Gingivitis: Causes, Symptoms, and Homeopathic Treatment Explained

Gingivitis is a reversible inflammatory condition of the gingiva (gums) caused by plaque accumulation, leading to redness, swelling, and bleeding gums without loss of supporting bone.

Etiology (Causes & Risk Factors):

1. Plaque-Induced Gingivitis (Most Common Cause):

• Dental Plaque (Biofilm Accumulation): Contains bacteria like Streptococcus mutans and Porphyromonas gingivalis.
• Poor Oral Hygiene: Leads to plaque buildup and gingival inflammation.

2. Non-Plaque-Induced Gingivitis:

• Hormonal Changes:
• Pregnancy Gingivitis (Gestational Hormonal Influence).
• Puberty & Menopause-Related Gingivitis.
• Nutritional Deficiencies:
• Vitamin C Deficiency (Scurvy Gingivitis).
• Iron & Vitamin B Deficiency (Anemic Gingivitis).
• Systemic Diseases:
• Diabetes Mellitus – Increased susceptibility to infections.
• Leukemia – Gingival hyperplasia & spontaneous bleeding.
• Drugs-Induced Gingivitis:
• Phenytoin (Dilantin) – Causes Gingival Hyperplasia.
• Calcium Channel Blockers (Nifedipine, Amlodipine).
• Immunosuppressants (Cyclosporine).
• Smoking & Alcohol Consumption:
• Causes vasoconstriction, reducing immune response in the gums.
• Infections:
• Bacterial (Acute Necrotizing Ulcerative Gingivitis - ANUG).
• Fungal (Candida albicans - Thrush-related Gingivitis).
• Viral (Herpetic Gingivostomatitis caused by HSV-1).

Pathogenesis:

1. Plaque Formation:
• Bacteria accumulate on the gingival margin, forming biofilm.
2. Inflammatory Response:
• Bacterial toxins (endotoxins) stimulate immune cells (neutrophils, macrophages, lymphocytes).
3. Gingival Changes:
• Leads to vascular dilation, edema, and infiltration of inflammatory cells.
4. Progression to Periodontitis (If Untreated):
• Gingivitis can lead to attachment loss, periodontal pockets, and alveolar bone resorption.

Clinical Features:

• Swollen, Puffy Gums (Edematous Gingiva).
• Redness (Erythema) of the Gingiva.
• Bleeding Gums (on brushing or spontaneous).
• Bad Breath (Halitosis) due to bacterial activity.
• Tenderness or Mild Pain in gums.
• Gingival Hyperplasia (Enlarged Gums) in drug-induced cases.
• No Bone Loss or Pocket Formation (Unlike Periodontitis).

Types of Gingivitis:

1. Acute Gingivitis:

• Sudden onset with pain, redness, and swelling.
• Commonly associated with infections or trauma.

2. Chronic Gingivitis:

• Long-standing gingival inflammation.
• Usually painless but causes persistent redness & swelling.

3. Acute Necrotizing Ulcerative Gingivitis (ANUG / Trench Mouth):

• Painful, ulcerated, and bleeding gums.
• Associated with poor oral hygiene, smoking, stress, and immunosuppression.
• Caused by Fusobacterium, Prevotella, and Spirochetes.

4. Hormonal Gingivitis:

• Pregnancy Gingivitis due to increased progesterone.
• Puberty Gingivitis due to hormonal fluctuations.

5. Drug-Induced Gingival Enlargement:

• Overgrowth of gingival tissue due to medications.
• Common Drugs: Phenytoin, Cyclosporine, Calcium Channel Blockers.

Diagnosis:

1. Clinical Examination:
• Inspection of gingival color, contour, consistency, and bleeding tendency.
2. Plaque Index & Gingival Index:
• Assesses severity and extent of inflammation.
3. Bleeding on Probing (BOP):
• Positive in gingivitis.
4. Microbiological Tests:
• Culture to identify specific bacteria.
5. Blood Tests (If Systemic Association Suspected):
• Complete Blood Count (CBC) for leukemia.
• Blood Sugar Levels for diabetes.

Treatment:

1. Plaque Control & Oral Hygiene Measures:

• Regular Brushing (Twice Daily) with Fluoridated Toothpaste.
• Flossing to remove plaque between teeth.
• Antiseptic Mouthwashes (Chlorhexidine, Betadine).

2. Scaling & Root Planing (Professional Cleaning):

• Removal of plaque & calculus (tartar) by a dentist.

3. Medications:

• Topical Antibacterial Gels: Metronidazole, Chlorhexidine.
• Vitamin C Supplements (For Nutritional Gingivitis).
• Antibiotics (For ANUG or Severe Cases):
• Metronidazole + Amoxicillin (For acute infections).

4. Surgical Treatment (For Severe Cases):

• Gingivectomy – Removal of overgrown gingival tissue.
• Gingivoplasty – Reshaping of the gingiva.

Complications of Untreated Gingivitis:

• Progression to Periodontitis (Loss of Tooth Support).
• Recurrent Gingival Infections (Abscess Formation).
• Halitosis (Chronic Bad Breath).
• Increased Risk of Systemic Diseases:
• Diabetes Mellitus (Worsens blood sugar control).
• Cardiovascular Disease (Due to chronic inflammation).
• Adverse Pregnancy Outcomes (Premature birth, low birth weight).

Prevention:

• Proper Brushing Technique (Modified Bass Method).
• Flossing Daily to Remove Interdental Plaque.
• Routine Dental Checkups Every 6 Months.
• Avoid Smoking & Alcohol to Reduce Gingival Irritation.
• Balanced Diet with Adequate Vitamins & Antioxidants.

Conclusion:

• Gingivitis is a reversible condition if treated early.
• Proper oral hygiene, plaque control, and regular dental visits can prevent progression to periodontitis and tooth loss.

Homeopathic Medicines:

1.     Mercurius Solubilis

• Spongy, bleeding gums with offensive breath.
• Ulcers and metallic taste in the mouth.
• Excessive salivation, especially at night.

2.     Kreosotum

• Inflamed, bleeding gums with rapid tooth decay.
• Burning sensation in the gums.
• Offensive, putrid odor from the mouth.

3.     Phosphorus

• Bleeding gums with sensitivity to temperature changes.
• Loosening of teeth with bone resorption.
• Gums pale and swollen, easily infected.