You may suffer from swollen gums, reddened gums, or bleeding gums, often accompanied by persistent bad breath. Your gums may be pulling away from your teeth, your teeth may be loose, your bite (the way your teeth fit together) may have changed, there may be pus in your mouth, it may be painful to chew or your teeth may be sensitive in general, or you may have partial dentures that no longer fit as they should. If that sounds like you, there’s a fair chance you have gingivitis, a form of periodontal disease (what your Chicago dentist calls gum disease.)
The risk factors for gingivitis include smoking or chewing tobacco, diabetes, taking certain medications (oral contraceptives, anticonvulsants, steroids, calcium channel blockers, and chemotherapy), crooked teeth, broken teeth, poorly fitting dental appliances, a genetic predisposition, pregnancy, and a compromised immune system.
There’s even a correlation between gingivitis and heart disease, lung disease, stroke, risk of diabetes, and mothers giving birth to premature or low birth weight babies, although science hasn’t established that gingivitis causes these other health issues.
People with gingivitis tend to seek treatment because this form of gum disease is unpleasant and alarming enough in and of itself. But a person should also seek gingivitis because if it remains untreated, it can easily turn into a condition that’s even more painful, even more unpleasant for other to look at, and apt to have permanent consequences.
Gingivitis and Trench Mouth
Left unchecked, ordinary gingivitis can worse into Acute Necrotizing Ulcerative Gingivitis (ANUG), often referred to as trench mouth. It acquired that name in World War One, where many soldiers in the trenches suffered from it. It wasn’t (and isn’t) contagious, but the fact that the soldiers had no opportunity to practice proper oral hygiene made it a common affliction. The stress of war probably played a part as well, as did smoking and medicines that dried the mouth. These factors in combination produced excellent conditions for bacterial growth.
Symptoms of Acute Necrotizing Ulcerative Gingivitis
When gingivitis progresses to trench mouth, gum tissue actually starts to die (necrotize.) Gum tissue also swells and develops ulcers. The ulcers are especially likely to form on the papillae, which are the little triangles of gum tissue between the teeth. When the ulcers develop, they can make the affected tissue appear yellowish.
As a result of all this, ANUG is often quite painful. It’s also likely to produce extremely bad breath and a nasty taste in the mouth. Ultimately, there’s a high probability it will lead to tooth loss.
Gum Disease Treatment for Acute Necrotizing Ulcerative Gingivitis
The first step in treatment is a complete dental examination. The professionals in your Chicago dentist office have to determine the cause of the patient’s complaint to provide appropriate treatment.
The exam will likely involve probing the gums with a small ruler. This provides a check for inflammation while detecting and measuring pockets around the teeth. (A normal, healthy depth is 1 to 3 millimeters.) The dental team uses X-rays to determine if there’s been any bone loss.
Having determined that a patient suffers from ANUG, the dentist is then likely to recommend non-steroidal anti-inflammatory drugs like ibuprofen and aspirin. These relieve pain and inflammation. He or she may also recommend rinsing with a mouthwash containing chlorhexidine and mild salt water to alleviate symptoms.
At the same time, the dentist will attack the disease itself with antibiotics. Oral antibiotics address persistent area of inflammation. Amoxicillin, Metronidazole, and Doxycycline are three that are commonly used; the latter is particularly useful in preventing enzymes from damaging teeth. The dentist may also insert time-release antiseptic chips made with chlorhexide and ntibiotic microspheres made with minocycline into pockets after scaling and root planing.
The dental professionals must also deal with any underlying chronic gingivitis that gave rise to the acute condition. They do this by removing bacterial plaque and calculus (hardened plaque deposits) present on the teeth. It’s particularly important to remove calculus below the gums. It’s only by getting rid of all this material that the gum disease treatment team can minimize the chance of a recurrence.
Flap surgery lifts the gums back while the dental professional removes plaque and calculus from the deeper pockets. The gums are then sutured in place to hold the tooth securely.
As a last resort, when teeth, gums, and jaw are simply too damaged to heal, the dentist can repair the damage with bone and tissue grafts.
Prognosis for Acute Necrotizing Ulcerative Gingivitis
Provided treatment begins early, trench mouth is generally completely reversible with no permanent ill effects.
It’s common for dentists to recommend lifestyle changes including moving to a healthier, more nutritious diet, getting more rest, giving up smoking, eliminating stress, and brushing and flossing more often or more effectively. All these improvements reduce the odds that the patient will develop gingivitis again.