Periodontal disease associated with

cardiovascular risk in large multicentre study

Periodontal disorders such as tooth loss and gingivitis have been
identified as a potential risk marker for cardiovascular disease in a large
study reported April 9, 2014. More than 15,000 patients with chronic
coronary heart disease provided information on their dental health, with
results showing that indicators of periodontal disease (fewer remaining
teeth, gum bleeding) were common in this patient group and associated
with numerous cardiovascular and socioeconomic risk factors.
Conversely, a lower prevalence of tooth loss was associated with lower
levels of CVD risk factors, including lower glucose levels, low-density
lipoprotein cholesterol levels, systolic blood pressure, and waist
circumference. Diabetes and smoking were also less prevalent among
patients with more teeth, while the likelihood of higher education, alcohol
consumption and work stress was greater.
The report, published in the European Journal of Preventive Cardiology,
summarised information on self-reported dental health from the
STABILITY trial, a clinical trial involving 15,828 participants from 39
countries all with chronic coronary heart disease and at least one
additional risk factor for CHD. All participants had a physical
examination and blood testing, and completed a lifestyle questionnaire,
which included information on dental health. They reported their
remaining number of teeth (none, 1-14, 15-20, 21-25, or 26-32 (all)) and
frequency of gum bleeding (never/rarely, sometimes, often or always).
Results showed a high overall prevalence of tooth loss: 16% reported
having no teeth, and 41% reported having fewer than 15 remaining teeth.
Approximately one-quarter of the patients (26%) reported gum bleeding
when brushing teeth. However, there was some variation in these results
depending on region, country and ethnic group, with the highest rates of
tooth loss and gum bleeding found in Eastern Europe. Overall, almost
70% of participants were current or former smokers.
Statistical analysis showed that increasing prevalence of tooth loss was
significantly associated with higher fasting glucose levels, LDL
cholesterol levels, systolic blood pressure and waist circumference. A
higher prevalence of gum bleeding was significantly associated with
higher LDL cholesterol levels and systolic blood pressure.
This, say the authors, is the largest study of its kind to assess dental
disease in coronary patients, and demonstrates a heavier burden of CVD
risk factors and higher levels of biomarkers among those with more tooth
loss and gum bleeding, even after adjusting for confounders (such as age,
smoking, diabetes and education level). The findings suggest common
risk factors for dental disease and coronary heart disease, and raise the
question of whether self-described dental health can now be considered a
useful marker of CVD risk.
The observed regional variations in the prevalence of periodontal disease
"might partly be explained by regional differences in CV risk factor
prevalence; for instance smoking". However, they concede that such
differences in prevalence "indicate a complex relationship in which
demographic, genetic and socioeconomic disparities are likely
contributing factors". Both smoking and lower levels of education were
strongly associated with periodontal disease.
Indeed, said lead author Dr Ola Vedin from the University of Uppsala,
Sweden, "the evident and consistent relationship between self-reported
dental status and CV risk in this population could point towards
periodontal disease being a risk factor for incident CHD". However, he
added, the observation that poor dental health among chronic coronary
patients is linked to a heavier cardiovascular risk burden does not prove a
causal link between the two conditions.
Commenting further, Dr Vedin said: "It is still a matter of debate whether
periodontal disease is an independent risk factor for coronary heart
disease. Some studies point to a moderate association while others are
contradictory. Our findings show an association between self-reported
periodontal disease and several cardiovascular risk factors and as such
lend support to a possible association between the conditions." However,
he would not go so far as to advocate rigorous dental hygiene measures as
a strategy to reduce cardiovascular risk.
Age and smoking are well known risk factors common to both
periodontal and cardiovascular disease - and with established biological
explanations. "Our findings also support the notion that periodontal
disease and socioeconomic status are closely related," added Dr Vedin.
He and his colleagues were "astonished" by the high prevalence of severe
tooth loss seen overall in the study, but "puzzled" by the marked
differences in dental prevalence between countries, even within the same
geographical region.
Sumber : http://www.medicalnewstoday.com/releases/275278.php










































