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About gingivitis and periodontitis
Gingivitis
Gingivitis is an inflammation of the gums (gingiva), generally
caused by a build up of plaque, which is a sticky matrix formed
by oral bacteria. Plaque forms a layer over the surfaces of
the gums and teeth, and the bacteria in the plaque release
toxins, enzymes and metabolic products that cause local inflammation
and damage the gum. This is why one of the signs of gingivitis
is having gums that bleed easily. The removal or inhibition
of microbial plaque can prevent development of gingivitis.
A large proportion of the population – as many as 70-90%1,2,
of the adult population – is estimated to have some
degree of gum inflammation. Typically, gingivitis first occurs
in puberty, although it is most common in older adults. It
is a silent disease that can follow a chronic progression
for many years without affecting other periodontal tissues.
Periodontitis
Periodontitis can develop when gingivitis is left untreated
long term. Periodontitis is characterised by inflammation
and loss of the bone that ‘houses’ the tooth in
the jaw. The teeth become less securely attached, and untreated
periodontitis therefore carries a risk of tooth loss3.
Approximately 13% of the population may have periodontitis.
People with diabetes may have an above average chance of developing
periodontitis4.
If gingivitis is prevented or treated, this will prevent
development of periodontitis5.
Complications of gum disease
The symptoms of mild gum disease are bleeding gums and halitosis
(bad breath). The disease may progress to spontaneous bleeding
with loss of bone tissue or tooth loss when the disease reaches
its most severe level.
However, there are also more serious potential consequences.
The barrier function of the gum is reduced in people with
gingivitis. This means that toxins and bacteria may enter
the bloodstream through the gum. The implications of this
can be serious.
- Dental plaque bacteria, after entering the bloodstream,
can become trapped in plaque within the arteries6.
People with severe periodontal disease are more likely to
have an acute myocardial infarction (heart attack) or a
stroke than those without7,8.
- Patients with lung conditions may find that periodontal
disease increases their chance of a respiratory tract infection9,10.
- Periodontal disease in pregnancy is a strong predictor
of premature birth, as plaque bacteria are thought to produce
cervical/uterine inflammation and therefore premature birth11,12.
In summary, there are strong arguments for the treatment
and prevention of gum disease, for reasons beyond just dental
health – particularly in high-risk groups.
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