One morning, Michael went
in for his regular dental checkups,
expecting nothing out of the ordinary.
To his surprise, his trusted dentist,
Dr. Robinson informed him
and he had gingivitis.
He was shocked! while
he did not know much about it.
It sounded serious. He immediately asked,
"I didn't notice anything wrong.
Should I be worried?"
Dr. Robinson replied saying, "Don't worry.
Gingivitis is surprisingly
common and completely reversible.
Let me tell you more about it and
why it is important to address it."
Gingivitis refers to the early stages
of gum disease. It is caused
by a buildup of bacteria and
other particles on the surface of your teeth,
creating a sticky film known as plaque.
If not removed, the plaque hardens over time.
This hardened layer (tartar) leaves the gums
prone to bacterial infection.
Gingivitis results and symptoms
like bad breath, swollen,
tender gums, loose teeth,
and receding gums, or longer appearing teeth.
If left untreated, it can progress into
a more severe form of
gum disease called periodontitis,
where the gum line recede,
teeth may fall out
and supporting bone may be lost.
There are also some risk factors
involved in developing gingivitis.
Smoking, diabetes,
and even your genetics
can make you susceptible.
Research also shows that
socioeconomic barriers make it
more difficult to care for oral health.
Having a low tooth
brushing frequency on average,
as well as lower access
to oral health tools and
education contribute
to a high prevalence of gingivitis.
It is important to take action at
the gingivitis stage as this is
the only stage of gum
disease that is reversible.
So how exactly do you
know if you have gingivitis?
The first step to diagnosing gingivitis is
paying a visit to your dentist
or dental hygienist.
They have unnecessary experience and
expertise to examine your gums. For instance,
let's take a closer look at how Dr. Robinson
would diagnose gingivitis
in her patient Michael.
Dr. Robinson will make sure to
ask Michael whether he has
been experiencing any symptoms
related to the condition,
including whether his gums feel tender or
puffy, or bleed easily
when he brushes his teeth.
Then Dr. Robinson will
take a closer look into Michael's mouth.
One method that she may use to do this
is called gum probing.
This is a relatively painless method in
which dentists use a tiny ruler called a
"probe" to check for and measure
any pockets around
the teeth. In a healthy mouth,
the depth that these pockets is
usually between 1 to 3 millimeters.
Larger pockets of 5 millimeters or
greater may indicate
progression into gum disease.
Another method is utilizing x-ray machines to
check how much jawbone
a patient has surrounding each tooth.
The bone is what keeps your tooth secure
and so it is important to
identify if any bone loss has occurred.
Oral health professionals will also make sure
to ask about your medical history
in order to identify risk factors
you may have to developing
gingivitis and potential gum disease.
Once Dr. Robinson has
finished assessing Michael,
she considers whether she should
refer him to a periodontist.
Periodontist are experts in
the diagnosis and treatment of
gum disease and may provide you with
treatment options that are
not offered by your dentist.
Ultimately, she decides that
Michael's gingivitis has not
progressed enough to refer him.
If Michael are diagnosed with gingivitis,
Dr. Robinson would focus on providing
treatment that will reverse
the symptoms of the condition.
Scaling is a process in which
plaque and tartar or removed.
Root planing is a process that
removes the bacteria that causes
the inflammation and smooth
root surfaces to prevent
further build-up of tartar and bacteria.
Dr. Robinson explains,
after getting his
teeth professionally cleaned,
it is imperative that Michael makes
changes at home to
prevent further gum disease.
She recommends that he is brushing his teeth
twice a day and flossing everyday.
Dr. Robinson also emphasizes
to Michael that if he smokes,
stopping smoking will
prevent the progression of
gingivitis. While these are treatments
that Dr. Robinson saw fit for my goal,
make sure to talk to your dentist
about what treatment is best for you.
Now for some frequently asked questions,
Meet Dr. Ruhee Jaffer.
She's a practicing general
and cosmetic dentist
and the LA/DC areas.
She is here to help answer
some common questions towards oral health.
What are some of the common
signs of gum disease?
Signs of disease or like inflammation anywhere
else you get bleeding,
you get puffy gums.
You get sometimes pain on brushing or flossing.
You start getting what we call
pocketing because the gums are
more inflamed when we use
our periodontal probe to measure it,
The pockets
start getting deeper than three millimeters.
So that's why your hygienist
or your dentist will usually measure
the pockets in your mouth because we want to
make sure that the gums are nice and tight.
So a sign of healthy gums would be
firm pink stippled gingiva without
that puffy factor and the margins should not
look world like tires or rounded.
That- when you start seeing signs of that,
it means that the bacteria is starting
to sit under the gum line.
And you know, cause
a little bit of destruction.
How often do you notice patients with
gingivitis and do you bring it up
with the patient every time you encounter it?
Yes. I do bring it up every time I
encounter him because it's
totally preventable.
A lot of diseases in the mouth like
either gingivitis or cavities,
are prevented with proper oral hygiene care.
Assuming that there's no
or other things going on,
like depending on the type of medication
someone is or the other
medical conditions they have.
But because it's very
easy to prevent, it's something that we
always touch on and so prevention
includes things like flossing,
brushing while adjunct aids like mouthwashes
or different types of toothpaste can
definitely keep things under
control a little bit.
Gingivitis is actually a
reversible disease. Once it
progress this past a certain point and
becomes what we call periodontitis.
and what periodontitis is, it really
is a fancy Latin word, which means "perio,"
"gum." "Odonto" a word
for "bone" and "-itis" is "inflammation"
so periodontitis is once the inflammation
becomes so bad in gingivitis
and you start getting bone loss,
and once it reaches
that stage, it's irreversible.
So what you can do is maintain it,
but we try to always catch
our patients before it
becomes periodontal disease
because ultimately the consequence of
severe periodontal disease is that you
lose teeth and when people this teeth,
they lose a lot of form and function.
And you know, we use our mouths a lot.
So it really does affect quality of life.
Why is there a saying that gingivitis is
the gateway to other oral health concerns?
When they like to talk about the mouth,
I always say it's
really just the beginning of
your GI (gastrointestinal tract) and this is
either your breathing things
in or you're eating things in,
it really is
the gateway to a lot of other things.
So bacteria in your mouth unfortunately,
don't stay in your mouth.
They start to spread everywhere else.
And if we know that plaque and films of
bacteria are rampantly
colonizing every 12 to 24 hours.
They're like multiplying and size.
After the mouth,
they have to go somewhere else.
So that's where you start
getting all these other oral systemic things.
So you get a lot of inflammatory proteins
that cause
things like atherosclerosis
or in pregnant women,
preterm births and low birth weights or stroke
because inflammatory proteins don't
just- if it's inflammation in your mouth,
it's not just staying in their mouth,
it starts to affect other parts of your body.
And I hate to say this, but you know,
a lot of diseases have
their first manifestations in
the oral cavity as though things like,
you know, even COVID
had some oral manifestations,
which has the most recent example.
But when people have diabetes,
you see definitely changes in
the microvasculature and the mouth.
And patients who are immunocompromised
may have either
like other things going on,
you often see ulcerations or lesions in
the mouth that depict that
the systemic condition.
So I mean,
there's a lot you can tell by looking at
a mouth because of
how the mucosa is in the mouth.
And so it's really interesting.
It's just part of the body and vice versa.
Thank you to Dr. Ruhee Jaffer
for answering our questions.
We hope you have a better understanding of
gingivitis. Thank you for watching.