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12/10/2019

Gingivitis Treatment in Singapore: Causes, Symptoms, & Treatment

An Dental

“Gingivitis treatment” – What is this hard-to-pronounce condition even about?

Hands up, those who have even heard about this condition. I have heard it pronounced anywhere from “Ging-Gi-Vai-Tis” to “Ging-Gi-Vi-Tis’. The pronunciation is a lot more chi chi though. It’s pronounced “jin·juh·vai·tuhs”. Like how a bottle of alcoholic soda “Gin” is pronounced.

Unfortunately, this condition does not incite excitement like its mind-numbing cousin, Gin and Tonic. Gingivitis can incite so much fear you might need the real Gin and Tonic to numb your mind.

What causes Gingivitis?

Gingivitis is a gum disease that usually happens when the use of mouthwash, brushing, and flossing is not done well; when someone has poor oral hygiene, bacteria and food (plaque) accumulates along the gum line. It is considered a mild form of gum disease and easily treatable.

Plaque forms on your teeth and it can turn into Tartar (calculus).

Gingivitis photo
Plaque which can turn into Tartar at the gum line

Tartar is plaque that becomes calcified and once this calcified mass forms on your teeth, you cannot brush it away. (perio.org, 2019)

You will need a dentist to help you remove it. It also contains toxins that irritate the gum line and this causes our defence cells (immune cells) to flock to the area in an attempt to contain the bacteria and toxins during a process called inflammation.

However, this protective inflammatory mechanism is a double-edged sword. In its attempt to contain the bacteria, it also releases poisons meant to kill the bacteria into our own tissues and causes the gums to swell and bleed. This leads to the gingivitis symptoms listed below.

Symptoms of Gingivitis Include:

  • Swollen or puffy gums
  • Dusky red or dark red gums
  • Gums that bleed easily when you brush or floss
  • Bad breath
  • Receding gums
  • Tender gums

(mayoclinic.org, 2019)

When gum infection sets in, there is excessive inflammation, the gum disease may cause your gums to swell and look bright red or purple. Your gums may appear boggy and soft and may feel really tender. It may be extra scary when you start seeing your gums receding. The scariest symptom, in my opinion, is when the gums bleed when you brush or when they bleed seemingly without reason. Plus, if your other half has gingivitis, you might not appreciate that goodnight kiss so much as gingivitis is usually accompanied by bad breath *cough cough* or worse still, the taste of blood!

How is gingivitis treated in Singapore?

So if you have any of the above symptoms, it is absolutely necessary to get your gingivitis corrected. Otherwise, it may also lead to Periodontitis which is a more serious gum disease! Periodontitis means that the inflammation has caused bone loss; thus periodontitis treatments are more complicated and would cost more as well. When this happens the gums start receding and the bone starts dissolving and the teeth start to become mobile. (perio.org, 2019)

illustration of the stages of periodontal disease

Treating gingivitis includes seeing your dentist to get a proper diagnosis. Some systemic diseases may present as gingivitis and your dentist needs to help you rule that out. For example, Diabetes Mellitus, thyroid conditions, drug allergies etc may all have some symptoms that present on the gums. They can cause the gums to appear swollen. Even pregnancy and the hormones that come with it may also cause gingivitis due to the different hormones affecting the gums! (Awareness, Attitude and Knowledge Regarding Oral Health among Pregnant Women: A Comparative Study, 2018)

However, if we deem that it is just good old fashioned gingivitis, you will need professional treatment to scale your teeth and remove tartar. This is to remove the toxins that irritate the gums and lead to inflammation.

Home care to prevent or reverse gingivitis

Home care is particularly important as plaque builds up rapidly. You need to brush and floss not only your teeth but your GUMS too to remove plaque. Yup, you heard me right. This is all the Bass technique and it has been shown in many studies to be superior to normal brushing when it comes to removing plaque. (Comparison of modified Bass technique with normal toothbrushing practices for efficacy in supragingival plaque removal, 2003)

You don’t just have to brush your teeth, good oral hygiene practice requires you to also need to brush your GUMS to remove bacteria that is usually the root cause of the inflammation in the gums.

In fact, it is ABSOLUTELY counter-intuitive, but you do need to brush those parts of your gums that bleed. When I tell my patients or friends that they need to brush not only their teeth but their gums too, their reaction usually goes along the lines of, “Must brush gums meh?”

When must you see a dentist?

Please see a dentist or periodontist to seek medical advice once you see some of the above symptoms that last more than 2 weeks. You do want to get it checked out as it is important to initiate treatment of any systemic issues early. Why not use the gums as an indicator of health? 🙂 (Systemic disease or periodontal disease? Distinguishing causes of gingival inflammation: a guide for dental practitioners, 2019)

Also, good old gingivitis is a REVERSIBLE condition. It is easily treated with teeth scaling and good home care, you really do not want it to progress to Periodontitis where the bone is lost and you lose the bone that supports the teeth. It would be so sad!

Conclusion

So, remember to brush your gums, and don’t stop brushing them even when they bleed. If they bleed, it is usually not because you have traumatized them, but because they are injured and sick already. The use of mouthwash is highly recommended as well. You need to massage and brush them well to help them get better!

References

  1. https://www.perio.org/consumer/difference-between-plaque-and-calculus
  2. https://www.mayoclinic.org/diseases-conditions/gingivitis/symptoms-causes/syc-20354453
  3. https://www.perio.org/consumer/types-gum-disease.html
  4. Niger Med J (2018, Awareness, Attitude and Knowledge Regarding Oral Health among Pregnant Women: A Comparative Study)
  5. Ferrera, Egea, Fernandez (2003, Comparison of modified Bass technique with normal toothbrushing practices for efficacy in supragingival plaque removal) 
  6. Hirschfield, Higham, Blair F, Richards, Chapple (2019, Systemic disease or periodontal disease? Distinguishing causes of gingival inflammation: a guide for dental practitioners)
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