One of the common complaints that people tell the dentist is, “I have bleeding gums.” Others say, “sometimes when I am brushing, I see blood.” This condition in its commonest form is called Gingivitis. This refers to an inflammation of the gingivae which in layman terms is commonly known as the gums. Some of the common causes of gingivitis include:
Accumulation of plaque and calculus
Plaque refers to the whitish film which we notice settling on our teeth between tooth brushing. Its major constituents are bacteria. Its presence on the teeth is normal but it must be periodically cleared by proper tooth brushing. Whenever this is not done, there is a build up of the plaque which becomes an irritant to the gums with resultant bleeding.
When plaque builds up, calcium can deposit in it thus forming a calcified mass known as calculus. Calculus also serves as an irritant to the gums as well as attracting more plaque. This makes the person’s oral health worse than it was. While plaque can be removed by tooth brushing, calculus can only be removed by the dentist in a process known as scaling and polishing. The important take home message is the importance of proper tooth brushing at least twice daily.
Poorly controlled diabetes mellitus
It has been observed that patients with poorly controlled diabetes mellitus are prone to dental infections especially those affecting the supporting tissues of the teeth like the gum. In a case where a patient presents with severe gingivitis, one of the things to do is to make sure that the patient is not diabetic by checking the blood sugar. If they are, effort is made to make sure their blood sugar is well controlled else the dental problem may not get better.
In some cases, pregnant women may also experience an exaggerated case of bleeding gum. This should not be alarming because it is usually due to the interplay of normal hormones observed during pregnancy. The treatment would involve more diligent attention to proper tooth brushing as well as a visit to the dentist for scaling and polishing.
Some dental infections may present with gingivitis. This is especially common in poorly nourished children as well as individuals who have conditions that diminish their immunity like HIV/AIDS, diabetes mellitus, or cancers. The treatment for this form of gingivitis would center on treating the underlying infection and predisposing condition if present.
Some other less common causes of gingivitis include reaction to medications especially some anti-hypertensive drugs (Nifedipine) and anticoagulants.
Some forms of anemia may cause gingivitis as a symptom.
It is important that one sees the dentist if bleeding gums persist in the presence of proper and regular tooth brushing. In our next article on oral health, some common home remedies to help treat gingivitis would be highlighted.
Dr ‘Emeka Nwachukwu is a Fellow of the National Postgraduate Medical College of Nigeria and an Associate Fellow of the West African College of Surgeons. He is a Consultant Dental Surgeon with specialization in Restorative Dentistry. He currently provides general and specialist dental services at Skky Dental Services, Ikoyi. He is passionate about providing excellent dental services in a compassionate and pain free manner. He can be reached at firstname.lastname@example.org