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What is the concept of gingival inflammation?

Causes – The most common cause of gingivitis is poor oral hygiene that encourages plaque to form on teeth, causing inflammation of the surrounding gum tissues. Here’s how plaque can lead to gingivitis:

Plaque forms on your teeth. Plaque is an invisible, sticky film composed mainly of bacteria that forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Plaque requires daily removal because it re-forms quickly. Plaque turns into tartar. Plaque that stays on your teeth can harden under your gumline into tartar (calculus), which collects bacteria. Tartar makes plaque more difficult to remove, creates a protective shield for bacteria and causes irritation along the gumline. You need professional dental cleaning to remove tartar. Gingiva become inflamed (gingivitis). The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth, causing inflammation. In time, your gums become swollen and bleed easily. Tooth decay (dental caries) also may result. If not treated, gingivitis can advance to periodontitis and eventual tooth loss.

What are the stages of gingival inflammation?

What Treatments are Available for Gum Disease? – Just like any other disease, gum disease has different stages. In its earliest stage, gingivitis, the gums become inflamed and may bleed when brushed. If left untreated, gingivitis can develop into periodontitis, which is a more serious form of gum disease.

1. Periodontitis destroys the bone and connective tissue that support the teeth, and can eventually lead to tooth loss.
2. There are a number of different treatment options available for gum disease, depending on how severe it is.
3. In its early stages, gingivitis can often be reversed with good oral hygiene and regular professional cleanings.

More advanced forms of gum disease may require more aggressive treatment, such as scaling and root planing (a deep cleaning that removes tartar and bacteria below the gum line), antibiotics, or surgery.

How long do gums stay inflamed?

How Long Do Swollen Gums Last – In most cases, swelling in the gums should go away after 1 or 2 days. For example, if you have food stuck in your teeth, or have used a mouthwash that irritated your gums the swelling should not last long. Swollen gums that last for longer than a few days may be a sign of a more serious underlying issue such as gingivitis or an infected tooth.

What drug causes gingival inflammation?

Abstract – Drug-induced gingival overgrowth is a side effect associated principally with 3 types of drugs: anticonvulsant (phenytoin), immunosuppressant (cyclosporine A), and various calcium channel blockers (nifedipine, verapamil, diltiazem). In this review, we describe the features of phenytoin-, cyclosporine A- and nifedipine-induced gingival overgrowth in rats and discuss factors influencing the onset and severity of these disorders.

There are several features common to the gingival overgrowth induced by these drugs: 1) gingival overgrowth is more conspicuous in the buccal than in the lingual gingiva and less severe in the maxilla than in the mandible; 2) once the blood concentration of the drug reaches a certain level as a result of increasing the dose, the incidence of gingival overgrowth is 100% and its severity is dependent on the blood level, the most severe overgrowth being induced by cyclosporine A; 3) the duration of drug administration for maximal gingival overgrowth to develop is about 40 days; 4) the gingival overgrowth regresses spontaneously after discontinuing the drug; 5) accumulation of dental plaque is not essential for the onset of overgrowth, but plays a role in its severity; and 6) more severe overgrowth is induced in young than in old rats.

Furthermore, male rats are more susceptible than females to nifedipine-induced gingival overgrowth. These results suggest that drug-induced gingival overgrowth in rats is dependent on the oral drug dose, blood drug level, age, and sex and that preexisting gingival inflammation is a factor relevant to its severity.

How long does it take for gums to heal from inflammation?

How long does it take to treat gingivitis? – Patients who comply with their dentist’s recommendations will often see their condition reduce dramatically within two or three weeks. More serious stages of gingivitis may take longer to see results.

What deficiency causes inflamed gums?

– Vitamin C is essential for the production of a structural protein called collagen, which is an important part of your gums. This is why a vitamin C deficiency can result in inflamed, bleeding, and painful gums ( 3 ). Vitamin C deficiency is common worldwide, especially in developing countries.

