Gingivitis

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Gingivitis

Act Now for Healthier Gums

he next time you brush your teeth, look at your toothbrush. Are the bristles red? Look in the mirror and smile. Are your gums puffy and swollen or losing their pink glow? If so, you probably have gingivitis.

Scary as it may sound, gingivitis is a fancy word for gum disease. It occurs when a sticky film of dental plaque (a gluelike film of bacteria, food and saliva) invades the warm and inviting crevasses at and below your gum line. There it hardens into tartar (sometimes called calculus), triggering inflammation and infection.

In other words, if plaque and tartar collect on your teeth, you get cavities. If they sneak into your gums, you get gingivitis.

THE HORMONE LINK

Woman are at increased risk for developing gingivitis during pregnancy, says Rita D. Zachariasen, Ph.D., professor of physiology at the University of Texas Health Science Center at Houston. According to Dr. Zachariasen, estrogen and progesterone (female hormones produced by your ovaries) seem to enhance conditions for growth of certain types of plaque-forming bacteria, while reducing the ability of your gums to heal once gingivitis occurs. Therefore, you should pay special attention to cleaning your teeth during pregnancy and whenever you are taking oral contraceptives, since ovarian hormones are elevated at these times.

Pregnancy's flood of hormones can be especially hard on the gums, with scientists estimating that 60 to 75 percent of pregnant women will have gingivitis, says Dr. Zachariasen. Prevention is the key. Studies show that women who are plaque-free when they enter pregnancy or start taking oral contraceptives can avoid swollen, bleeding gums, or at least minimize the problem.

DON'T GET SCARED, GET BUSY!

Some women tend to pull back from their dental hygiene routine when they see bleeding or experience sore gums, says Caren Barnes, R.D.H., professor of clinical dentistry at the University of Alabama School of Dentistry in Birmingham. But that's when simple steps can do the most good.

"We can stop gum disease, but we can't reverse it," she warns. So make cleaning your teeth and gums a priority now, and you can put the brakes on before you have full-blown periodontitis, where bacteria from the dental plaque actually undermines the bone and structures that hold your teeth in their sockets. Women doctors say that it's never too late to treat gingivitis.

Don't wait until your gums hurt, say women doctors. Here are some home tips to help you on the road back to healthier gums.

Brush and floss. You probably already own the two simplest tools for fighting gingivitis: a toothbrush and dental floss (thread specifically designed to clean between the teeth). "Used properly and regularly, they can thoroughly remove the plaque and bacteria from your teeth and gums at least once a day," says Barnes.

Brushing should be done a minimum of twice a day, says Mahvash Navazesh, D.M.D., associate professor and vice-chair in the Department of Dental Medicine and Public Health at the University of Southern California School of Dentistry in Los Angeles. Flossing should be done at least once a day.

If you're pregnant, brush and floss thoroughly and carefully after each meal, says Dr. Navazesh.

Lighten up. "Some people think that the harder you scrub, the more plaque you remove," says Diane Schoen, dental hygienist, clinical assistant professor and coordinator of the Preventive Dentistry Program at the University of Medicine and Dentistry of New Jersey in Newark. But brushing your teeth isn't like scrubbing a floor. Plaque is sticky like jelly, not sticky like glue, she says. "It adheres to teeth softly, so you don't need to scrub hard--it just needs to be mechanically broken up." Schoen recommends a soft-bristled toothbrush, held at a 45 degree angle to the gum line.

Start with an ultrasoft brush. If your gingivitis has left your gums sore and inflamed, keep brushing. But go with an ultrasoft brush until your dentist-directed healing program takes hold, says Schoen.

Pick up a tiny tool. A special brush called an interproximal brush has tiny bristles that go below the gum line, where floss can't reach. They can remove bacteria in the pockets formed by periodontal disease and can be helpful to use in conjunction with normal brushing and flossing, says Barnes. "One such tool is the Proxabrush, found in the toothbrush aisle."

Use no-frills floss. Dental floss or tape works whether you use waxed or unwaxed, regular gauge or extra-fine, thread or ribbon, looped or unlooped, plain or mint-flavored, says Barnes, as long as you use it. You don't need anything elaborate. Barnes and her associates compared gingivitis in men and women who used traditional dental floss to those who tried out an electromechanical flossing device that can fit between tightly spaced teeth. After a month both groups had benefited from flossing, but the new device offered no better results than ordinary floss from the drugstore.

When To See A Doctor If you feel pain or notice bleeding when you brush, don't wait until your next scheduled appointment to see your dentist: Unchecked, serious gum disease can undermine the tissues that support your teeth and lead to tooth loss. If you're pregnant, be sure to schedule several prenatal visits with your dentist, says Mahvash Navazesh, D.M.D., associate professor and vice-chair in the Department of Dental Medicine and Public Health at the Universty of Southern California School of Dentistry in Los Angeles. Hormonal changes during pregnancy leave pregnant women especially vulnerable to gum disease.

Swish as you style. At least once a day, swish mouth rinse around your mouth for about a minute (maybe while drying or styling your hair) after brushing and flossing, advises Heidi K. Hausauer, D.D.S., instructor of operative dentistry at the University of the Pacific Dental School in San Francisco and a spokesperson for the Academy of General Dentistry. Look for rinses that say "antiplaque" on the label. They kill bacteria that causes gingivitis and can be quite effective when combined with brushing, flossing and regular checkups, says Dr. Hausauer.

Buy a crate of oranges. You don't hear much about scurvy these days. But the fact remains, the hallmark of a textbook case of vitamin C deficiency--or scurvy--is rampant gum disease, leading to tooth loss. Vitamin C benefit is essential to healthy connective tissue, including gums, says Carole Palmer, R.D., Ed.D., professor and co-head of the Division of Nutrition and Preventive Dentistry in the Department of General Dentistry at Tufts University School of Dental Medicine in Boston.

"If you don't get enough vitamin C, your gums will be less able to resist bacterial infection," says Dr. Palmer. She recommends eating fresh fruits and raw or lightly steamed vegetables. "And it won't hurt to take a multivitamin, too."

Swallow two aspirin, and call your dentist in the morning. If your gums are really sore, rinsing with saltwater or taking over-the-counter analgesics such as aspirin or ibuprofen may help. But don't make the mistake of putting your aspirin where your pain is--directly on your gum. "I see this all the time, but aspirin is acidic," notes Dr. Hausauer. "It can really burn your gums."