Gingivitis is a non-destructive periodontal disease caused by bacterial biofilms (plaque) on tooth surfaces. It is characterized by swollen, red or purple gums that bleed easily. While gingivitis is reversible with improved oral hygiene, it can progress to periodontitis if left untreated. Risk factors include poor oral hygiene, smoking, stress, certain medical conditions and medications. Gingivitis is treated by removing the bacterial plaque through regular brushing, flossing and professional cleanings.

1. The oral disease
gingivitis
Prepared, Designed & Presented by:
Mhmd Esam, Mohammed Yaqdhan & Maryam Kazam

2. Gingivitis:
Gingivitis ('inflammation of the gum tissue') is
a non-destructive periodontal disease. The most
common form of gingivitis, and the most common
form of periodontal disease overall, is in response to
bacterial biofilms (also called plaque) adherent to
tooth surfaces, termed plaque-induced gingivitis.

3. • Gingivitis is reversible with good oral hygiene.
• However in the absence of treatment, or if not
controlled, gingivitis can progress
to periodontitis- where the inflammation
results in tissue destruction and alveolar bone
resorption, which can ultimately lead to tooth
loss.

7. Gingivitis causes:
Gingivitis is a bacterial infection of the gums. The
exact reason why gingivitis develops has not been
proven, but several theories exist.
• For gingivitis to develop, plaque must accumulate in
the areas between the teeth. This plaque contains
large numbers of bacteria thought to be responsible
for gingivitis. But it is not simply plaque that causes
gingivitis. Almost everyone has plaque on their
teeth, but gingivitis is far less common.

8. • It is usually necessary for the person to have an
underlying illness or take a particular medication that
renders their immune system susceptible to gingivitis.
For example, people with diabetes, Addison's disease,
HIV, and other immune system diseases have weaker
ability to fight bacteria invading the gums. People with
Sjögren's syndrome have chronic dryness of the mouth
that predisposes them to develop gingivitis.
• Sometimes hormonal changes in the body during
pregnancy, puberty, and steroid therapy leave the gums
vulnerable to bacterial infection.
• A number of medications used for seizures, high blood
pressure, and organ transplants can suppress the
immune system and change the structure of the gums
enough to permit bacterial infection.

9. Signs and symptoms:
• The symptoms of gingivitis are somewhat non-
specific and manifest in the gum tissue as the classic
signs of inflammation:
• Swollen gums Bright red or purple gums. Gums that
are tender or painful to the touch Bleeding gums or
bleeding after brushing and/or flossing Bad breath
(halitosis)

10. • Additionally, the stippling that normally exists on
the gum tissue of some individuals will often
disappear and the gums may appear shiny when
the gum tissue becomes swollen and stretched over
the inflamed underlying connective tissue. The
accumulation may also emit an unpleasant odor.
When the gingiva are swollen, the epithelial lining
of the gingival crevice becomes ulcerated and the
gums will bleed more easily with even gentle
brushing, and especially when flossing.

11. Risk factors:
Risk factors associated with gingivitis are:
• increase in age
• low socio-economic status
• poor education
• low dental care utilization
• poor oral hygiene levels
• smoking
• psychosocial stress and genetic factors
• pre-existing conditions

13. • Gingivitis is the mildest form of periodontal
disease and affects 50% to 90% of adults
worldwide. It is ubiquitous and affects males and
females, young and old. As defined by gingival
bleeding adjacent to ≥1 teeth, about half of the
US population has gingivitis with the prevalence
slightly greater in males than females, and in
black people and Mexican Americans than in
white people.

14. The prevalence of gingivitis:
• There is evidence that the prevalence of gingivitis
has been decreasing in developed countries over
the last few decades. Globally, there appears to be
considerable heterogeneity in the prevalence of
gingivitis with higher prevalence reported in certain
parts of the world.

15. • The prevalence of necrotizing ulcerative gingivitis
(NUG) varies widely, and it is frequently reported
among young HIV/AIDS patients in some
countries. Studies including outpatients,
particularly after introduction of antiretroviral
therapy, have shown relatively low prevalence
figures, similar to those of the general population.
This disease is frequently seen in developing
countries, especially in sub-Saharan Africa, where
it occurs almost exclusively among children,
usually between the ages of 3 and 10 years, from
low socio-economic backgrounds.

16. Its prevalence has been reported to be about 0.3%
in Swiss Army recruits and 3% in a South African
population, and is as high as 27% among Nigerian
children aged <12 years at a west Nigerian dental
clinic. In this population, prevalence of this disease
increases from 2% to 3% of children with good oral
hygiene to 67% of children with very poor oral
hygiene.

17. Geographical variation in Prevalence of Gingival:
• In 1969 presented data which documented a
very high prevalence of periodontal disease in a
sample of several thousand persons ranging in
age from 13 to over 60. When the data were
compared to data for Norwegian students,
periodontal disease was shown to be much more
severe in Sri Lanka. When the same analysis was
performed after adjustment for differences in
oral hygiene however, very small differences
were found.

18. • In a longitudinal survey conducted by LSe and
coworkers the baseline examination showed that
the number of gingival units with a score of 2 or
more was almost seven times higher in Sri Lanka
than in Norway. The same study showed that before
the age of 20,loss of periodontal attachment was
considerably higher in Sri Lanka than in Norway.
When the annual rate of attachment loss was
studied on a longitudinal basis, the individuals from
Sri Lanka tended to lose two to three times as much
periodontal attachment per year as the individuals
from Norway.

19. The incidence rate of gingivitis:
• The objective of this study is to investigate the
incidence of gingivitis and periodontitis among
schoolchildren of 6 - 14 years old in Kaunas City.
The state of oral hygiene and incidence of
periodontitis was evaluated among 89
schoolchildren between 6-8 years old, 86
schoolchildren between 9-11 years old and 75
schoolchildren between 12-14 years old.

22. The treatment:
Removing the source of the infection is primarily how
simple gingivitis is treated. Home treatment is key.
Ultimately these home remedies can lead to a cure
for gingivitis.
• By brushing teeth regularly with a toothbrush and
fluoride toothpaste approved by dentists, plaque
buildup can be kept to a minimum.
• Flossing is another means of removing plaque in
between teeth and other areas hard to reach.

23. • Regular checkups with a dentist are also important.
A dentist is able to remove plaque that is too dense
to be removed by a toothbrush or dental floss.
• Severe gingivitis may require antibiotics and
consultation with a physician. Antibiotics are
medications used to help the body's immune
system fight bacterial infection and have been
shown to reduce plaque. By reducing plaque,
bacteria can be kept to a level manageable by the
human immune system. Taking antibiotics is not
without risks and should only be done after
consultation with a dentist or doctor.

24. The prevention:
• Good mouth and teeth care.
• Regular dental follow-up.
• Treatment of associated underlying illnesses.

26. Thank
you