Dental implants from nanodiamonds

UCLA researchers have discovered that diamonds on a much, much
smaller scale than those used in jewelry could be used to promote bone
growth and the durability of dental implants.
Nanodiamonds, which are created as byproducts of conventional mining
and refining operations, are approximately four to five nanometers in
diameter and are shaped like tiny soccer balls. Scientists from the UCLA
School of Dentistry, the UCLA Department of Bioengineering and
Northwestern University, along with collaborators at the NanoCarbon
Research Institute in Japan, may have found a way to use them to
improve bone growth and combat osteonecrosis, a potentially debilitating
disease in which bones break down due to reduced blood flow.
When osteonecrosis affects the jaw, it can prevent people from eating and
speaking; when it occurs near joints, it can restrict or preclude movement.
Bone loss also occurs next to implants such as prosthetic joints or teeth,
which leads to the implants becoming loose - or failing.
Implant failures necessitate additional procedures, which can be painful
and expensive, and can jeopardize the function the patient had gained
with an implant. These challenges are exacerbated when the disease
occurs in the mouth, where there is a limited supply of local bone that can
be used to secure the prosthetic tooth, a key consideration for both
functional and aesthetic reasons.
The study, led by Dr. Dean Ho, professor of oral biology and medicine
and co-director of the Jane and Jerry Weintraub Center for
Reconstructive Biotechnology at the UCLA School of Dentistry, appears
online in the peer-reviewed Journal of Dental Research.
During bone repair operations, which are typically costly and time-
consuming, doctors insert a sponge through invasive surgery to locally
administer proteins that promote bone growth, such as bone morphogenic
protein.
Ho's team discovered that using nanodiamonds to deliver these proteins
has the potential to be more effective than the conventional approaches.
The study found that nanodiamonds, which are invisible to the human
eye, bind rapidly to both bone morphogenetic protein and fibroblast
growth factor, demonstrating that the proteins can be simultaneously
delivered using one vehicle. The unique surface of the diamonds allows
the proteins to be delivered more slowly, which may allow the affected
area to be treated for a longer period of time. Furthermore, the
nanodiamonds can be administered non-invasively, such as by an
injection or an oral rinse.
"We've conducted several comprehensive studies, in both cells and
animal models, looking at the safety of the nanodiamond particles," said
Laura Moore, the first author of the study and an M.D.-Ph.D. student at
Northwestern University under the mentorship of Dr. Ho. "Initial studies
indicate that they are well tolerated, which further increases their
potential in dental and bone repair applications."
"Nanodiamonds are versatile platforms," said Ho, who is also professor
of bioengineering and a member of the Jonsson Comprehensive Cancer
Center and the California NanoSystems Institute. "Because they are
useful for delivering such a broad range of therapies, nanodiamonds have
the potential to impact several other facets of oral, maxillofacial and
orthopedic surgery, as well as regenerative medicine."
Ho's team previously showed that nanodiamonds in preclinical models
were effective at treating multiple forms of cancer. Because osteonecrosis
can be a side effect of chemotherapy, the group decided to examine
whether nanodiamonds might help treat the bone loss as well. Results
from the new study could open the door for this versatile material to be
used to address multiple challenges in drug delivery, regenerative
medicine and other fields.
"This discovery serves as a foundation for the future of nanotechnology
in dentistry, orthopedics and other domains in medicine," said Dr. No-
Hee Park, dean of the School of Dentistry. "Dr. Ho and his team have
demonstrated the enormous potential of the nanodiamonds toward
improving patient care. He is a pioneer in his field."
Sumber : http://www.medicalnewstoday.com/releases/266322.php








What is orthodontics?

Orthodontics is a branch of dentistry that specializes in treating
patients with improper positioning of teeth when the mouth is closed
(malocclusion), which results in an improper bite. Orthodontics also
includes treating and controlling various aspects of facial growth
(dentofacial orthopedics) and the shape and development of the jaw. An
orthodontics specialist is called an orthodontist.

Orthodontics used to be called orthodontia - the word comes from the
Greek orthos, meaning "straight, perfect or proper", and dontos, which
means "teeth".

Orthodontics also includes cosmetic dentistry; when the patient's aim is to
improve his/her appearance.

