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Gingivitis

Gingivitis is the inflammation of the gums (gingiva) around the teeth due to improper cleaning of teeth. The condition is generally reversible. Brushing teeth with toothpaste and flossing with dental floss are the best ways to prevent gingivitis. more...

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Causes

Gingivitis is usually caused by improper cleaning of teeth. When the teeth are not cleaned properly, the plaque irritates the gums. Bacteria and toxins may cause the gums to become red and swollen. Contributing factors include pregnancy and uncontrolled diabetes, due to hormonal changes that may increase the susceptibility of the gums or alter the composition of the dentogingival microflora. Hormonal changes during puberty also may put one at risk for gingivitis. The risk of gingivitis is increased by dental calculus, misaligned teeth, the rough edges of fillings, and ill fitting or unclean dentures, bridges, and crowns. The drug phenytoin, birth control pills, and ingestion of heavy metals such as lead and bismuth may also cause gingivitis.

Symptoms

The symptoms of gingivitis are as follows:

  • Swollen gums
  • Mouth sores
  • Bright-red, or purple gums
  • Shiny gums
  • Gums that are painless, except when touched
  • Gums that bleed easily, even with gentle brushing

Prevention

Gingivitis can be prevented through regular oral hygiene, including the brushing and flossing of the teeth.

Diagnosis

It is recommended that a dentist be seen after the signs of gingivitis appear. A dentist will check for the symptoms of gingivitis, and may also examine the amount of plaque in the oral cavity. A dentist may also test for periodontitis, by the use of X-rays, or by gingival probing.

Treatment

A dentist or dental hygienist will perform a thorough cleaning of the teeth and gums. Following that, persistent oral hygiene is necessary. The removal of plaque is usually not painful, and the inflammation of the gums should be gone between one and two weeks. Oral hygiene is required to prevent the recurrence of gingivitis. Anti-bacterial rinses or mouthwash may reduce the swelling.

Complications

  • Recurrence of gingivitis
  • Periodontitis
  • Infection or abscess of the gingiva or the jaw bones
  • Trench mouth (bacterial infection and ulceration of the gums)

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Folic acid mouthwash for gingivitis
From Townsend Letter for Doctors and Patients, 6/1/05 by Alan R. Gaby

Thirty dental students and auxiliary personnel (aged 21-32 years) were randomly assigned, in double-blind fashion, to rinse their mouths for 5 minutes twice a day with 5 ml (1 teaspoon) of either a 0.1% folic acid solution or placebo solution. After 60 days of treatment, gingival inflammation, as assessed by the gingival index and bleeding index, was significantly less in the folic acid group than in the placebo group.

[ILLUSTRATION OMITTED]

Comment: Several studies have shown that folic acid supplementation can improve gingivitis. Topical application of folic acid, as in a mouth rinse, has been found to be more effective than oral ingestion of a similar amount of the vitamin. It has been suggested that a localized deficiency of folic acid plays a role in the development of gingivitis, and that this deficiency can be corrected by bathing the gingival tissues in folic acid.

Folic acid has also been used to treat phenytoin (dilantin)-induced gingival hyperplasia. Although this treatment may improve gum health, it should be used with caution, because large doses of folic acid (more than 1 mg/day) have the potential to interfere with the anticonvulsant effect of phenytoin. On the other hand, treatment with phenytoin frequently causes folic acid deficiency, so people taking this drug should receive at least a modest dose of supplemental folic acid.

Vogel RI, et al. The effect of topical application of folic acid on gingival health. J Oral Med 1978;33:20-22.

by Alan R. Gaby, MD

301 Dorwood Drive * Carlisle, Pennsylvania 17013

COPYRIGHT 2005 The Townsend Letter Group
COPYRIGHT 2005 Gale Group

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