Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that is attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced. While some cases of gingivitis never progress to periodontitis. Periodontitis is always preceded by gingivitis.

 Gingivitis is reversible with good oral hygiene; however, without treatment, gingivitis can progress to periodontitis, in which the inflammation of the gums results in tissue destruction and bone resorption around the teeth. Periodontitis can ultimately lead to tooth loss.

Signs and symptoms

The symptoms of gingivitis are somewhat non-specific and manifest in the gum tissue as theclassic signs of inflammation: preparing the tooth for placement of restorative material or materials, and another consideration is unsupported tooth structure. When preparing the tooth to receive a restoration, unsupported enamel is removed to allow for a more predictable restoration. While enamel is the hardest substance in the human body, it is particularly brittle, and unsupported enamel fractures easily. This technique involves placing a soft or malleable filling into the prepared tooth and building up the tooth. The material is then set hard and the tooth is restored. The advantage of direct restorations is that they usually set quickly and can be placed in a single procedure. The dentist has a variety of different filling options to choose from. A decision is usually made based on the location and severity of the associated cavity. Since the material is required to set while in contact with the tooth, limited energy (heat) is passed to the tooth from the setting process.

Treatment

The focus of treatment is to remove plaque. Therapy is aimed at the reduction of oral bacteria and may take the form of regular periodic visits to a dental professional together with adequate oral hygiene home care. Thus, several of the methods used in the prevention of gingivitis can also be used for the treatment of manifest gingivitis, such as scaling, root planning, and curettage, mouth washes containing chlorhexidine or hydrogen peroxide, and flossing. Interdental brushes also help remove any causative agents. Powered toothbrushes work better than manual toothbrushes in reducing the disease. The active ingredients that "reduce plaque and demonstrate effective reduction of gingival inflammation over a period of time" are triclosan, chlorhexidine digluconate, and a combination of thymol, menthol, eucalyptol, and methyl salicylate. These ingredients are found in toothpaste and mouthwash. Hydrogen peroxide was long considered a suitable over-the-counter agent to treat gingivitis. There has been evidence to show the positive effect on controlling gingivitis in short-term use. A study indicates the fluoridated hydrogen peroxide-based mouth rinse can remove teeth stain and reduce gingivitis. Based on limited evidence, mouthwashes with essential oils may also be useful, as they contain ingredients with anti-inflammatory properties, such as thymol, menthol and eucalyptol.The bacteria that cause gingivitis can be controlled by using an oral irrigator daily with a mouthwash containing an antibiotic. Amoxicillin, cephalexin, or minocycline in 500 grams of a non-alcoholic fluoride mouthwash is an effective mixture.

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Sarah eve

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Journal of Oral Hygiene and Health