How to Identify and Treat Gingivitis
Hey everyone, this is Dr. Mike Hardcastle from Village Dental Care. I get a lot of questions about gingivitis, and today I want to take a minute to try to answer some of the most common questions about gingivitis. Let's get into it.
What is gingivitis and is it different from periodontitis?
Periodontitis is commonly referred to as gum disease. Gingivitis is really the precursor to actual gum disease. Gingivitis is inflammation of the gums due to uncontrolled bacteria that creates inflammation and starts to break down the supporting structures of the teeth, but it doesn't have bone loss associated with it yet. When we take X-rays and clinically examine your mouth, we're going to notice red, swollen gums, and when we measure the gums, they'll bleed easily. We'll also reference the X-rays to see what the bone level looks like. For someone with active gingivitis, we will see pretty normal bone levels. People with a history of or active periodontitis may look similar, especially in the early stages, but on the X-ray, we'll notice breakdown and loss of bone supporting the teeth. That's the main difference between gingivitis and periodontitis.
What are the first symptoms of gingivitis?
The main thing is that gingivitis is normally painless. There are some situations where it has pain associated with it, which is called acute gingivitis. It involves aching, swollen gums that are painful and uncomfortable. For most people, there's no pain. You would notice by looking in the mirror and smiling that the gums are red, puffy, and swollen, rather than tight, firm, and pink as we want to see with healthy gums.
How dangerous is gingivitis?
Gingivitis is sneaky. In the short term, it's not majorly dangerous, but long term, it can be very dangerous. There's a lot of bacteria that grow in the gingivitis environment, and those bacteria can be found in people with coronary plaque. When you hear about thinning or narrowing of the blood vessels, it narrows most commonly because of plaque that lines the inside of the blood vessels. Inside that plaque are bacteria that can only be found in the mouth, commonly in large numbers with gingivitis. To protect your blood vessels and your heart long term, it's really important to treat any gum disease or gingivitis. We see bleeding gums as a warning sign of future problems, most likely systemically with your heart and blood vessels. Gingivitis locally around the teeth creates a really acidic environment. There's a lot of bacteria producing plaque acids, and acid eats away at the enamel of teeth and can ultimately lead to decay. Even if you don't get decay, you might get bone loss. Gingivitis can progress not only to decay but also to full-blown gum infection or gum disease called periodontitis.
Can you have gingivitis and periodontitis at the same time?
You can. You can have generalized gingivitis, with inflamed, swollen gums that bleed easily when we touch them. Locally, we could have areas of periodontitis where we see the same appearance, but on X-ray, we see bone loss in those areas. Typically, we treat the mouth as a whole and can treat both problems at the same time. Ultimately, our goal is to have tight, healthy, pink gums that don't bleed when we touch them or blow air on them.
How do dentists treat gingivitis?
Typically, it's the hygienist who would treat the gingivitis. The dentist helps to diagnose the gingivitis condition, and then we create a plan to do localized scaling similar to how we treat gum disease but with a less invasive and quicker treatment modality. In our office, we combine manual instrument treatment to remove hard deposits and bacteria with diode laser therapy. This cold laser therapy reduces inflammation, similar to how someone might use cold laser therapy on an achy joint or muscle. We use it to kill the bacteria in the pocket contributing to the gum disease or gingivitis condition.
How long does it take to cure gingivitis?
That's a two-part answer. One is the treatment, and getting the results from the treatment. Typically, we see significant improvement within two to four weeks. When we do a gingivitis treatment in our office, we have the patient come back four weeks later for a follow-up to measure the improvement and work on any areas that need extra attention. It's also a time to double-check the patient's home care.
The main reason why a patient might have less than optimal healing results is due to less than optimal home care. The treatment we do in the office helps about 30% towards the solution, while the other 70% is the effort and diligence the patient applies at home. We partner with our patients and want to teach them new techniques that are more effective. We're also your accountability partners, ensuring you're applying home care techniques properly and encouraging improvement if there's more opportunity. Our office has a strict policy: we don't preach or lecture anyone. Nobody's doing anything wrong, but there are things you can do better. Many people try, but their technique isn't adequate for the result we want. We aim to help our patients improve with their home techniques for the most optimal results. Think of our feedback as a partner or coach helping you improve. That's the role we play in our practice.
When should I schedule a dental appointment if I suspect I have gingivitis?
The answer is always right now. Don't wait. The gingivitis condition is always going to get worse and lead to a more difficult condition that's harder to treat. Once you lose bone, you never get it back, and you end up with gaps between your teeth. Why take a chance waiting for an appointment and risk these bad outcomes that none of us wants? Once you have them, you're stuck with them for life.
Do yourself a favor. Call now and make an appointment. If you don't have a dentist, I'd love to be your dentist. Just give us a call. Dr. Mike Hardcastle at Village Dental Care. Our website is villagedentaldallas.com. Our office phone number is (972) 992-5223. Come, let me check you out and see how we can help.