Gingivitis

Gingivitis is the inflammation of the ginvival tissues (“gums”) and is one of the two major periodontal diseases. Gingivitis manifests clinically with signs such as redness and enlargement of the gums (edema) as well as gum bleeding during brushing or automatically. Sometimes patients may also report “bad breath” as well as taste alteration. The main difference between gingivitis and periodontitis (see corresponding chapter) is that gingivitis is a fully reversible condition and it is not characterized by bone loss around teeth.

In most cases the etiology of gingivitis is the presence of microbial plaque, however its gravity may be modified by a number of systemic or local factors.

Local factors may include ill-fitting or overhanging restorations, which facilitate plaque accumulation and hamper proper oral hygiene. Systemic factors such as changes in hormone levels (i.e. puberty, pregnancy), systemic diseases (i.e. diabetes mellitus, leukemia) or systemic use of certain medication (i.e. contraceptives) enhance clinical symptoms in pro-inflammatory manner.

Relatively rarely, clinical symptoms of gingivitis may be manifestations of systemic diseases/conditions of microbial, allergic or autoimmune origin.

Treatment of gingivitis involves the removal of all etiologic factors (plaque and tartar) by the use of ultrasonic devices and hand scalers as well as instructing the patient in proper oral hygiene.