1 GINGIVITIS-GUM DISEASE
a serious infection of the gums caused by plaque buildup at the gumline.
Gingivitis is inflammation of your gum tissue and is
the beginning stage of periodontal or gum disease.
Gingivitis is one of the most common untreated infections.
35, approximately three out of four adults develop some form of gum disease.
Plaque-induced gingivitis is defined as inflammation of the
gingiva in the absence of clinical attachment loss*.
damages your gums and reduces their ability to protect vulnerable areas.
Gingivitis, and its progression to
periodontitis, starts with the plaque that forms mostly at the gumline at the
base of the visible part of your teeth.
is caused by food debris and
bacteria that grow in this area.
This group of harmful bacteria begins to recolonize and
dominate in only 24 hours after you brush. Their levels of toxins
continue to increase causing an infection that can damage your gums and
affect your immune system.
this plaque is not removed daily it will harden to form calculus (tartar) around
the necks of your teeth.
calculus will often result in a mechanical irritation that damages your gums.
Additionally, calculus provides an area on which more bacteria easily grow,
plaque and calculus will, if not removed, continue to grow and form deep pockets
at the base of your teeth that will sooner or later fill with pus, infect
the bone and cause tooth loss.
on your toothbrush or dental floss is one of the earliest and most common signs
of early gingivitis. Other
signs of early gingivitis are:
gums should never bleed while brushing or flossing.
your oral hygiene habits are poor, gingivitis may progress
to periodontitis. This
disease attacks your gums, bones and supporting structures of your teeth.
You can never completely get rid of all the
bacteria in your mouth but brushing and flossing make sure the number of bacteria
you do have is in a safe range. A common mistake most people make is to brush
but not floss. This allows bacteria to build up to dangerous levels between
your teeth where brushing alone cannot reach. When any one group or family
of bacteria begin to dominate their levels of toxins increase to a
point where they cause an infection.
The good news is that in early gingivitis:
Reattached gum tissue to a spotlessly clean
structure around the teeth has yet been lost.
It is preventable.
Easier to treat in a non-surgical manner.
Less costly to treat in its early stages.
And it is reversible through:
Professional treatments-to remove this harmful bacterial growth from you
teeth and gums.
This will include one session containing dental
cleaning with fluoride along with oral hygiene
month recare visit to remove the tartar, which harbors and nurtures the growth of
Good brushing for a
minimum of twice a day and after meals for at least two
4. Daily flossing.
Start cleaning BETWEEN
your teeth. Periodontal disease
begins between the teeth. The area
between the teeth are more prone to
infection than facial or tongue gum tissue
surfaces simply by anatomy. This
tissue is not keratinized like tissue found
on the facial and tongue surfaces.
Non-keratinized tissue is more susceptible
to breakdown. It is also a very
protected area, NOT reached by brushing or
disease starts between the teeth, it makes sense to start
cleaning in between the teeth and than brush. You can
clean this area with interdental
brushes, picks, sticks, oral
irrigation, and automatic flossers.
remember this disease needs to be treated both in the office and
Do not smoke or use alcoholic
beverages while your gums are inflamed.
Good dietary habits.
Cut back on foods and beverages that contain sugar.
Gingivitis is the only stage of gum
disease that can be completely reversed to a healthy undamaged
condition. More advanced gum disease can often be
controlled but damage to the teeth’s bone support cannot be
reversed or rebuilt. It is vital that gum disease be
stopped and reversed in its earliest stages.
To insure successful results following periodontal treatments, patient
cooperation in maintaining excellent oral hygiene is essential.
early gingivitis will develop into periodontitis or severe gum disease, which will
DISEASE IS USUALLY A PAINLESS PROGRESSIVE INFECTIOUS DISEASE
gingivitis may be a bacterially nonspecific effect of plaque
accumulation and emphasizes the need for regular plaque
removal to maintain optimal gingival health.
Associated With Dental ProphylaxisJ. Max Goodson, Michael D.
Palys, Elizabeth Carpino,
Elizabeth O. Regan, Michael Sweeney, Sigmund S.
SocranskyJADA 2004; 135:1559-1564.
Case Type I Gingivitis-
Diagnosis Code 4500- Inflammation of the gingiva characterized
clinically by changes in color and gingival form with the
presence of bleeding and/or exudates without attachment or bone
loss. Light plaque and subgingival calculus can be present.
Vitamin C (ascorbic acid) is responsible for the
formation and preservation of collagen in the body. "Collagen is
a proteinfound in teeth, bones, tendons, blood vessels, skin,
joints, and muscles. As a maintainer of collagen, vitamin C
helps to heal wounds like periodontal pockets."
While the current recommended daily allowance (RDA) for vitamin
C in adults over eighteen years of age is 90 mg for men and 75
mg for non pregnant, non lactating women, research suggests the
body's tissue absorbs up to 200mg of vitamin C in one day - any
more is excreted in the urine.
"A study at Loma Linda University in California compared using a
multivitamin or a placebo and the subsequent effect on patients
with Type II periodontal disease who are not currently
undergoing active periodontal therapy. They were looking at
quantifiable improvements in soft-tissue health - gingival
index, bleeding index, periodontal pocket depth and attachment
level over a period of 60 days.""At the end of the study,
there was clinical reduction in the
gingival index, bleeding index and pocket depth
for the experimental group. No significant changes for
attachment levels were found in the experimental or control
group." Simply adding nutritional supplements to the therapy
improved gingival health more than not taking the supplement.
Vitamin C is a readily available and affordable adjunct that can
be used safely and effectively to treat active and maintenance
Berger EK The efficacy of vitamin C in conjunction with
periodontal therapy Contemporary Oral Hygiene 2004;4(4):31
populations warrant special attention with respect to vitamin C
requirements. These include patients with periodontal
pregnant and lactating
women, and the elderly.
[Bsoul SA, Terezhalmy GT. Vitamin C in Health and Disease.
JContemp Dent Pract 2004 May;(5)2:001-013.]
Parameters of Care