An orthodontist uses a range of medical dental devices, including
headgears, plates, braces, etc. to help in:
Closing wide gaps between the teeth
Making sure the tips of the teeth are aligned
Straightening crooked teeth
To improve speech or eating (oral function)
To improve the long-term health of gums and teeth
To prevent long-term excessive wear or trauma (of the teeth)
Treating an improper bite
What is malocclusion?
Malocclusion literally means bad bite. Some children's jaws and teeth do
not develop properly. Malocclusion refers to crooked, misaligned teeth
and a fault in the relation between the bottom and top set of teeth (the two
dental arches). This may develop because of injury to the teeth or facial
bones, frequent thumb sucking, or for reasons unknown.

Thumb sucking (or finger sucking) can result in localized deformation of
the teeth and supporting bone. In order to restore a natural improvement,
the thumb sucking habit has to be stopped.

Generally, malocclusions do not affect physical health, malocclusion is
not a disease, it is a variation in the normal position of teeth. However, it
may impact on the shape of the person's face and the appearance of their
teeth, which can lead to embarrassment, a lack of self-confidence, and
even depression.

Severe malocclusion may affect eating, speech and keeping the teeth
clean.

UK health authorities say that approximately one third of all 12 year-olds
in the country probably need orthodontic treatment. People may require
orthodontic treatment for different problems:
The front teeth protrude - treatment not only improves the patient's
appearance, but also protects the teeth from damage; people with
protruding front teeth are more likely to injure them in sports,
falling down, etc.

Crowding - if the patient's jaw is narrow, there may not be enough
space for all the teeth. In such cases the orthodontist may have to
remove one or more teeth to make room for the others.

Impacted teeth - as the adult teeth come through, they are not in the
right position

Asymmetrical teeth - the upper and lower teeth do not match,
especially when the mouth is closed but the teeth are showing.

Deep bite (overbite) - when the teeth are clenched, the upper ones
come down over the lower ones too much

Reverse bite - when the teeth are clenched, the upper teeth bite inside
the lower ones

Open bite - when the teeth are clenched, there is an opening between
the upper and lower teeth.
Example of open bite, before and after treatment

Underbite - the upper teeth are too far back, or the lower teeth a too far
forward ("bulldog" appearance)

Crossbite - at least one of the upper teeth does not come down slightly
in from of the lower teeth when the teeth are clenched; they are too
near the cheek or the tongue

Spacing - there are gaps or spaces between the teeth, either because a
tooth is missing, or the teeth simply do not fill-up the mouth
(opposite of crowding)

When can orthodontic
treatment start?
Treatment will not usually commence until the child is about 12 or 13
years old; when the adult teeth have come through and developed fully. In
some cases treatment may start a couple of years later if teeth problems
had not become noticeable beforehand.

Children with a cleft lip and palate may require orthodontic treatment
before their adult teeth have developed completely.

Good oral hygiene is essential before any orthodontic work can begin.
When devices are placed on the teeth, bits of food are much more likely
to become stuck; the patient will need to brush much more carefully and
more often to prevent tooth decay while treatment is ongoing.

Patients who have not reached good oral hygiene standards beforehand
are much more likely to suffer from tooth decay after treatment begins.
Diagnosing dental problems and recommending treatment
options
Assessment - the orthodontist will assess the state of the patient's teeth
and make a prediction on how they are likely to develop without
treatment. The following diagnostic procedures will be performed:
A full medical and dental health history
A clinical examination
X-rays of the teeth and jaw
Plaster models of the teeth
After the assessment is done, the orthodontist will decide on a treatment
plan.
Examples of orthodontic appliances
There are two types of orthodontic appliances: fixed and removable ones.

Fixed appliances - the most common devices used in orthodontics. They
are used when precision is important. Although the patient can eat
normally with fixed appliances, some foods and drinks need to be
avoided, such as carbonated drinks, hard sweets, or toffee. People who
participate in contact sports need to tell their orthodontist, so that special
gum shields can be made.

Examples of fixed appliances include:
Braces - consisting of brackets and/or wires and bands. Bands are fixed
firmly around the teeth and serve as anchors for the appliance,
while brackets are usually connected to the front of the
teeth.Wires in the shape of an arch pass through the brackets
and are fixed to the bands. As the arch wire is tightened, tension is
applied to the teeth, which over time moves them into proper
position.A patient sees the orthodontist once a month so that
the braces can be adjusted. The treatment course may last from
several months to a number of years.Children tend to prefer the
colored braces, while adults usually go for the clear styles.

