivitis is a common and mild inflammatory form of gum disease (periodontal disease) that causes irritation, redness and swelling of your gingiva, the part of your gum around the base of your teeth due to bacterial infection. If left untreated, it can become a more serious infection known as periodontitis.
There are two main categories of gingival diseases –
• Dental plaque-induced gingival disease
This can be caused by plaque, systemic factors, medications, or malnutrition.
• Non-plaque induced gingival lesions
This can be caused by a specific bacterium, virus, or fungus. It might also be caused by genetic factors, systemic conditions (including allergic reactions and certain illnesses), wounds, or reactions to foreign bodiesTrusted Source, such as dentures. Sometimes, there is no specific cause.
Healthy gums are firm and pale pink and fitted tightly around the teeth. Signs and symptoms of gingivitis include:
• Swollen or puffy gums
• Dusky red or dark red gums
• Gums that bleed easily when you brush or floss
• Bad breath
• Receding gums
• Tender gums
The most common cause of gingivitis is poor oral hygiene that encourages plaque to form on teeth, causing inflammation of the surrounding gum tissues. Here’s how plaque can lead to gingivitis:
• Plaque forms on your teeth.
Plaque is an invisible, sticky film composed mainly of bacteria that forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Plaque requires daily removal because it re-forms quickly.
• Plaque turns into tartar.
Plaque that stays on your teeth can harden under your gumline into tartar (calculus), which collects bacteria. Tartar makes plaque more difficult to remove, creates a protective shield for bacteria and causes irritation along the gumline. You need professional dental cleaning to remove tartar.
• Gingiva become inflamed (gingivitis).
The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth, causing inflammation. In time, your gums become swollen and bleed easily. Tooth decay (dental caries) also may result. If not treated, gingivitis can advance to periodontitis and eventual tooth loss.
Risk Factors –
Other risk factors can contribute to periodontal 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 and cavities.
• 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 diseasecan be a contributing factor for the development of gingivitis.
If left unchecked, gingivitis can cause the gums to separate from the teeth. This can cause:
• injury to the soft tissue and bone supporting the teeth
• the tooth to become loose and unstable
• the loss of the tooth, if infection progresses
A dentist or oral hygienist will check for symptoms, such as plaque and tartar in the oral cavity.
Checking for signs of periodontitis may also be recommended. This may be done by X-ray or periodontal probing, using an instrument that measures pocket depths around a tooth.
You must practice good oral hygiene to treat gingivitis.
Other treatments include:
There are several techniques that can be used to deep clean your teeth without surgery. They all remove plaque and tartar to prevent gum irritation:
• Scaling. Teeth scaling removes tartar from above and below the gum line.
• Root planing. This smooths rough spots and removes plaque and tartar from the root surface.
• Lasers. This treatment may remove tartar with less pain and bleeding than scaling and root planing.
A number of medications can be used to treat gum disease:
• Antiseptic mouthwashcontaining chlorhexidine can be used to disinfect your mouth.
• Timed-release antiseptic chips containing chlorhexidine can be inserted into pockets after root planing.
• Antibiotic microspheres made with minocycline can be inserted into pockets after scaling and planing.
• Oral antibioticscan be used to treat persistent areas of gum inflammation.
• Doxycycline, an antibiotic, can help keep enzymes from causing tooth damage.
If your gingivitis is severe, especially if it’s caused any gum or bone tissue loss, you may need surgery. Types of gum surgery, which is performed by a periodontist, include –
• Flap surgery
• Bone and tissue grafts
• Dental crown lengthening
Ayurvedic Perspective –
Periodontal diseases are mentioned in Ayurveda and Shitada appear to correspond to the condition mentioned Gingivitis today.
Gums is an associated tissue of muscles, hence, in diseases like Shitada;
Ayurvedic Herbs which acts on muscular tissue are useful such as –
• Patola (Trichosanthus cucumerina)
• Nimba (Azadirachta indica)
• Triphala (Terminalia chebula,Terminalia bellerica, Phyllanthus emblica)
• Musta (Cyperus rotondus)
• Kutaja (Holarrhena antidysenterica)
All these could be given orally in the form of decoction or in medicated ghee form.
Apart from this Dantya Rasayana i.e. dental tonics which includes
• Bakula (Mimusops elengi) fruits
• Haritaki (Terminalia chebula)
• Black sesame seeds (Sesamum indicum)
• Nyagrodha (Ficus bengalensis),
• Arjuna (Terminalia arjuna)
should be administered to increase the strength and stability of the tooth supporting structures as curative measure in disease condition like Shitada.
As Gandusha ( Holding fluid in mouth) like Nagaradi Kwatha, Triphala + Sphatika Jala, Irimedadi Taila, Sahacharadi Taila etc. are already proven formulations for periodontal health.
Steps you can take at home to prevent and reverse gingivitis include:
• Brush your teeth twice a day or, better yet, with fluoride toothpaste after every meal or snack.
• Use a soft toothbrush and replace it at least every three to four months.
• Consider using an electric toothbrush, which may be more effective at removing plaque and tartar.
• Floss daily.
• Use a mouth rinse to help reduce plaque between your teeth.
• Supplement brushing and flossing with an interdental cleaner, such as a dental pick, interdental brush or dental stick specially designed to clean between your teeth.
• Get regular professional dental cleanings on a schedule recommended by your dentist.
• Don’t smoke or chew tobacco.
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