People treat and prevent this condition by taking vitamin C supplements ( 3 ). Studies have found that low, but not necessarily deficient, levels of vitamin C have been associated with an increased risk of periodontal diseases ( 4, 5 ). A 2019 review of 14 studies looked at the relationship between people’s vitamin C levels and periodontal disease.

It found that people who had lower blood levels of vitamin C and lower dietary intake of vitamin C were more likely to develop gum disease than people who had optimal blood levels and higher dietary intake ( 6 ). A 2021 review of six studies found that taking vitamin C supplements reduced gum bleeding in people with gingivitis and those with diabetes.

1. However, it did not improve other aspects of periodontal disease ( 7 ).
2. Therefore, taking a vitamin C supplement may reduce your risk of periodontal disease and promote gum health.
3. It could be especially helpful if your diet is currently low in foods that are rich in vitamin C, such as fruits and vegetables.

Plus, if you have periodontal disease, taking vitamin C supplements may improve some of your symptoms.

What deficiency causes inflammation of the gums?

Receive Expert Dental Care from Your Knoxville Dentist – If you have swollen gums and they don’t seem to be getting any better, it’s time to seek the help of a dental professional. A general dentist can figure out what the problem is and provide you with the treatment necessary to fix it.

When you are searching for a Knoxville dentist with the best education, skill, and technology, look to University General Dentists. Our two dentists each have over 30 years of experience providing top-notch dental care to the residents of Knoxville. We offer a full range of services and treatments to help you achieve the best dental health possible.

Whether you need gum disease therapy or it’s simply time for a checkup and routine cleaning, we are here to help. For your convenience, we have two Knoxville dentist locations, one at the University of Tennessee Medical Center and one in West Knoxville.

What bacteria causes gum inflammation?

Gum disease – Two types of bacteria are commonly associated with gum disease – Treponema denticola and Porphyromonas gingivalis. Both of which can survive without oxygen and multiply to cause inflammation of the gums. When these organisms produce toxins it disrupts cultures of normal and healthy oral bacteria.

What is the best antibiotic for gingivitis?

Tetracycline antibiotics – Antibiotics which include tetracycline hydrochloride, doxycycline, and minocycline are the primary drugs used in periodontal treatment. They have antibacterial properties, reduce inflammation and block collagenase (a protein which destroys the connective tissue).

Does salt water help gingivitis?

Salt water treatment for gingivitis – The results of a 2016 study showed that using a salt water rinse can be very beneficial in healing gums inflamed by gingivitis. Salt is a natural disinfectant that helps your body to heal itself. Salt water may also:

• soothe inflamed gums
• help ease pain
• reduce bacteria
• remove particles of food
• relieve bad breath

To use a salt water rinse:

1. Add 1/2 to 3/4 teaspoon of salt to a glass of lukewarm water and mix well.
2. Swish the solution in your mouth for up to 30 seconds.
3. Spit out the solution.
4. Repeat two to three times per day.

Using a salt water rinse too often or for too long could have negative effects on tooth enamel. Long-term use may cause your teeth to erode because of the mixture’s acidic properties. If the salt water rinse isn’t relieving your symptoms, it may be time to try a more advanced mouthwash.

Can gingivitis go away on its own?

Can gingivitis be cured? – Unlike the other stages of gum disease, gingivitis is curable as long as you treat it early enough. If you notice symptoms of gingivitis, you should schedule an appointment with a dentist and immediately begin practicing better oral hygiene at home.

What are the red flags of gingivitis?

Symptoms – The main signs of gingivitis are red, swollen and bleeding gums. The gums bleed when you clean your teeth, and sometimes for no obvious reason too. Gingivitis generally doesn’t cause any pain or other symptoms, so it remains undetected for quite some time.

Periodontitis often doesn’t cause any symptoms either until it has become advanced. As well as red and bleeding gums, it can also lead to sensitive teeth and receding gums (“long teeth”), sore gums and bad breath. If the gums are inflamed, they may start pulling away from the neck of the tooth. This causes gaps to form between the teeth and the gums, known as gum pockets (or periodontal pockets).