Dental braces

Fixed space maintainers - if the child loses a milk tooth, a space
maintainer will stop the two teeth at either side of the spaces from
moving into it until the adult tooth comes through. A band is fixed
to one of the teeth next to the space, and a wire goes from the band
to the other tooth.

Special fixed appliances - these may be recommended to control
tongue thrusting or thumb sucking. Patients may find them
uncomfortable, especially when they are eating. Experts say they
should only be used if they are really necessary .
Removable appliances - these are typically used for treating minor
problems, such as preventing thumb sucking or correcting slightly
crooked teeth. They should only be taken out when cleaning, eating or
flossing. Sometimes, the orthodontist may advice the patient to remove
them during certain activities, such as playing a wind instrument or
cycling.

Examples of removable appliances include:
Aligners - an option instead of traditional braces for adult patients.
They are virtually unnoticeable by other people and can be taken
out when patients brush their teeth, floss, or eat.

Headgear - there is a strap around the back of the head, which is
attached to a metal wire in the front, or face bow. The aim is to
slow down upper jaw growth, and keeping the back teeth in
position while the front ones are pulled back.

Lip and cheek bumpers - specially made to relieve the pressure of
cheeks or lips on the teeth.

Palatal expander - an appliance designed to make the arch of the
upper jaw wider. The device consists of a plastic plate that is
placed in the palate (the roof of the mouth). The plate has screws
which exert pressure on the joints in the bones, forcing them
outward, thus expanding the size of the palatal area (roof of mouth
area).

Removable retainers - these are placed on the roof of the mouth. They
are designed to stop the teeth from moving back to their original
positions. If modified, they may also be used to stop children from
sucking their thumbs.

Removable space maintainers - an alternative to fixed space
maintainers.

Splints (jaw repositioning appliances) - they are placed either in the
top or lower jaw and help the jaw close properly. Splints are
commonly used for TMJ (temporomandibular joint disorder)
syndrome.
Written by Christian Nordqvist
Sumber : http://www.medicalnewstoday.com/articles/249482.php


















Periodontitis

Periodontitis means "inflammation around the tooth" - it is a serious
gum infection that damages the soft tissue and bone that supports the
tooth. All periodontal diseases, including periodontitis, are infections
which affect the periodontium. The periodontium are the tissues around a
tooth, tissues that support the tooth. With periodontitis, the alveolar bone
around the teeth is slowly and progressively lost. Microorganisms, such
as bacteria, stick to the surface of the tooth and multiply - an overactive
immune system reacts with inflammation.

Untreated periodontitis will eventually result in tooth loss, and may
increase the risk of stroke, heart attack and other health problems.
Bacterial plaque, a sticky, colorless membrane that develops over the
surface of teeth, is the most common cause of periodontal disease.

In dentistry, periodontics deals with the prevention, diagnosis and
treatment of diseases involving the gums and structures which support
teeth. There are eight dental specialties, of which periodontics is one. If
you want dental implants, you see a periodontist.

In most cases, periodontitis is preventable. It is usually caused by poor
dental hygiene. What is the difference between periodontitis
and gingivitis?
Gingivitis occurs before periodontitis. Gingivitis usually refers to gum
inflammation while periodontitis refers to gum disease and the
destruction of tissue and/or bone. Initially, with gingivitis, bacteria plaque
accumulates on the surface of the tooth, causing the gums to go red and
inflamed; teeth may bleed when brushing them. Even though the gums
are irritated and bothersome, the teeth are not loose. There is no
irreversible damage to bone or surrounding tissue.

Untreated gingivitis can progress to periodontitis. With periodontitis, the
gum and bone pulls away from the teeth, forming large pockets. Debris
collects in the spaces between the gums and teeth, and infect the area.
The patient's immune system attacks bacteria as the plaque spreads below
the gum line. Bone and connective tissue that hold the tooth start to break
down - this is caused by toxins produced by the bacteria. Teeth become
loose and can fall out.

Put simply, Periodontitis involves irreversible changes to the supporting
structures of the teeth, while gingivitis does not.
What are the signs and symptoms of periodontitis
A symptom is something we feel and describe to the doctor, while a sign
is something others, including the doctor can see. For example, pain is a
symptom while redness or inflammation is a sign.

