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Gingival Diseases


Periodontology is the area of dentistry that covers the structure of hard (cement tissue and bone around the root) and soft (periodontal ligament connecting the gingiva and tooth-bones) areas as well as the diseases and treatments for these tissues.

Teeth are not directly connected to the bone in which they are located. There is the tissue that is called periodontal ligament that is made of fibers between the teeth and bone ensuring that the force applied through the teeth are conveyed to maxilla bone. The periodontal ligament and bone are also covered with gingiva. All these tissues are named as periodontal tissues and covered by periodontology.

Healthy Gingiva and Periodontal Tissues

Healthy gingiva are pale pink colored with tight texture and opaque. They don’t bleed during brushing.

Gingival Diseases

Gingival diseases are chronic bacterial infections. They don’t cause pain unless they are at very late phases. Gingival diseases are infections that should be taken seriously and they might progress without any symptom for many years and if not treated, they might cause even the healthy teeth to be lost due to the loss of periodontal tissue.

Gingival diseases are caused by the inflammation in the gingiva caused by bacteria plaque. This is called gingivitis. The main complaints are swelling in gingiva, rush, bleeding when brushing and oral malodor. At this phase, there is inflammation in gingiva however it hasn’t yet reached the bone supporting the tooth.


In case of Gingivitis;

  • There is bleeding when brushing the teeth.
  • Gingiva is red and swollen.
  • Gingiva surface is bright with disturbed contour.
  • There is no pain.

If gingival diseases are not treated at this phase, the following phase will be periodontitis. In case of periodontitis, inflammation has now reached periodontal ligament and the bone supporting the tooth. The gingival cavity that is present while the tooth and gingiva was healthy has now turned into a periodontal pocket by deepening due to inflammation. Such pocket forms a suitable environment for the reproduction of bacteria and facilitates the progress of disease.

In case of Periodontitis

  • There is spontaneous bleeding or during teeth brushing.
  • Gingiva gets red and swollen.
  • Gingiva is bright and contours are disordered.
  • There is malodor in the mouth.
  • Gingiva withdrawal starts as the disease progresses and consequently teeth become sensitive against hot and cold since the root surface is revealed.
  • Gingiva disease progresses if not treated. Teeth become loose and drift away from each other.


Treatment of Gingival Diseases

Treatment during gingivitis phase covers cleaning of the tartar and bacteria plaque on the teeth. Once the plaque and tartar are removed, the bacteria causing the disease will also be removed. This treatment is generally enough for eliminating the disease symptoms and inflammation and reattachment of the gingiva on the teeth surface. Moreover, the patient should also be very careful about the protection of mouth hygiene and bacteria plaque control.

If the disease has reached periodontitis phase, it means there is also periodontal pocket and the objective at this phase should be to clean the tartar in the pockets and form a smooth root surface. After the treatment, patients should be kept under control and the tartar and plaque should be eliminated if already formed. Furthermore, there are some other treatments covering certain surgical operations in the treatment of periodontitis. In order to maintain healthy status after treatment, the individual should continue mouth care very carefully.

Causes of Gingival Disease

The biggest factor in the formation of gingival diseases is bacteria plaque. The calcium salts in saliva attach to teeth by means of plaques and cause tartar. If there is no bacteria plaque, then calcium salts can not cling to teeth which means no formation of tartar.

In the formation of bacteria plaque, following factors play role:

  • Wrong or insufficient brushing
  • Absence of auxiliary mouth care materials such as dental floss or mouthwash liquids
  • Lack of regular control.

Moreover, genetic effects, systemic diseases, medicine intake, pregnancy, stress, unbalanced nutrition and smoking are also factors causing tendency for gingival disease.

Is it possible to defend against gingival diseases?

The most important actor in defense against gingival disease is the individual himself/herself. Since the main factor is bacteria plaque, it is a must to remove plaque by regular mouth care. In addition, regular dentist visits are also recommended. It may not be possible to remove plaque by brushing completely which causes tartar formation. The possible problems can be diagnosed and prevented at early stage thanks to the examination by dentist.