Gingivitis (also reIerred to as gum disease) is inIlammation oI the gingiva

or gums. In gingivitis, the damage that occurs can be reversed and there is no
permanent loss oI supporting structures oI the teeth. Gingivitis is characterized by
swelling and reddening oI the gum tissue. The tissue becomes very sensitive and
bleeds easily during brushing. Surprisingly, gingivitis usually does not cause pain.
Although no one wants to be in pain, pain is a signal Irom our bodies that
something is wrong. When we Ieel pain, we immediately act to alleviate the pain
or to Iind the cause oI it. II something is wrong, such as in gingivitis, and the
problem is not addressed, it can become worse and possibly irreversible. Chances
are, either you or the person sitting next to you will have gingivitis within your
liIetimes. Gingivitis aIIects more than halI the population and the prevalence
becomes even greater as we age. Perhaps you could help decrease this number
within your liIetime by learning more about gingivitis and the simple ways to
prevent it.
There are many uncontrollable Iactors that can aIIect your chances oI
contracting the disease and the severity oI the disease. Men have a higher
incidence oI gingivitis than do women.
Gingivitis is the result oI many types oI bacteria colonizing the oral cavity.
Some oI the bacteria commonly associated with gingivitis include Streptococcus
sp., Actinomyces sp., Capnocytophaga sp., Fusobacterium sp, Prevotella sp.,
Campylobacter gracilis, Peptostreptococcus micros, Eubacterium nodatum,
Campylobacter concisus, and Eikenella corrodens. These bacteria are all part oI
plaque.
Bacteria alone, however, are not enough to cause disease. Gingivitis is a
disease that requires both plaque bacteria and our immune response. Very simply,
gingivitis id the result oI our immune system responding to abnormal plaque
accumulation on the tooth surIace. The outcome is an inIlammatory response in
the gum tissue (hencve redness and swelling). When we maintain proper oral care,
our plaque remains at minimal, healthy levels.
Several componenents oI the immune response are activated during
gingivitis. First, an immediate response occurs that results in the migration oI
inIlammatory cells to the gingiva. These cells produce cytokines. Some oI the
cytokines cause our blood vessels to dilate within the area oI inIection. This
causes leakage oI blood cells in the gingiva, which results in the redness and
swelling that is characteristics oI gingivitis. Cytokines also tell certain cells to
produce destructive proteins that help destroy bacterial cells. The problem is, in
addition to killing bacteria, the destructive proteins also damage our own cells and
cuase tissue breakdown.
A second, more delayed response is the production oI antibodies. This
process takes longer than the production oI cytokines because several types, B-
cells and T-cells, must process and analyze all the bacterial protein beIore an
antibody is actually produced. Once antibodies are produced, which takes several
days, our immune system begins to target and eliminate the Ioreign bacteria and
proteins. In the process oI eliminating plaque bacteria, bacteria guts are released,
inclulding LPS, DNA, and intracellular proteins. These bacterial components
Iurther stimulate the immune system.
When the immune system is not working properly, bacteria grow
uncontrollably and disease can become worse. Our immune system can be
adversely aIIected (immuno-compromised) by disease or by environmental
Iactors.

Scott C. Kachlany. 2007. InIectious diseases oI the mouth. New York : Chelsea
House.
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lid#vonepage&qgingivitis&IIalse

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