Periodontitis signs and symptoms can include:
Inflamed (swollen) gums, gum swelling recurs
Gums are bright red, sometimes purple
Gums hurt when touched
Gums recede, making teeth look longer
Extra spaces appear between the teeth
Pus may appear between the teeth and gums
Bleeding when brushing teeth
Bleeding when flossing
Metallic taste in the mouth
Halitosis (bad breath)
Loose teeth
The patient's "bite" feels different because the teeth do not fit the same

Dental plaque What are the causes of periodontitis?
forms on teeth - this is a pale-yellow biofilm that develops
naturally on teeth. If is formed by bacteria that try to attach
themselves to the tooth's smooth surface.
Brushing teeth gets rid of plaque, but it soon builds up; within a day or
so.
If it is not removed, within two or three days it hardens into tartar.
Tartar is much harder to remove than plaque. Another name for
tartar is calculus. Getting rid of tartar requires a professional - you
cannot do it yourself.
Plaque can gradually and progressively damage teeth and surrounding
tissue. At first, the patient may develop gingivitis - inflammation of
the gum around the base of the teeth.
Persistent gingivitis can result in pockets developing between the teeth
and gums. These pockets fill up with bacteria.
Bacterial toxins and our immune system's response to infection start
destroying the bone and connective tissue that hold teeth in place.
Eventually the teeth start becoming loose, and can even fall out.

A risk factor is What are the risk factors for periodontitis?
something that increases the risk of developing a condition or disease.
For example, obesity is a risk factor for diabetes type 2 - this means that
obese people have a higher chance of developing diabetes. The following
risk factors are linked to a higher risk of periodontitis:
Smoking - regular smokers are much more likely to develop gum
problems. Smoking also undermines the efficacy of treatments.
Hormonal changes in females - puberty, pregnancy, and the
menopause are moments in life when a female's hormones undergo
changes. Such changes raise the risk of developing gum diseases.
Diabetes - patients who live with diabetes have a much higher
incidence of gum disease than other individuals of the same age
AIDS - people with AIDS have more gum diseases
Cancer - cancer, and some cancer treatments can make gum diseases
more of a problem
Some drugs - some medications that reduce saliva are linked to gum
disease risk.
Genetics - some people are more genetically susceptible to gum
diseases

A qualified dentist should find it fairly Diagnosing periodontitis
straightforward to diagnose periodontitis. The dentist will ask the patient
questions regarding symptoms and carry out an examination of his/her
mouth.

The dentist will examine the patient's mouth using a periodontal probe - a
thin, silver stick-like object with a bend at one end. The probe is inserted
next to the tooth, under the gum line. If the tooth is healthy, the probe
should not slide far below the gum line. In cases of periodontitis, the
probe will reach deeper under the gum line.


Two types of periodontal probes. 1. Michigan O Probe (left). 2. Naber's
Probe (right)

The dentist may order an X-ray to see what condition the jaw bone and
teeth are in.
What are the treatment options for periodontitis?
The main aim of the periodontist, dentist or dental hygienist, when
treating periodontitis, is to clean out bacteria from the pockets around the
teeth and prevent further destruction of bone and tissue.

For best treatment results, the patient must maintain good oral hygiene
and care. This involves brushing teeth at least twice a day and flossing
once per day. If there is enough space between the teeth, an interdental
brush (Proxi-brush) is recommended. Soft-picks can be used when the
space between the teeth is smaller. Patients with arthritis, and others with
dexterity problems may find that using an electric toothbrush is better for
a thorough clean.

It is important that the patient understands that periodontitis is a chronic
(long-term) inflammatory disease - this means oral hygiene must be
maintained for life. This will also involve regular visits to a dentist or
dental hygienist.

Initial treatment

It is important to remove plaque and calculus (tartar) to restore
periodontal health.

The healthcare professional will use clean (non-surgically) below the
gumline. This procedure is called scaling and debridement. Sometimes an
ultrasonic device may be used. In the past Root Planing was used (the
cemental layer was removed, as well as calculus).

