Causes
The bacteria that cause gingivitis lurk in the gumline, at the point where the teeth emerge. Many species of bacteria are involved, but they go by the universal name of plaque. Plaque is made of bacteria, mucus, and small particles of food. New bacteria are arriving constantly, and if they're not brushed off within about three days, they form a rock-hard layer called tartar. Toothbrushes and dental floss can't remove tartar, only a dentist can.
Some people are more prone to getting gingivitis than others. Gingivitis is particularly likely to occur in people with diabetes, AIDS, or leukemia. Other factors linked to an elevated risk of gingivitis include:
- puberty
- pregnancy
- menopause
- smoking
- vitamin C deficiency (scurvy)
- niacin (vitamin B3) deficiency (pellagra)
- use of the female contraceptive pill
- poorly aligned teeth or poorly fitted mouth appliances (such as retainers or crowns)
Pregnant women frequently have gum problems. Hormonal changes and tartar can combine to provoke an excess growth of gum tissue. Sometimes, a lump forms that may bleed easily. It's called a pregnancy tumor, though it has nothing to do with cancer. This lump can obstruct areas of gumline from brushing, letting bacteria prosper in safety.
Postmenopausal women can develop a painful condition called desquamative gingivitis. For unknown reasons, the outer layers of the gums come away from the teeth and lose their solidity. This disease can be very painful, as nerve endings are often exposed.
Some medications are also associated with gingivitis, including:
- cyclosporine* (used to treat rheumatoid arthritis and other autoimmune diseases)
- phenytoin (used to control epilepsy and other seizures)
- calcium channel blockers such as nifedipine (used treat high blood pressure and other heart conditions)
Some viruses can also infect the mouth. The one most likely to attack the gums is the herpes virus. It causes tiny ulcers and holes to appear in the gums and other parts of the mouth. This disease is called acute herpetic gingivostomatitis (a stoma is a medical term for "hole"). It only strikes people who have just caught herpes for the first time, and have caught it in the mouth.