Gingivitis and Halitosis: Gigi Relunia, DMD

Gingivitis and Halitosis
Prepared By: Dr. Gigi Relunia
GINGIVITIS
DEFINITION
 Gingivitis is a common condition that can occur in almost anyone. It is an early stage of
gum disease caused by the buildup of plaque on tissues that surround the teeth.
 Plaque is extremely sticky, colorless to pale yellow deposit of bacteria that builds up on
your teeth if not brushed regularly. It occurs especially when you consume sugary or
starchy foods.
 Plaque forms quite quickly and if you allow the plaque to remain on your teeth for more
than a couple of days, it can turn into tartar. This tartar shields the bacteria and if
remained for a long periods of time, they cause irritation to the sensitive area of the
gums around the base of the tooth. This will cause your gums to swell and become
tender.
 If neglected and left untreated, gingivitis can develop to a more severe form of gum
disease, known as periodontitis. When gingivitis progresses to periodontitis, the gums
begin to pull away from the teeth, creating small pockets. Bacteria can then become
trapped in these pockets, weakening the bone supporting the teeth and eventually
tooth loss.
SIGNS AND SYMPTOMS OF GINGIVITIS
 Swollen gums
 Bright red or purple gums
 Gums that are tender or painful to touch
 Bleeding gums or bleeding after brushing or flossing
 Persistent bad breath (Halitosis) or bad taste in the mouth
 Receding gums
CAUSES OF GINGIVITIS
Plaque is the primary cause of gum disease. However, other factors can contribute, and these
include:
GIGI RELUNIA,DMD 1
 Smoking – make it harder for gum tissue to repair itself.
 Poor Oral Hygiene Habits – such as not brushing and flossing, making it easier for
gingivitis to develop.
 Hormonal Changes – such as during pregnancy, puberty, menopause, and monthly
menstruation as these make gums more sensitive.
 Illnesses – may affect the condition of your gums. This includes diseases such as cancer,
HIV that interferes with the immune system. Diabetic patients are at higher risk of
developing infections, including periodontal disease and cavities, and affects the body’s
ability to use blood sugar.
 Medications – can also affect oral health because some lessen the flow of saliva, which
has a protective effect on teeth and gums. Some drugs such as anticonvulsant
medication Dilantin and anti-angina drug Procardia and Adalat, can cause abnormal
growth of gum tissue.
 Overly aggressive oral hygiene – such as brushing with stiff bristles
 Mouth breathing during sleep
 Poor Nutrition
 Old age
 Poorly fitted dentures or dental restorations. – Common areas where the plaque is
trapped. Others include bulky and overhanging restorative margins and claps on
removable partial dentures.
MANAGEMENT AND TREATMENT

Gingivitis can be reversed and progression of gum disease can be stopped in nearly all cases.
The goals of gum disease treatment are to promote reattachment of healthy gums to the
surface of the teeth and eventually reduce swelling. Treatment options depend on the stage of
disease and your overall health. Treatment options are the following:
Proper plaque control – this consists of professional dental cleanings at least twice a year and
daily brushing and flossing, The use of powered toothbrushes work better than manual
toothbrushes in reducing disease.
Health and lifestyle changes – such as:
 Smoking cessation. Tobacco use is a significant risk factor for development of gum
disease. Smokers are seven times more likely to get gum disease than nonsmokers.
GIGI RELUNIA,DMD 2
 Reduce stress. Stress may make it difficult for your body’s immune system to fight off
infection.
 Maintain a well-balanced diet. Proper nutrition helps your immune system fight
infection. Ensure that you get an adequate supply of fiber through the diet. Include
whole grains, beans, fruits and vegetables in daily meals.
 A good supply of vitamins and minerals enables you to fight infections such as gingivitis.
Your diet should be high in the vitamin B and C. Minerals such as potassium, calcium,
iron, zinc and selenium are also important.
 Avoid eating foods which are rich in sugar as bacteria thrive on sugars. The sugar that gets
lodged between the teeth provides an ideal breeding ground for the bacteria. Therefore,
cut down on white flour, sweets, colas, and fruit juices.
GIGI RELUNIA,DMD 3
HALITOSIS
DEFINITION
 Bad breath, (oral malodor), also known as halitosis, is a symptom in which a noticeably
unpleasant odor is present on the breath.
 Concerns of bad breath is the third most common reason people seek dental care.
Of those who have genuine bad breath, about 85% of cases come from inside the mouth
while the remaining cases are believed to be due to disorders in the nose, sinuses,
throat, lungs, esophagus, or stomach.
 It should not be confused with momentarily disturbing odor caused by food intake
(such as garlic, onions, meat, fish, and cheese), smoking, and alcohol consumption.
 Since the mouth is exposed to less oxygen and is inactive during the night, the odor is
usually worse upon waking up (morning breath).
CAUSES OF HALITOSIS
Physiologic
 Fasting
 Beverages
 Dairy products
 Alcohol
 Dehydration
 Stress/Anxiety
 Smoking
 Volatile foods – e.g. onion, garlic, durian, cabbage, cauliflower and radish.
Pathologic
 Tongue coating
 Deep carious lesions (dental decay) – which cause localized food impaction and
stagnation
 Recent dental extraction sockets – fill with blood clot, and provide an ideal habitat for
bacterial proliferation
GIGI RELUNIA,DMD 4
 Acrylic dentures (plastic false teeth) – inadequate hygiene practices such as failing to
clean and remove the prosthesis each night, may cause malodor from the plastic
itself or from the mouth. This predisposes to bacterial and yeast retention which
is accompanied by a typical smell.
 Gingivitis
 Xerostomia
 Oral sepsis
 Oral cancer
MANAGEMENT AND PREVENTION

 Smoking cessation
 Periodical oral prophylaxis by dental professional
 Brushing of teeth twice daily
 Use of tongue scraper to get rid of the lurking odor –causing bacteria in the
tongue surface
 Flossing after brushing to remove food particles stuck in between the tooth
surfaces.
 Limit intake of strong odor foods.
 Limit sugar and caffeine intake.
 Drink plenty of liquids.
 Chew sugar-free gum when mouth feels dry.
 Eat fresh and fibrous vegetables
 Use of mouthwashes as this chemically reduced oral microbial load, such as
Chlorhexidine, Essential oils, etc.
 If gum disease and cavities are present, it is highly recommended that these be treated
 If diseases outside of the mouth (physiological halitosis) is the contributing
factor, treatment may results in improvement
 Counseling may be useful for those who falsely believe that they have bad
breath
GIGI RELUNIA,DMD 5

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Gingivitis and Halitosis

Prepared By: Dr. Gigi Relunia

MANAGEMENT AND TREATMENT

MANAGEMENT AND PREVENTION

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