Gingivitis – Treatment Options Available for Treating the Disease
You’re brushing your teeth, and when you rinse and spit, you see a little blood. No big deal, you think to yourself. It happens all the time. Well, it’s time to think again-and get to a dentistbecause that bit of blood may be a much bigger deal than you think. It may be a sign of gingivitis, the first stage of gum disease. According to the American Dental Association (ADA), gum disease-not dental caries, or “cavities” -is the leading cause of tooth loss among adults.
Gingivitis is inflammation, swelling, and bleeding of the gum tissue caused by the bacteria that naturally coat everyone’s teeth. The bacteria form a sticky, whitish film on the teeth called plaque. If plaque isn’t thoroughly removed every day, the bacteria produce toxins that irritate the gums and make them red, swollen, and likely to bleed easily. Eventually, the toxins destroy gum tissue, causing it to separate from the tooth and form pockets. The pockets hold more bacteria and detach even further. This is periodontitis, an irreversible stage of gum disease that can destroy the bone and soft tissue that support the teeth.
If you have gingivitis, you’re not alone. According to the ADA and the American Academy of Periodontology, three out of four adults have gingivitis. Most gingivitis results from poor oral hygiene-not brushing and flossing correctly or often enough and not having teeth professionally cleaned on a regular basis. Ronald Wismer, D.M.D., a dentist in private practice in Beaverton, Oregon, who routinely sees gingivitis among his patients, says other factors may increase the risk of developing gingivitis. “Stress is a big factor in gingivitis,” he says. “Hormonal imbalances like pregnancy, menstruation, and the changing hormones of adolescence can increase gingivitis. Some diseases like diabetes and drugs like Dilantin [phenytoin] can cause a gingivitis flare-up. Even habitually breathing through the mouth, which tends to dry out the gums and cause an overgrowth of gum tissue, can increase your risk of developing gingivitis.”
For most of us, it’s lack of good oral hygiene that’s the problem. Good oral hygiene is also a major part of the solution. “The clinical definition of gingivitis is that it involves only the gums, explains Sandra Hazard, D.M.D., managing dentist for Willamette Dental Group, Inc., in Oregon, “so it’s entirely reversible. If you can get things cleaned up, the damage can be taken care of.”
If you suspect that you have gingivitis, you need to see a dentist, because only a dentist can diagnose gum disease. If you have been diagnosed with gingivitis, the following tips, used in addition to your dentist’s advice and treatments, can help you improve your oral-hygiene habits and keep gum disease from stealing your smile.
Use the “three-three” rule. Whenever possible, brush your teeth three times a day for at least three minutes each time. The ADA says that most people spend less than one minute per day on dental hygiene. Ken Waddell, D.M.D., a dentist in private practice in Tigard, Oregon, understands why people don’t brush and floss more. “Undoubtedly, brushing and flossing are the two most boring activities on earth, so we don’t devote enough time to them,” he says. “But to do it right, you’ve got to brush for at least three minutes each time.” (For more information on proper brushing technique, see TARTAR AND PLAQUE.)
Try brushing dry. Waddell says you can take some of the boredom out of dental hygiene by “dry” brushing-or brushing without toothpaste-while doing other activities such as watching television.
Be consistent. “Find a routine and stick with it,” suggests Waddell. “Start at one spot in the mouth each time and work around the mouth the same way each time. It’ll help you be consistent and prevent missing tooth surfaces.”
Lighten up. One of the biggest mistakes people make when they brush is pushing too hard with the toothbrush, says Waddell. Try the following experiment. Apply the bristles of your toothbrush to the back of your hand. Push as hard as you normally would for toothbrushing, and try to move the brush around. Then apply only a tiny amount of pressure and move the brush. You’ll find that the hard pressure doesn’t allow the tips of the bristles-the part of the brush that cleans the teeth- to move.
In addition, Waddell says to avoid a “traveling” stroke. Instead of moving the brush up and down and traveling rapidly over several teeth, brush a couple of teeth at a time, holding the brush in one place.
Use a softie. Often, people choose toothbrushes that have bristles that are too stiff. “Stiff bristles can actually injure the gums and create gingivitis,” says Jack W Clinton, D.M.D., associate dean of Patient Services at Oregon Health Sciences University School of Dentistry in Portland. “The softer the bristles, the less you have to worry about technique. ”
Brush your tongue and palate. In addition to brushing your teeth, Waddell advises brushing your tongue and the roof of your mouth to cut down on the amount of bacteria present and to increase circulation in the tissue.
Electrify ‘em. Okay, so you hate to brush. It’s awkward and boring, or maybe it’s too difficult because you don’t have as much dexterity as you used to. Try one of the new “rotary” electric toothbrushes. “I advise anyone I see who has a gum disorder to use an electric toothbrush,” says Waddell. But, he warns, not all electric toothbrushes are created equal. Ask your dentist for a recommendation.
Floss, and floss again. “No matter how good a tooth brusher you are, you aren’t going to get your toothbrush bristles in between your teeth,” says Hazard. “That’s why flossing becomes important.” You might want to try a waxed floss (it may be easier to move between the teeth without getting hung up). Whenever possible, floss at least twice a day, advises Wismer. (For more information on proper flossing technique, see TARTAR AND PLAQUE.)
Irrigate it. While water irrigation devices like the Waterpik don’t take the place of flossing, they do clean debris out from pocket areas and from between the teeth and they massage the gums, says Hazard.
Use tartar-control toothpaste. Tartar is a hardened material that often contains bacterial debris and sometimes even plaque. “Tartar-control toothpastes help control some of the mineralization of plaque,” says Hazard. “Look for products that have the American Dental Association Seal of Acceptance or Recognition, which means they’ve been put through a testing process and their claims have been proven.”
Brush with baking soda. Once or twice a week, brush your teeth with baking soda. “Baking soda is a good abrasive, but not too abrasive so that it damages the enamel,” says Hazard. “It cleans the teeth well and makes the gums feel terrific.” Make a paste with a little baking soda and water, and brush thoroughly, especially around the gum line. Not only will the baking soda scrub off the plaque, it also neutralizes acidic bacterial wastes, deodorizes, and polishes your teeth.
Rinse it. Despite what many of the television advertisements seem to say, only one over-thecounter dental rinse, Listerine, has the acceptance of the ADA’s Council on Dental Therapeutics for reducing plaque. Ask your dentist if he or she thinks adding Listerine to your dental arsenal would be helpful for you. Hazard warns, however, that no mouth rinse will take the place of thorough brushing and flossing.
Bring on the salt water. Clinton recommends rinsing the mouth with a warm saltwater solution (half a teaspoon of salt to four ounces of warm water). Swish it around in your mouth for 30 seconds and spit (don’t swallow). “The salt water is very soothing to the inflamed tissue and gets rid of some of the bacteria,” says Clinton.
Swish. If you can’t brush right after eating, at least rinse your mouth out thoroughly with water, advises Clinton. “Even plain water can flush out debris and help prevent the inflammation of gingivitis,” he says.
Eat a balanced diet for overall good health. According to some researchers, a poor diet may cause gum diease to progress more rapidly or may increase the severity of the condition. So be sure to choose a wide variety of foods from the basic food groups-fruits and vegetables, breads and cereals, meat and dairy products-to make sure you are giving your body all of the nutrients it needs for good health.
Schedule regular dental appointments. Having your teeth professionally cleaned and checked on a regular basis is essential for preventing and treating gum disease. It is especially important since you can have gum disease-or a recurrence of it-without noticing any symptoms. Talk to your dentist about how often you should schedule appointments. Then be sure to keep those appointments.
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