Gingivitis : Gum disease

Gingivitis: Gum Disease

Gingivitis (also known as) Inflammation of gingiva, is pathological change in gingiva (gums) due to presence of microorganisms in gingival sulcus (area between gingiva and tooth). These microorganisms secrete different metabolic products which cause damage to epithelial and connective tissue cells and other constituents of gingiva.

Progression of gingivitis can be divided into 4 main steps:

1] Initial Lesion: It is characterized by vascular dilatation and gingival fluid flow.
2] Early lesion: It is characterized by Vascular proliferation and Erythem as well as bleeding on probing.
3] Established lesion: It is characterized by vascular proliferation and blood stasis andchanges in color, size and texture of gingiva.
4] Advanced lesion: It is characterized by Extension of lesion into alveolar bone and periodontal breakdown.

Gingivitis can be grossly divided into 2 categories as:

1] Localised gingivitis: Which is confined to the gingiva of a single tooth or a group of teeth.
2] Generalised gingivitis: which involves the gingiva of the whole mouth.

Furthermore, Gingivitis is of three types, as follows:

1] Marginal gingivitis: It involves only marginal part of gingiva, but may extend to attached gingiva (attached to tooth).
2] Papillary gingivitis: It involves interdental papilla (V-shaped gums between two teeth) and extend to adjacent marginal gingiva.
3] Diffuse gingivitis: It involves all the parts of the gingiva including Marginal gingiva, Attached gingiva, Interdental gingiva.

Effects of Gingivitis on our Dental Health:

1] Gingivitis is always associated with increased gingival fluid production rate and bleeding from the gingival sulcus on gentle probing or even brushing.

2] Most common cause of bleeding from gum is chronic inflammation to gums. Usually bleeding starts from tooth brush, toothpicks or due to food accumulation between gums and teeth or even biting on hard foods like apple.

3] Gingival bleeding is because of thinning of epithelium of gingival sulcus and dilatation of blodd capillaries, which rupture on ordinary stimuli like tooth brushing or biting on hard food, thus causing beelding.

4] Acute bleeding are caused by injury or laceration by toothbrush bristles during aggressive toothbrushing or by sharp pieces of hard food. This can be present even in absence of gingival disease.

5] Gingival bleeding may be caused by systemic factors such as Vitamin C deficiency, allergic reactions, platelet disorders, vitamin K deficiency due to liver disease, or other blood diseases.

6] Color of the gingiva changes from coral pink (healthy) to bright read to shiny slate gray which can become dull whitish gray.

7] Consistency of gingiva changes from firm, resilient consistency to edematous and fibrotic consistency.

8] Usually surface texture of gingiva is stippled, but in gingival disease it becomes either smooth and shiny or firm and nodular.

9] Gingiva may change its position and shift to apical area, which is called recession, and it results in exposure of root surface of tooth.