Medications
Prescription antimicrobial mouthrinse - for example chlorhexidine. It
controls bacteria when treating gum disease, as well as after
surgery. Patients use it like they would a regular mouthwash.
Antiseptic "chip" - this is a small piece of gelatin which is filled with
chlorhexidine. It controls bacteria and reduces periodontal pocket
size. This medication is placed in the pockets after root planing.
The medication is slowly resealed over time.
Antibiotic gel - a gel that contains doxycycline, an antibiotic. This
medication controls bacteria and shrinks periodontal pockets. It is
placed in the pockets after scaling and root planing. It is a slow-
release medication.
Antibiotic microspheres - miniscule particles containing minocycline,
an antibiotic. Also used to control bacteria and reduce periodontal
pocket size. They are placed into pockets after scaling and root
planing. A slow-release medication.
Enzyme suppressant - keeps destructive enzymes in check with a low-
dose of doxycycline. Some enzymes can break down gum tissue,
this medication holds back the body's enzyme response. Taken
orally as a pill, and is used with scaling and root planing.
Oral antibiotics - either in capsule or tablet form and are taken orally.
They are used short-term for the treatment of acute or locally
persistent periodontal infection.
Advanced periodontitis

If good oral hygiene and non-surgical treatments are not enough, the
following surgical interventions may be required:
Flap surgery - the healthcare professional performs flap surgery to
remove calculus in deep pockets, or to reduce the pocket so that
keeping it clean is easier. The gums are lifted back and the tarter is
removed. The gums are then sutured back into place so they fit
closely to the tooth. After surgery, the gums will heal and high
tightly around the tooth. In some cases the teeth may eventually
seem longer than they used to.
Bone and tissue grafts - this procedure helps regenerate bone or gum
tissue that has been destroyed. With bone grafting, new natural or
synthetic bone is placed where bone was lost, promoting bone
growth.In a procedure called guided tissue regeneration, a
small piece of mesh-like material is inseted between the gum tissue
and bone. This stops the gum from growing into bone space, giving
the bone and connective tissue a chance to regrow.The dentist
may also use special proteins (growth factors) that help the body
regrow bone naturally.The dental professional may suggest a
soft tissue graft - tissue taken from another part of the mouth, or
synthetic material is used to cover exposed tooth roots.
Experts say it is not possible to predict how successful these procedures
are - each case is different. Treatment results also depend on how
advanced the disease is, how well the patient adheres to a good oral
hygiene program, as well as other factors, such as smoking status.
What are the complications of periodontitis?
The most common complication from periodontitis is the loss of teeth.
However, patients with periodontitis are also at a higher risk of having
respiratory problems, stroke, coronary artery disease, and low birth
weight babies.

Pregnant women with bacterial infections that cause moderate-to-severe
periodontal disease have a higher risk of having a premature baby.

Periodontitis can make it harder for patients with diabetes to control
blood sugar.

Written by Christian Nordqvist
Sumber : http://www.medicalnewstoday.com/articles/242321.php



























Gingivitis

Gingivitis means inflammation of the gums (gingiva). It commonly
occurs because of films of bacteria that accumulate on the teeth - plaque;
this type is called plaque-induced gingivitis. Gingivitis is a non-
destructive type of periodontal disease. If left untreated, gingivitis can
progress to periodontitis, which is more serious and can eventually lead
to loss of teeth.

A patient with gingivitis will have red and puffy gums, and they will
most likely bleed when they brush their teeth. Generally, gingivitis
resolves with good oral hygiene - longer and more frequent brushing, as
well as flossing. Some people find that using an antiseptic mouthwash,
alongside proper tooth brushing and flossing also helps.

In mild cases of gingivitis, patients may not even know they have it,
because symptoms are mild. However, the condition should be taken
seriously and addressed immediately.


(Top) Severe gingivitis before treatment.
(Bottom) After mechanical debridement of teeth and surrounding gum tissues
There are two main categories of gingival diseases (1999 World
Workshop in Clinical Periodontics):
Dental plaque-induced gingival disease Gingivitis caused only by
plaque Gingivitis caused by systemic factors Gingivitis caused
by medications Gingivitis caused by malnutrition
Non-plaque induced gingival lesions Gingival diseases - caused by a
specific bacterium Gingival diseases - caused by a specific
virus Gingival diseases - caused by a specific fungus Gingival
diseases - caused by genetic factors Gum inflammations caused
by systemic conditions Gum inflammations caused by traumatic
lesions Gum inflammations caused by reactions to foreign
bodies Gum inflammations without known causes
What are the signs and symptoms of gingivitis?
A symptom is something the patient feels and describes, such as painful
gums, while a sign is something everybody, including the doctor or nurse
can see, such as swelling.

