Gingivitis & Gum Disease
When it comes to your gums, you want to take care of them. Why? Because your gums take care of your teeth, and happy gums are likely to surround happy teeth. But when your gums become irritated, a condition known as gingivitis, this is the first step of gum disease, clinically known as periodontitis.
Dr. Ari Moskovitz and our entire team at Baltimore Periodontics Lasers & Dental Implants want to keep you off the path to gum disease. To that end, here’s some background on these issues with your gums.
What is gingivitis?
Despite its serious name, gingivitis is nothing more than gum inflammation. It is an easily treatable and reversible level of gum disease. You know your gums have moved into gingivitis because they will be red, swollen, and will bleed easily. There’s little or no discomfort at this early stage of gum disease.
causes of gingivitis
Plaque is the main irritant of the gums. Plaque is the film that forms on the teeth throughout the day consisting of bacteria, bacterial waste products, food residue, and saliva. When you brush and floss you remove the plaque. Then it starts to rebuild, only to be removed again when you brush. But if you neglect your oral hygiene the plaque can develop beneath the gumline, where it is very irritating to your gums. If allowed to stay there, the plaque hardens into tartar, causing more persistent irritation. If this irritation is allowed to continue and progress it can advance to periodontitis.
What are the signs of gingivitis?
Most people are unaware they have gingivitis because there isn’t any pain. Plus, since most gingivitis is caused by poor home oral hygiene, they may not be paying much attention to their teeth. But your gums will tell you they are irritated: they will be swollen, puffy, and will bleed easily. They may have started to recede and they will have changed from a healthy pink to an angry red. Plus, your breath will have gone south.
How to treat gingivitis
The good thing about gingivitis is that in this early form of gum disease nothing is yet irreversible. Any damage can be walked back. Diligent twice daily brushing for two minutes, along with daily flossing is what you’ll need to do. You’ll also need to keep your regular twice-yearly professional cleanings with your general dentist. These cleanings are necessary every six months because that is about the time it takes tartar to form and start moving under your gums.
Your dentist will likely also do these two procedures to walk back your tartar development:
- Scaling – If you have a fair amount of tartar built up under your gumline, it is scraped it off with dental tools. This is called scaling, and depending how much is necessary, it may require local anesthesia.
- Root planing – Root planing could be necessary, as well. Here tiny grooves or pits are removed from the tooth roots to make it easier for the gums to adhere and stop receding. This is done in multiple appointments with local anesthesia.
What If I leave Gingivitis Untreated?
Gingivitis is early gum disease. It’s mostly just irritated gums crying out for better care and it is reversible, but it is still gum disease. If you don’t address the plaque and tartar that are moving under your gums, the next step is full-blown advanced periodontitis.
Gum Disease Patient Testimonial
“When it became clear I would need substantial gum grafting surgery I made appointments with three different well-known periodontists. Not only did Dr. Moskowitz spend the longest in a thorough analysis of my gums (close to two hours in the initial consultation appointment), he provided the most detailed feedback on the conditions of my gums and his strategies for rectifying the situation. I could clearly understand his expert opinions and why he took those stances and recommended the path he wanted to take with my teeth. On top of this, he was so gentle in the analysis of the gums that I barely felt the dental tools, which directly contrasted with my experiences at the other periodontists whose handling of the teeth were rougher. And it was for those reasons why I chose to go with Dr. Moskowitz for the gum grafting surgery…… along with Dr. Moskowitz’s recommendations for the ongoing daily care for the gums. Dr. Moskowitz’s desire to help you improve your gums is genuine, which is demonstrated by his knowledge of periodontal treatments and the cutting edge developments in the world of dentistry. I can strongly recommend him to anyone seeking periodontal treatment.”
Thomas S. – October 2018
What is periodontal disease (Gum Disease)?
