Gum disease

Gum disease is also called periodontal disease. It is defined as the
inflammation of the structures that surround and support the teeth. If
left untreated, gum disease may progress to the point where there is
destruction of the jawbone. It is one of the most common causes of tooth

Gum Diseases

Starts as


Gingivitis is the earliest stage of a gum infection. It may recur or
even become chronic Injury to the gums from any cause – overly vigorous
brushing or flossing of the teeth General illness , poor dental hygiene ,
pregnancy , uncontrolled diabetes. Misaligned teeth, rough edges of
fillings, and ill-fitting or unclean mouth appliances (such as braces,
dentures, bridges, and crowns).

Medications – phenytoin and birth control pills, and heavy metals such as lead and bismuth are also associated with gingivitis.

Many people have gingivitis to a varying degree. It usually develops
during puberty or early adulthood due to hormonal changes and may
persist or recur frequently, depending on the health of your teeth and


  • Mouth sores
  • Swollen gums
  • Bright red or red-purple appearance to gums
  • Shiny appearance to gums
  • Bleeding gums (blood on toothbrush even with gentle brushing of the teeth)
  • Gums that are tender when touched, but otherwise painless

Consult the dentist if signs of gingivitis are present and for the treatment. Otherwise periodic yearly check up is recommended.


The goal is to reduce inflammation. The teeth are cleaned thoroughly
by the dentist or dental hygienist. This may involve various instruments
or devices to loosen and remove deposits from the teeth.

Meticulous oral hygiene is necessary after professional tooth
cleaning. The dentist or hygienist will demonstrate brushing and
flossing techniques. Professional tooth cleaning in addition to brushing
and flossing may be recommended twice per year or more frequently for
severe cases. Antibacterial mouth rinses or other aids may be
recommended in addition to frequent, careful, tooth brushing and

Repair of misaligned teeth or replacement of dental and orthodontic
appliances may be recommended. Any other related illnesses or conditions
should be treated.


If gingivitis is not treated properly, it may progress to
periodontitis, an inflammation of the periodontal ligament that helps
hold the teeth in the bone. Periodontitis is sometimes called pyorrhea,
which means a pus discharge. Severe cases of periodontitis may affect
the jawbone.


Periodontitis occurs when inflammation or infection of the gums
(gingivitis) is untreated or treatment is delayed. Infection and
inflammation spreads from the gums (gingiva) to the ligaments and bone
that support the teeth. Loss of support causes the teeth to become loose
and eventually fall out. Periodontitis is the primary cause of tooth
loss in adults. This disorder is uncommon in childhood but increases
during adolescence.


  • Swollen gums
  • Gums that appear bright red or red-purple
  • Gums that appear shiny
  • Gums that bleed easily (blood on toothbrush even with gentle brushing of the teeth)
  • Gums that are tender when touched but are painless otherwise
  • Breath odor
  • Loose teeth

Note: Early symptoms resemble gingivitis.


The goal of treatment is to reduce inflammation, eliminate pockets if
present, and address any underlying causes. Dental irritants, such as
rough surfaces of teeth or dental appliances, should be repaired.
General illness or other conditions should be treated.

It is important to have the teeth cleaned thoroughly. This may
involve use of various instruments or devices to loosen and remove
deposits from the teeth (scaling). Followed by similar treatment as in

Surgical treatment may be necessary. Deep pockets may need to be
opened and cleaned. Loose teeth may need to be supported. Extraction
(removal) of a tooth may be necessary for advanced periodontitis so
destruction doesn’t spread to adjacent teeth.

Trench Mouth / Vincent Stomititis / Acute Necrotising Gingivitis

A severe case of gum disease that comes on suddenly is a disease
known as trench mouth. Trench mouth, or necrotizing ulcerative
gingivitis, is also known as Vincent’s infection. It is caused by an
infection of both spirochetes and fusiform bacilli. It was once a major
problem for soldiers during World War I. Currently, trench mouth is
particularly common among teenagers and young adults under stress, often
at examination time. Inflammation from trench mouth can also spread to
nearby tissues of the face and neck.

Trench mouth is a painful bacterial infection and ulceration of the gums (gingiva).

Also nick named as – Vincents stomatitis; Acute necrotizing ulcerative gingivitis


The mouth normally contains a balance of different microorganisms.
Trench mouth occurs when there is an overabundance of normal mouth
bacteria resulting in infection of the gums, which develop painful
ulcers. Viruses may be involved in allowing the bacteria to overgrow.

    Risks include the following:

  • Poor oral hygiene
  • Poor nutrition
  • Throat, tooth or mouth infections
  • Smoking
  • Emotional stress

This disorder is rare. When it does occur, trench mouth most often affects adults younger than 35.


  • Painful gums
  • Profuse gum bleeding in response to any pressure or irritation
  • Gums appear reddened and swollen
  • Grayish film on the gums
  • Crater-like ulcers between the teeth
  • Foul taste in the mouth
  • Bad breath

Note: Symptoms often begin suddenly.

There may be a gray film caused by decomposed gum tissue.
Occasionally, there may be fever and swollen lymph nodes of the head and


The goals of treatment are cure of the infection and relief of symptoms.(symptomatic treatment provided).

Good oral hygiene is vital to the treatment of trench mouth.

You may be asked to visit a dentist to have your teeth
professionally cleaned, with thorough plaque removal . Dental cleaning
and examination may be recommended on a regular, frequent basis until
the disorder is cleared.

You may be given instructions regarding methods to stop smoking,
reduce stress, maintain good oral hygiene, or other steps to prevent
this condition from recurring. You may also be advised on how to
maintain good general health, including proper nutrition and rest
balanced with exercise.

Irritants must be avoided, including smoking and hot or spicy foods.