In mild cases of gingivitis there may be no discomfort or noticeable
symptoms.

Signs and symptoms of gingivitis may include:
Gums are bright red or purple
Gums are tender, and sometimes painful to the touch
Gums bleed easily when brushing teeth or flossing
Halitosis (bad breath)
Inflammation (swollen gums)
Receding gums
Soft gums

What are the causes of
gingivitis?
The accumulation of plaque and tartar

The most common cause of gingivitis is the accumulation of bacterial
plaque between and around the teeth, which triggers an immune
response, which in turn can eventually lead to the destruction of gingival
tissue, and eventually further complications, including the loss of teeth.

Dental plaque is a biofilm that accumulates naturally on the teeth. It is
usually formed by colonizing bacteria that are trying to stick to the
smooth surface of a tooth. Some experts say that they might help protect
the mouth from the colonization of harmful microorganisms. However,
dental plaque can also cause tooth decay, and periodontal problems such
as gingivitis and chronic periodontitis.

When plaque is not removed adequately, it causes an accumulation of
calculus (tartar - it has a yellow color) at the base of the teeth, near the
gums. Calculus is harder to remove, and can only be removed
professionally.

Plaque and tartar eventually irritate the gums.

Gingivitis may also have other causes, including:
Changes in hormones - which may occur during puberty, menopause,
the menstrual cycle and pregnancy. The gingiva may become more
sensitive, raising the risk of inflammation.
Some diseases - such as cancer, diabetes, and HIV are linked to a
higher risk of developing gingivitis.
Drugs - oral health may be affected by some medications, especially if
saliva flow is reduced. Dilantin (anticonvulsant), and some anti-
angina medications may also cause abnormal growth of gum tissue.
Smoking - regular smokers more commonly develop gingivitis
compared to non-smokers.
Family history - experts say that people whose parent(s) has/had
gingivitis, have a higher risk of developing it themselves.

A dentist or oral hygienist checks for Diagnosing gingivitis
gingivitis symptoms, such as plaque and tartar in the oral cavity.

Checking for signs of periodontitis may also be recommended; this may
be done by X-ray or periodontal probing.
What are the treatment options for gingivitis?
If the patient is diagnosed early on, and treatment is prompt and proper,
gingivitis can be successfully reversed.

Treatment involves care by a dental professional, and follow-up
procedures carried out by the patient at home.

Gingivitis care with a dental professional:
Plaque and tartar are removed. This is known as scaling. Some patients
may find scaling uncomfortable, especially if tartar build-up is
extensive, or the gums are very sensitive.
The dental professional explains to the patient the importance of oral
hygiene, and how to effectively brush his/her teeth, as well as
flossing
Periodically following-up on the patient, with further cleaning if
necessary
Fixing teeth so that oral hygiene can be done effectively. Some dental
problems, such as crooked teeth, badly fitted crowns or bridges,
may make it harder to properly remove plaque and tartar (they may
also irritate the gums).
What the patient can do at home:
Brush your teeth at least twice a day
Bear in mind that in most cases, electric toothbrushes do a better job
than we can do on our own
Floss your teeth at least once a day
Regularly rinse your mouth with an antiseptic mouthwash. Ask your
dentist to recommend one.

In the What are the possible complications from gingivitis?
vast majority of cases, if gingivitis is treated and the patient follows the
dental health professional's instructions, there are no complications.
However, if the condition is left untreated, gum disease can spread and
affect tissue, teeth and bones, leading to periodontitis.

Possible complications from gingivitis may include:
Abscess in the gingiva
Abscess in the jaw bones
Infection in the jaw bone or gingiva
Periodontitis - this is a more serious condition that can lead to loss of
teeth
Recurrent gingivitis
Trench mouth - ulceration of the gums caused by bacterial infection
Several studies have linked gum diseases, such as periodontitis, to
cardiovascular diseases, including heart attack or stroke. Other reports
have found an association with lung disease risk.


Written by Christian Nordqvist
Sumber : http://www.medicalnewstoday.com/articles/241721.php