Gum Problems

Gingivitis and Periodontitis

An alteration in the balance of the bacteria that inhabit the mouth and the accumulation of oral biofilm (bacterial plaque) can cause gingival inflammation and bleeding, leading to disease of the soft tissue surrounding teeth (gingivitis and periodontitis) or surrounding dental implants (peri-implant mucositis and peri-implantitis).

Gingivitis and Periodontitis

An alteration in the balance of the bacteria that inhabit the mouth and the accumulation of oral biofilm (bacterial plaque) can cause gingival inflammation and bleeding, leading to disease of the soft tissue surrounding teeth (gingivitis and periodontitis) or surrounding dental implants (peri-implant mucositis and peri-implantitis).


Gum diseases

Periodontal and peri-implant diseases

Gum disease is caused by the accumulation of oral biofilm, witch is the main aetiological agent involved in the different forms of periodontal disease (gingivitis and periodontitis) and of peri-implant disease (peri-implant mucositis and peri-implantitis).

Gum diseases: causes

Factors that favour the onset of oral biofilm-induced gingivitis:

  • Local factors: Poor oral hygiene, which favours the accumulation of biofilm, dental malposition, occlusal trauma, overcontoured fillings, fixed and removable orthodontics and removable and fixed prostheses (bridges and crowns).
  • Hormonal factors: Sometimes gingivitis is related to endocrine system, such as during pregnancy, puberty, menstrual cycle
  • Systemic factors: such as uncontrolled diabetes.
  • Medications: certain medications can increase the risk of gingivitis.
  • Malnutrition: associated with nutritional deficits.

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If gingivitis progresses, it may evolve to become periodontitis. In this case, the inflammation of the gum extends to deeper areas of the tooth (periodontal ligament, connective tissue and alveolar bone).

Gum diseases: causes

Factors that favour the onset of periodontitis

  • Poor oral hygiene
  • Smoking
  • Stress
  • Genetic predisposition
  • Acute infections and chronic desease such as diabetes

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These same causes are also risk factors of peri-implant disease (peri-implant mucositis and peri-implantitis).


Gum diseases

Gingivitis

Redness, inflammation and bleeding of the gum are usually observed. Peri-implant mucositis can be observed at the same level, where there is inflammation, redness and bleeding of the mucosa surrounding the implant.

Periodontitis

Characterised by redness, inflammation, bleeding and other symptoms derived from the destruction of periodontal tissue: recession of the gum, tooth mobility and loss of alveolar bone which supports the teeth. Similarly, peri-implantitis is characterised by inflammation, bleeding, gum recession and loss of alveolar bone which supports the implant.


Gum diseases

Currently, between 60% and 75% of pregnant women develop gingivitis during pregnancy, which is known as pregnancy gingivitis, and usually gets worse as of the second trimester.

50% of women with gingivitis can experience a worsening of their periodontal condition, potentially developing periodontitis.

During the months of pregnancy, there is an increase in vascular permeability, which, in the case of severe periodontal disease, can favour periodontopathogenic bacteria, and local inflammation mediators can be spread systemically, reaching other organs and even the placenta, thereby increasing the risk of complications in the newborn: preterm delivery, low birth weight or preeclampsia/eclampsia.

For this reason, prevention plays a fundamental role. During pregnancy, it is recommended to pay special attention to daily oral hygiene by physically controlling oral biofilm with a specific toothbrush for gum care and interproximal hygiene, and by chemically controlling biofilm with toothpastes and mouthwash solutions that contain safe and effective antiseptics, such as Cetylpyridinium chloride (CPC).

Also, it is recommended to visit the dentist before, during and after pregnancy for the appropriate checks.

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