Gingivitis Gum Disease
Gingivitis is a reversable condition caused by an inflammatory response to the presence of dental plaque. The main diagnostic features of gingivitis that are assessed during your dental hygiene appointment are as follows:
- A change in gingivae colour appearing more red rather than pale pink.
- Swelling of the gingival tissue at the gingival margin accompanied by bleeding when the tissue is touched gently with a probe.
- Sometimes in cases of chronic gingivitis present for a longer time, a loss of contour of the interdental papilla.
The key feature in the diagnosis of gingivitis is that the attachment of the gingival tissue to the tooth is not lost and pocket depths are 3mm or less.
Every year a detailed chart should be prepared measuring 6 points around each tooth to assess the pocket depths or amount of attachment loss if any. This gives a comprehensive view of the presence and level of gingivitis disease.
Systemic Risk Factors
Gingivitis can be modified or made worse by systemic factors, including:
- Associated with the endocrine system, being:
- Puberty-associated gingivitis
- Menstrual cycle-associated gingivitis
- Pregnancy-associated gingivitis and or pyogenic granuloma
- Diabetes associated gingivitis
- Associated with blood dyscrasias, for example, Leukaemia.
Gingivitis can also be modified or made worse by medications. These include immunosuppressant drugs and calcium channel blockers used to treat hypertension.
Once it has been established that a patient is experiencing gingivitis and all the risk factors taken into account, the first priority is addressing plaque control. The best effort needs to be designed to help patients master an efficient and through home care routine, tailored to their specific needs. This includes helping to access difficult or tight interdental spaces either with pickster brushes or toothpicks or floss. Detailed instruction including observing patients using these products forms the starting point to addressing gingivitis. Once patients have mastered cleaning between teeth, we demonstrate effective and safe toothbrushing.
As part of their overall plan for Dental Health patients will be encouraged to use a Fluoride toothpaste to help protect teeth from decay. In cases of chronic gingivitis an antibacterial rinse may be advised in the short term but not for the long term. Dental plaque that causes gingivitis cannot be washed or rinsed away so controlling it relies on effective mechanical removal of plaque with interdental aids and good tooth brushing technique.