Gingivitis and Periodontal Treatment

Gingivitis is an inflammation of the gums caused by a buildup of bacteria. With proper brushing and flossing at home along with regular professional dental cleanings, gingivitis can be reversed. If ignored, it can lead to serious bone loss.

How do you describe the symptoms of gingivitis? And are periodontal disease, periodontitis, and gum disease the same thing?

Dr. Darren McKeever: Well, in regards to the second part of that question, pretty much periodontal disease, periodontitis, gum disease, they’re really all the same thing in terms of how people perceive the disease. Those are any variation of either an irreversible form of bone loss or, like gingivitis, a warning of the potential for bone loss. So that’s kind of like how people use the term a cap or a crown interchangeably. They kind of mean the same thing.

Gingivitis is a specific animal unto itself. Gingivitis is the red inflammation of the gums that is almost always caused by an accumulation of plaque bacteria around the gums that’s leaking out acid, irritating the gums, and that’s what causes the redness. It’s the body’s response to that. It’s inflammation. Later on, it can progress to the irreversible form, which is when you have bone loss. But that’s not quite gingivitis. That’s the next level in the progression of the disease. The gingivitis is the thing that lets us know something’s not right, something needs to be done. And hopefully, we can get the patient to commit to some kind of change in their oral care at home, or they may have to commit to some treatment in the office.

What are some common causes of gingivitis? And what can be done to prevent it?

Dr. Darren McKeever: Well, there actually are a few causes of gingivitis, but it all almost always boils down to the response of the gums to the plaque, the bacteria that accumulates around them. One of the things that we’re seeing nowadays, which is kind of frightening, is medicinally induced dry mouth syndrome. This is a new animal that’s come along because, unfortunately, there’s a lot of people nowadays who are on a lot of different medications. Sometimes they’re on many different medications. And some of the results are dry mouth. Now, they can be brushing their teeth till their arms fall off and they get bursitis. But the problem there is, without the additional help of saliva, the bacteria can propagate even faster. So that’s one of the things that’s scaring us a lot lately in the dental world. But more often than not, gingivitis is caused basically because people just are either not tending to their teeth professionally at the proper interval or they’re not taking care of them at home with enough effectiveness to keep the bacteria at bay. They’re not brushing properly or frequently enough, or they’re not flossing at all.

How is gingivitis treated in your dental practice?

Dr. Darren McKeever: Well, we’re very conservative on the treatment of gingivitis, because it’s not uncommon for people to have it. Once you remove the bacteria from around the teeth, and hopefully you also smooth off the teeth and sometimes that includes the roots of the teeth, the teeth should be more easily cleansable by the patient in between professional cleanings. As long as their fastidious about doing it and they’re doing it on a regular basis, that more often than not is enough to keep gingivitis from really getting a foothold and keeping its negative impacts from causing further damage.

Is it possible to completely heal from gingivitis? Or will someone always have an issue?

Dr. Darren McKeever: Gingivitis is almost always completely reversible. Gingivitis is the reaction that’s within the soft tissues. It’s when the issue is allowed to progress and become a problem for the bone. That’s when we have a problem. But gingivitis in itself is almost always reversible with care.

What can happen if someone does not get treated for gingivitis?

Dr. Darren McKeever: That’s the problem. Gingivitis is, like I said, really just the soft tissue, the gums, having the problem. My analogy for people is the bacteria are allowed to hang out on the teeth too long. They secrete acid. The acids irritate the gums. It’s no different than if I was to hold somebody’s hand in a vat of orange juice for too long. The citric acid would irritate their skin. If the acid from the bacteria around the teeth irritates the gum, if gives you gingivitis. It gives you inflammation. The problem lies that when the acid is allowed to accumulate enough, it will inevitably irritate the bone around the teeth. That’s a whole different problem. The bone reacts because it doesn’t like the acid. It reacts by dissolving itself. Now, that’s so critical, I always say it twice to patients. The bone responds by dissolving itself in response to the irritation.

Now, the healthier you are, even though it’s a dumb thing to do, the more quickly your bone might react to that. And you might see quicker bone loss in a healthy person rather than what we normally think of gum disease as an old person’s disease. It may not progress as fast as you age later in life. So that’s really the thing we have to worry about, because bone loss is not reversible. It can be treated. Sometimes we can bring some bone back. But those are some significant treatments in order to do that. So, you never want to let gingivitis progress for long. It’s never a good thing.

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If you are interested in speaking with Dr. Darren McKeever, visit or call 973-839-8180 to schedule an appointment.

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