Periodontal disease means that the infection and irritation of gingivitis has spread to the other structures involved with your teeth. The word tells all. “Peri” means around, and “odontal” refers to the teeth. Periodontal disease, gum disease, is an infection of the structures around your teeth. What started with bacteria infecting and irritating the gums has now moved into the cementum that covers the tooth root, the periodontal ligament, and the alveolar bone. Now your teeth and jawbone are at risk.
Periodontitis vs. gingivitis
Gingivitis is the early form of periodontitis, where bacteria in the plaque on your teeth are infecting and irritating the gums. As plaque moves beneath the gumline the gums become more inflamed and begin to pull away from the teeth. Now gingivitis has advanced to periodontitis.
causes of periodontal disease
Periodontal disease, or periodontitis, is simply an acceleration of gingivitis. The infection has moved from simply bacteria irritating the gums to the other supporting tissues of your teeth.
The culprit doesn’t change — it’s bacteria in dental plaque. If the bacteria are not dealt with they will multiply and build up below the gumline. As the gums become more and more inflamed they will begin to detach/pull away from the tooth. This process forms a space, or “pocket,” between the tooth and gum. These pockets are perfect for breeding even more bacteria. Now the bacteria will attack the periodontal ligament and the alveolar bone. Allowed to continue the next step is tooth loss and jawbone deterioration.
What Causes Gum disease?
The main cause of periodontal disease is simply the bacteria in everyday plaque on the teeth. But there are other factors that can increase a person’s risk of developing gum disease or make it worse once infection has taken hold.
- Genes — While there is a genetic tendency, this can be headed off with good oral hygiene.
- Smoking — Smoking increases your risk, plus it makes periodontal disease more difficult to treat. Smokers build more tartar and they develop deeper pockets in the gums when they pull away from the teeth.
- Crowded, misaligned, tough-to-get-at teeth — If you have issues with alignment or if you have braces, it can be harder to keep your teeth clean.
- Grinding or clenching your teeth — While these habits don’t cause gum disease, they accelerate it. This is because more pressure placed on the teeth speeds the breakdown of the periodontal ligament and bone.
- Stress — Ongoing stress makes it harder for your body to fight the infection of periodontal disease.
- Medicines — Certain medicines have dry mouth as a side effect. Saliva in your mouth helps neutralize plaque, so less saliva allows more plaque to take hold.
- Certain diseases — Certain diseases such as diabetes, rheumatoid arthritis, and HIV create a higher risk for developing gum disease.
symptoms of Gum Disease
Healthy gums are firm and pale pink and the fit snuggly around the teeth. These are the signs of periodontitis:
- Swollen gums
- Bright red or purplish gum color
- Bleeding Gums
- Gums that are tender to the touch
- Gums that have pulled away from the teeth (this make the teeth look longer)
- New space developing between your teeth
- Pus between your teeth and gums
- Bad breath
- Loose teeth
- Pain when chewing
- A change in your bite
How is periodontitis treated?
With early gum disease, root scaling and root planing, where tartar and bacteria are removed from beneath the gumline and the root surfaces are smoothed, may be all that is needed. Antibiotics can help address the bacterial infection.
But once you situation has progressed to advanced periodontitis, it will likely require surgery by Dr. Moskovitz.
- Osseous surgery — Dr. Moskovitz makes tiny incisions in the gums to lift back a section. This enables effective scaling and planing under the gums in that area.
- Laser gum therapy — Dr. Moskovitz uses a diode laser to remove infected gum tissue from around the root of the tooth. The laser closes the incision line instantly and disinfects the area. Laser treatment is effective for addressing infected gum pockets that have pulled away from the teeth.
- Soft tissue grafts — When the gums are infected and recede, you will probably need to have some of this gum loss replaced. Gum grafts are usually taken from the roof of the mouth and attached to the areas when the gums have receded.
- Bone grafting — Advanced periodontal disease destroys the bone surrounding your tooth root. That’s why teeth become loose and then fall out. Bone grafting is used to build this bone back up.