Gingivitis…is usually caused by plaque, bacteria and food particles that accumulate in the spaces between the gums and the teeth. These accumulations may be tiny, even microscopic, but the bacteria in them produce foreign chemicals and toxins that cause inflammation of the gums around the teeth. This inflammation can, over the years, cause loss of bone around teeth otherwise known as periodontitis. Since the bone in the jaws holds the teeth into the jaws, the loss of bone can cause teeth over the years to become loose and eventually to fall out. Regular cleanings below the gum line, best accomplished professionally by a dentist, disrupt these plaque and bacteria and help prevent inflammation. Once cleaned, it takes 3-4 months for the bacteria and plaque to grow back and once again restart the inflammation process. Ideally, then, scientific studies show that all people should have their gums cleaned by a dentist every 3-4 months. However, most dentists recommend cleanings every 6 months, because this has been the standard advice for decades, and because the benefits of regular tooth cleanings are too subtle for many patients to notice. If the inflammation in the gums becomes especially well-developed, it can break through the gums and allow tiny amounts of bacteria and bacterial toxins to enter the bloodstream. The patient may not be able to notice this, but studies suggest this can result in a generalized increase in inflammation in the body and possible long term heart problems.

Sometimes, the inflammation of the gingiva can suddenly amplify, such as to cause a disease called Acute Necrotizing Ulcerative Gingitivitis, otherwise known as “trenchmouth.” This results in the breath being extremely bad-smelling, and the gums feeling considerable pain. Fortunately, this can be cured with a 1-week dose of Metronidazole antibiotic, followed by a deep cleaning of the gums by a dentist.

When the teeth are not cleaned properly, dental plaque accumulates, transforming into a hard material called tartar and irritating the gums, and bacteria and toxins may cause the gums to become red and swollen. Alternatively, excessive injury to the gums caused by very vigorous brushing may lead to inflammation and infection. Pregnancy, uncontrolled diabetes mellitus and the onset of puberty increase the risk of gingivitis, due to hormonal changes that may increase the susceptibility of the gums or alter the composition of the dentogingival microflora. The risk of gingivitis is increased by dental calculus, misaligned teeth, the rough edges of fillings, and ill fitting or unclean dentures, bridges, and crowns. The drug phenytoin, birth control pills, and ingestion of heavy metals such as lead and bismuth may also cause gingivitis. The sudden onset of gingivitis in a normal healthy person should alert to the possibility of an underlying viral aetiology.