Gingivitis

Gingivitis is an inflammation or infection of the gums, particularly the tissue around the teeth, that is characterized by swelling and bleeding when teeth are being brushed or flossed. The condition can affect anyone at any age but usually appears first during puberty and then persists throughout adult life.

Most often, the cause is irritation from plaque, a sticky substance produced by bacteria that live in the mouth. Plaque can form on any tooth surface, but the accumulation is heaviest between the teeth and along the gum line, areas that are not self-cleaning. In time, plaque hardens into calcium, or tartar, and layers of new plaque form over it, causing further irritation.

If gingivitis is allowed to progress, pockets form between the swollen gums and teeth, and plaque penetrates deeper into the tissue. As food and bacteria become trapped in these pockets, infection may develop, leading to periodontitis, a more serious infection that is a leading cause of adult tooth loss in the United States. At this stage, the gums are red, swollen, painful, and fragile. As pockets deepen, abscesses may form. The infection will gradually destroy the underlying bone, causing the teeth to loosen and fall out.

Diagnostic Studies and Procedures

Either a doctor or a dentist can diagnose gingivitis by inspecting the gums. If gums are badly infected, a sample of the plaque may be removed and cultured to identify the bacteria. X-rays can determine whether any loss of the jawbone has occurred. Gingivitis and periodontitis may be associated with an underlying disease, such as diabetes or leukemia. If this is suspected, the patient will be referred to a physician for diagnosis.

Medical Treatments

A thorough cleaning and removal of plaque and tartar is the essential first step. In a mild case of gingivitis, this may be done in one visit to a dentist or dental hygienist. In more advanced cases, treatment will probably require more than one visit and may include replacing fillings, excising gingival tissue, operating on the gums, or even removing loose teeth. Antibiotics, as well as a special mouthwash, may be prescribed to fight the infection.

Alternative Therapies

Herbal Medicine. Western herbalists recommend using a diluted mixture of myrrh or self-heal (Prunella vulgaris) as a mouthwash for bleeding gums. Some also suggest massaging the gums with eucalyptus oil at bedtime. Chinese herbalists advocate taking a combination of pinellia, ginseng, and ginger twice a day, either as a tea or in tablet form.

Homeopathy. Staphysagria (stavesacre) is often prescribed for gingivitis, to be used in mixture three times daily. Borax (borate of sodium) may be used to treat bleeding ulcers on the gums.

Naturopathy and Nutrition Therapy. A diet high in vitamins B and C-or supplements of these vitamins plus zinc, calcium, and vitamin A may be advised. A nutritionist may suggest also increasing your intake of raw fruits and vegetables to exercise the gums more. Massaging the gums with vitamin E oil may also promote healing.

Self-Treatment

Self-care plays an essential role in both the prevention and treatment of gingivitis. Brush thoroughly with a soft toothbrush at least twice a day, and floss your teeth daily. Replace your toothbrush promptly when it becomes worn. Use a wooden pick or irrigation device to stimulate the gums and remove bits of food from between the teeth after each meal. The gums may bleed at first, but with continued care, the bleeding will stop in a few weeks when the gums heal.

Before brushing, rinse the mouth with a product that helps loosen plaque. Some dentists recommend brushing with a paste made of baking soda and 3 percent hydrogen peroxide, but others feel that it's thorough brushing and flossing, not the paste, that's important. After brushing and flossing, rinse the mouth with salt water, a solution of water and baking soda, or an antibacterial mouthwash. A rinse made of one part hydrogen peroxide and four parts water also helps fight gum infection. Use more water if this solution irritates the gum tissue.

Smoking or using tobacco in any other way promotes gingivitis. If you continue smoking, the gum disease may continue to worsen even with improved dental hygiene.

In addition to self-care, you should see a dentist regularly, at least twice a year, or more often if you experience new symptoms of gingivitis or other dental problems.

Other Causes of Bleeding Gums

Some women's gums bleed during pregnancy, but the problem usually disappears soon after the baby is born. Bleeding gums can also be a symptom of thyroid problems and blood-clotting disorders. Grinding the teeth, known as bruxism, and malocclusion (teeth that do not fit together properly) also promote gingivitis.