At a more advanced stage, periodontitis can cause teeth to shift position, start wobbling or hurt when you chew.

What is inflammation of the gingival margin?

Inflammation of the gingiva: The other reasons besides the obvious Gingival inflammation is usually attributed to bacterial-induced gingivitis and/or periodontitis. Although bleeding is most often caused by this etiology, there can be other systemic issues at work.

• The most common of these entities are the diseases listed under the category desquamative gingivitis.
• Desquamative gingivitis is a clinical term used to characterize attached and/or free (marginal) gingiva that demonstrates epithelial erythema and erosion.
• Desquamative gingivitis can be seen alone or with focal areas of ulceration.

When a patient presents with desquamative gingivitis, the most common diseases or disorders that may be causing the problem are 1. (benign) mucous membrane pemphigoid, 2. erosive lichen planus, 3. lichenoid mucositis, and, less frequently, 4. pemphigus vulgaris.

1. There are other diseases such as lupus erythematosus and erythema multiforme that under certain instances could be considered, but for our purposes we will address the most common entities.
2. OTHER ORAL PATHOLOGY ARTICLES,
3. Once you have clinically identified desquamative gingivitis, since all the causative entities can look clinically similar, the next step is to determine a definitive histologic diagnosis.

This can be done with an incisional biopsy taken at the edge of a lesion so that the interface between normal and abnormal mucosa can be evaluated microscopically. The biopsy should be taken so that normal appearing tissue adjacent to the lesion is submitted along with the lesional tissue.

1. If only ulcerated or eroded tissue from the center of an erosion or ulceration is submitted, there may not be enough diagnostic information to make a definitive diagnosis.
2. A conventional biopsy, placing the surgical specimen in 10% buffered formalin, is acceptable, but since two autoimmune diseases are in the differential diagnosis list, consideration should be given to direct immunofluorescence on the initial submission.

Such specimens will need to be held in Michel’s solution instead of formalin for transport to the pathology laboratory. You can request Michel’s solution from the oral pathology laboratory you use. Michel’s solution has a relatively short shelf life compared to formalin, so contacting the lab a week or so prior to the biopsy procedure is all that is needed.

1. Once a definitive diagnosis is obtained, treatment for the diseases in the differential list will vary and are partially based on extent of involvement: Pemphigus vulgaris (Fig.1) can be a life-threatening disease and should be managed by either a vesicullo-bullous clinic or a dermatologist.
2. Dentists can collaborate with their medical colleagues in treating the oral lesions, typically with an immunosuppressant (such as topical corticosteroids) or immune modulators (such as tacrolimus or dapsone).

Fig.1 Mucous membrane pemphigoid (Fig.2) can be treated with topical corticosteroids by the general dentist, but referral to an ophthalmologist is imperative as patients may also develop scarring of the mucous membranes of the eye. If only the gingiva is involved, I will often fabricate carrier trays for delivery of the medication.

1. These are soft acrylic appliances similar to bleaching trays; the difference is the tray is extended to cover the gingiva.
2. Topical corticosteroid ointment can be placed in the tray and inserted in the oral cavity for 15 to 30 minutes three times per day.
3. The ointment will be in contact with the gingiva for a longer period of time thus increasing efficacy.

Fig.2 Lichen planus (Fig.3) may also be treated in a similar fashion with topical corticosteroids, but patients with erosive lichen planus should be made aware of the reported increased risk of developing squamous cell carcinoma in involved areas. This risk is relatively small, but patients should be educated about it and reminded that their oral mucosa should be evaluated regularly.

Initially, I see patients every three months. If they are disease-free, I may increase that up to a maximum of twice per year. In patients with a history of lichen planus or lichenoid mucositis, any ulceration that does not heal after two weeks of appropriate use of topical corticosteroid should be biopsied to rule out epithelial dysplasia or squamous cell carcinoma.

Fig.3 With lichenoid mucositis (Fig.4), you and the patient need to become detectives to try to sleuth out the offending drug, supplement, product, etc., that might be causing desquamation and then have the patient discontinue the product. If a medication is found to be the etiology, consult with the patient’s physician to try to change the medication or the class of medication.

