mouth and dental disorders
Gingivitis
Gingivitis Due to Plaque
Almost all gingivitis is due to Overview of Tooth Disorders , which is a filmlike substance made up primarily of bacteria, saliva, food debris, and dead cells that is continually being deposited on teeth. Tartar is hardened plaque. By far, the most common cause is Inadequate brushing and flossing Without adequate brushing, plaque remains along the gumline and builds up between the gums and the teeth (gingivitis does not occur in places where teeth are missing). Plaque also accumulates in faulty fillings and around the teeth next to poorly cleaned partial dentures, bridges, and orthodontic appliances. When plaque stays on the teeth for more than 72 hours, it can harden into Overview of Tooth Disorders (calculus), which cannot be completely removed by brushing and flossing. Plaque irritates the gums and creates pockets between the teeth and gums. Bacteria living in these pockets may cause gingivitis as well as Cavities in the roots of the teeth. The gums appear red and swollen and become movable instead of being firm and tight against the teeth. The gums may bleed easily, especially while brushing or eating. People usually do not have pain. Gingivitis due to plaque can be prevented with good oral hygiene—the daily use of a toothbrush and dental floss. Some mouthwashes also help control plaque. After tartar forms, it can be removed only by a dentist or dental hygienist. People typically need professional cleanings (called scaling and prophylaxis) every 6 to 12 months. However, people with poor oral hygiene, medical conditions that can lead to gingivitis, or a tendency to develop plaque more quickly than usual may need professional cleanings more often. Because of their excellent blood supply, gums quickly become healthy again after tartar and plaque are removed, as long as people brush and floss carefully. In addition to poor oral hygiene, gingivitis due to plaque may also be started or worsened by Drugs Overview of Vitamins None Hormone changes Overview of Leukemia and Diabetes Mellitus (DM) None Human Immunodeficiency Virus (HIV) Infection None Some drugs can cause an overgrowth (hyperplasia) of gum tissue, so that removing plaque becomes more difficult, and gingivitis often develops.Phenytoin(taken to control seizures),cyclosporine(taken by people who have had organ transplants), and calcium channel blockers such asnifedipine(taken to control blood pressure and heart rhythm abnormalities) can cause such an overgrowth. Also, oral or injectable contraceptives can aggravate gingivitis, as can exposure to lead or bismuth (which is used extensively in cosmetics) or to other heavy metals such as nickel (used in jewelry). Medical conditions that might cause or worsen gingivitis should be treated or controlled. If people must take a drug that causes gum tissue overgrowth, the excess gum tissue may need to be removed surgically. However, meticulous oral hygiene at home and frequent cleanings by a dentist or dental hygienist may slow the rate of tissue growth and eliminate the need for surgery. Vitamin deficiencies, in rare cases, can cause gingivitis. Vitamin C Deficiency (scurvy) can lead to inflamed, bleeding gums (see deficiency ( Niacin Deficiency ) also causes inflamed, bleeding gums and a predisposition to certain mouth infections, such as These deficiencies are rare in the United States. Vitamin C andniacindeficiencies can be treated with vitamin C andniacinsupplements, plus a diet that includes more fresh fruits and vegetables. can worsen mild gingivitis, primarily because of hormonal changes. Some pregnant women may unknowingly contribute to the problem by neglecting oral hygiene because they feel nauseated in the morning (morning sickness) and fatigued. Also during pregnancy, a minor irritation, often the buildup of tartar or a restored tooth with a rough edge, may cause a soft, reddish, lumplike overgrowth of gum tissue, called a pregnancy tumor ( Pyogenic Granulomas ). The bloated tissue bleeds easily if injured and may interfere with eating. If pregnant women are neglecting oral hygiene because of morning sickness and/or fatigue, dentists can suggest ways to keep the teeth and gums clean without making the nausea worse. Gentle brushing without toothpaste, or even salt water rinses after brushing, can help. A bothersome pregnancy tumor can be surgically removed. However, such tumors tend to recur until, and even after, the pregnancy ends. Menopausecan cause desquamative gingivitis, a poorly understood, painful condition that occurs most commonly in postmenopausal women. In this condition, the outer layers of the gums bleed easily and separate from the underlying tissue (desquamate), exposing nerve endings. The outer layers of the gum tissues can be rubbed away with a cotton swab or blown off with a dentist’s air syringe. If desquamative gingivitis develops during menopause, hormone replacement therapy may help. Otherwise, dentists may prescribe a corticosteroid rinse or a corticosteroid paste that is applied directly to the inflamed areas. can cause gingivitis. In fact, gingivitis is the first sign of disease in about 25% of children with leukemia. An infiltration of leukemia cells into the gums causes the gingivitis, and a reduced ability to fight infections worsens it. The gums become swollen, painful, and red and bleed easily. Often, the bleeding continues for several minutes or more because blood does not clot normally in people with leukemia. Less commonly, A person with gingivitis due to leukemia can prevent bleeding by gently wiping the teeth and gums with a gauze pad or sponge instead of brushing and flossing. Dentists can prescribe achlorhexidinemouth rinse to control plaque and prevent mouth infections. When the leukemia is in remission (when evidence of the cancer disappears), good dental care can restore the gums to health. 