What is gingivitis?
Perfect. So, what exactly is gingivitis? What does that mean? How does that differ from gum disease, also known as periodontitis? To break up the words, gingiva means gums and itis means inflammation or disease of the gums. So, gingivitis is where we're having just the early inflammation of the gums. That's where we can have some redness, maybe it bleeds a little bit when we floss or when we brush our teeth. When we go in as a dentist and measure the gums, we'll get some bleeding as well. What it means is that the bacteria are forming; they like to form little colonies around your teeth, around the gum area. That's called plaque. It's the sticky white stuff. That sticky white stuff, as it sits there, starts to eat away at the gums. And that's why we'll get early inflammation, which is the redness that we see. That is what gingivitis is. Now, periodontitis is where we start to venture in, where it starts to move under the gums. As it goes under the gums, it starts to eat away at the bone. When it starts to eat away at the bone, that's when it becomes full-on gum disease periodontitis. I hope that helps in describing the differences between the two and exactly what gingivitis is.
What are the first symptoms of gingivitis?
The first symptoms of gingivitis that we want to look out for are that redness and bleeding when we first start to either brush or floss. Like I said, bleeding is the first sign. For example, if I get a wound on my arm and I have a scab, well, if I brush against that scab, the scab comes off, it bleeds. But if I have healthy skin and I do the same thing, if I scratch it or if I brush it, it doesn't bleed because my skin is healthy. So, the same thing with our gums. A lot of times people will think, oh, I'm bleeding, I must be brushing too hard, or oh, I bled because the dentist poked me with that instrument, the pokey instrument. It's like, well, no, because if it's healthy, just like with our skin, it's not going to bleed. It only bleeds when there's something unhealthy there. I always like to give the illustration: it's almost like the bacteria are like a leech and they're eating away at the gums. If you've ever seen a leech being removed from the skin, it's like, well, you don't want to leave the leech there because it's bad, right? It's sucking your blood. But when you remove that leech, it bleeds, but it needed to be done so it could heal. The same thing, if we brush our teeth and we notice that it bleeds, we're actually removing the plaque that is eating away at the gum. It does bleed for a moment, but if you keep up with that, it will eventually heal. Same thing when we go in and measure with our tool, we're removing a little bit of the plaque when we go in with our tool, it bleeds. That's the first and most early sign. At this stage of disease, it's not painful, so we don't notice it. That's why it's important that if we see these early signs of redness or bleeding when we brush or probe, we need to make sure we address it right away because it will lead to more advanced disease later.
How dangerous is gingivitis?
A question we get asked is, how dangerous is gingivitis? Like I said, gingivitis is the start of the disease. It's like someone coming in to a doctor and they're being told, okay, they have the early signs of cancer. Well, let's treat it before it becomes cancer, right? Same thing with gingivitis. That's the start of the full-on periodontitis gum disease. Let's treat it before it becomes full-on gum disease where we start to have bone loss and bone destruction and eventually tooth loss, right? So gingivitis in itself is not a very destructive disease, but it's the start of a path that will be much more destructive, so it has to be dealt with early.
Can you have gingivitis and periodontitis at the same time?
A question people will ask me is, well, can I have gingivitis and periodontitis at the same time? When we go through your gum measurements, we're going to measure different areas. We might have some areas that are healthy. Oftentimes, it's the front of the mouth because it's the easiest to access. Then we might have areas that are unhealthy. Most often, it's the back of the mouth where it's harder to access, harder to floss. Even though the mouth is split up where some areas could be healthy or some areas are not as worse as other areas, whatever areas are the worst, you end up being classified as that. So we're not going to have areas that are just, oh, this area is just gingivitis and this area is just periodontitis. Whatever is the worst area, you end up being classified as that medically speaking, and then we treat you for that because if you have that disease in one area, that means all other areas are just as susceptible. It just hasn't happened just yet, but you give it time, it will happen. You can't be diagnosed with both diseases at the same time. It's one or the other.
If someone has gingivitis, how do we treat it?
Well, we treat it by doing a cleaning. There's actually a specialized type of cleaning called a gingivitis cleaning where we do go under the gums. We're not going so deep that you have to be numbed or we're going down to your bone, but we are going under the gums just below where the plaque would rest. That way we can make sure we're cleaning everything super thoroughly, and that way things will heal back to healthy and normal. Then we actually do a follow-up to make sure, is it stable? Because like I said, we want to make sure it does not progress to full-on gum disease. It's very important that we address it at this stage. Then we track it to make sure it becomes stable. If it does become stable, well, good news, now you get to have a regular cleaning, because that's our ultimate goal is to get everyone to the point where they can have just regular cleanings. Because one, most insurers cover it completely, so it's less out-of-pocket. And two, it's just more pleasant, and it means we're healthy, right? So our goal is to get you healthy. Part of getting someone to a regular cleaning is really we're getting them to that point because that means they are now healthy.
How long does it take to cure gingivitis?
A question that is often asked, well, how long does it take to cure gingivitis? Gingivitis, unfortunately, there's not necessarily a cure for that disease. Some people tend to be more susceptible to gingivitis and gum disease because it has to do with the type of bacteria in their mouth. Now, there are treatments and things that we can prescribe to help change that bacteria that can help improve it. But if someone has that bacteria, we gain our bacteria kind of partially genetically, and also that comes from our family exposure throughout our life. But the good news is we can return the gums to a stable state where the bacteria goes into remission. Remission means that it's dormant, it's not active. As long as a person does good maintenance at home, they use the mouth rinse we prescribe, they use the probiotics that we recommend, and then they keep up with their brushing and their flossing. If someone does those things, then it will stay in remission, it will stay dormant, and that way it can maintain and be healthy. So that's usually the process in treating this. Like I said, unfortunately, there's not just a cure of disease for, you know, an absolute cure for this where, oh, I never have to worry about it again. It does take maintenance, it does take continued work at it, but as long as those things are done, it will stay gone away.