If this is not possible, the patient will require palliative treatment for the periods of breakout, typically with a topical corticosteroid or immune modulator. Fig.4 While the general dentist can manage most cases, if you do not feel comfortable managing the patient, referral to a specialist such as an oral and maxillofacial surgeon or oral and maxillofacial pathologist is an option.

Denise A. Trochesset, DDS, is an assistant professor of oral biology and pathology at Stony Brook University School of Dental Medicine, where she is director of oral pathology. Dr. Trochesset is jointly appointed in the Departments of Pathology and Dermatology at Stony Brook University School of Medicine.

Dr. Trochesset is a graduate of the University of Minnesota School of Dentistry. She completed a one-year General Practice Residency at the West Haven Veterans Administration Medical Center in Connecticut prior to working in private practice for 10 years. Dr. Trochesset left private practice to pursue her interests in oral pathology.

She completed a three-year residency program in oral and maxillofacial pathology at New York Hospital, Queens, and joined the faculty at Stony Brook University School of Dental Medicine in 2002. She became a fellow of the American Academy of Oral and Maxillofacial Pathology and attained her specialty boards in oral and maxillofacial pathology in 2002.

• Dr. Trochesset is currently a full-time faculty member at Stony Brook, teaching oral pathology and oral medicine to the dental students and in the graduate programs.
• She is director of Stony Brook Oral Pathology, a biopsy service, and has an active faculty practice in clinical oral pathology/oral medicine.

: Inflammation of the gingiva: The other reasons besides the obvious

What is gingival inflammation during orthodontic treatment?

Gingival hyperplasia – Occasionally, plaque buildup or gum irritation caused by braces may trigger a condition known as gingival hyperplasia, Gingival hyperplasia is also referred to as gingival enlargement, or hypertrophy. It results from an overgrowth of gum tissue around the teeth.

Swollen gums can be soothed at home by rinsing several times daily with warm salt water.Taking an over-the-counter anti-inflammatory medication that reduces swelling and pain can also help. Avoid eating tough, hard-to-chew foods when your gums feel tender. Flossing between your teeth is the key to reduce inflammation of you gum. You could use a waterpik as an option, yet unwaxed floss is the best option.

If your swollen gums have been caused by gingivitis, seeing your dentist for regular cleanings and checkups will help, provided that you remain diligent with at-home dental care. If your gums are very painful or so swollen that they appear to be growing over your teeth, see your dentist or orthodontist.

If the cause is severe gingival hyperplasia which doesn’t respond to at-home treatment, your orthodontist may need to remove the irritated or diseased gum tissue. This is often done with a laser. It is hard to avoid gum swelling when you are wearing braces. However, proper dental hygiene can make your gums healthier and less prone to severe swelling.

It can also help reduce your chances of getting gingivitis or advanced gum disease, which is known as periodontitis, Braces can make it hard to clean your teeth. However, maintaining proper oral hygiene is essential for reducing gum swelling caused by plaque buildup and gingivitis.

Brush your teeth with an electric tooth brush that has a soft brush head.Use an orthodontic floss threader that makes it easier to clean between teeth and under the gumline.Use an antibacterial mouth rinse after brushing.

In addition, avoid eating foods which can get trapped in your braces easily. These include:

steakcorn on the cobhard candypopcorn

Swollen gums may last for up to a week when you first get your braces. Each time they are tightened, you may also experience pain and swelling for one to three days. Swollen gums that last longer than that should be examined by your dentist or orthodontist.

If gum swelling is accompanied by bleeding from an errant wire or braces that are cutting into them, let your dentist know. They will either adjust your braces or give you soft wax to protect the area. Swollen gums are a common occurrence you can expect when you first get braces put on. The gums may also swell and become tender after braces are tightened.

Having braces on your teeth may make it harder to take care of them. However, poor oral hygiene habits may lead to gum disease, which can also cause gum swelling. This can be avoided by brushing, flossing, and rinsing daily.