Bleeding gums and gingivitis
To detect and treat gingivitis as early as possible, you should examine your teeth and gums yourself regularly for the first signs.
Check your toothbrush. If the bristles are discolored pink, your gums may be bleeding from the light pressure of the toothbrush. This may indicate a burgeoning infection.
Check the color of your gums. Healthy gums look bright and pink. However, if you notice color changes and it looks dark and red in some places, this is a sign of inflammation.
How do your gums feel? In the early stages of gingivitis, the gums may be soft and swollen. Healthy gums, on the other hand, are firm and do not pull back from the teeth.
Gingivitis describes the inflammation of the gums. It can occur due to plaque or non-plaque. Non-plaque-related gingivitis occurs considerably less frequently. Usually gingivitis precedes periodontitis. The gingivitis condition may persist for years before it develops into periodontitis.
The development of plaque-related gingivitis can be divided into different stages; initiale-, established-, as well as advanced lesion.
In the early lesion stage, initial tissue damage can be observed. Pathogenic bacteria secrete enzymes, toxins and other metabolites that degrade the gingival connective tissue. Furthermore, there is an increase in immune defense cells (lymphocytes and macrophages). The first signs of inflammation become clinically visible, such as permanent redness, swelling and bleeding gums.
The established lesion is already the chronic form of gingivitis. It is linked to the presence of subgingival plaque. The incipient formation of a gingival pocket can often be observed.
The initial lesion can hardly be distinguished clinically from the established lesion. With optimal oral hygiene, the initial stages of gingivitis are completely reversible.
The advanced lesion denotes the transition from chronic gingivitis to periodontitis. Tissue breakdown is now not limited to the gingiva, but also involves the bone. Periodontal pockets are present, which allow bacterial material to further penetrate between the tooth and the bone. The bone is degraded in both horizontal and vertical directions. Bone pockets may form.
Plaque-induced gingivitis may be systemic or drug-induced. Hormonal changes, e.g. during pregnancy or puberty, can also have an aggravating effect. In addition, diseases such as diabetes or leukemia can promote the development of gingivitis.
Non-plaque induced gingivitis
Non-plaque induced gingivitis usually occurs as a symptom of a bacterial, viral or fungal infection and as a result of autoimmune diseases. Furthermore, allergies to certain materials or drugs as well as trauma due to mechanical injury (e.g. over-contoured crown margins) can also contribute to the development of gingivitis.