The infection of the gums, gingivitis, is one of the most common untreated infections. With infected eyes, or infected ears, people will be fast to visit a clinic. The reason is that eye and especially ear infections often are quite painful, or at least very disturbing.
But unlike the eyes and the ears, the mouth is an organ much more apt to
live with pathogens, often without causing problems on a level with ear and eye infections. After all, as food-intake organ, the mouth is designed in a much broader sense to deal with infectious agents, as well as with wounds caused during chewing.
People often don't go to a dentist with gingivitis because it usually
doesn't cause pain or systemic symptoms such as fever except when in an
advanced stage. People may notice a foul smell emerging from the mouth,
caused by pus and other effects of the gum infection. They may find their gums (gingiva) bleeding easily and may notice that their gums are red from inflammation. But they may consider these symptoms part of their physical constitution, just like shortsightedness, or baldness, or pimples, and not as a disease that requires the attention of a physician.
However, carrying along, for months and possibly for years, an infection
that causes pus and permanently engages the immune system, is not conducive to optimal health, even before gingivitis develops into its more severe manifestation, periodontal disease. We speak of periodontal disease (periodontitis) instead of gingivitis when the inflammation goes beyond the gums and reaches the bone that hold the teeth (alveolar bone).
Gingivitis, and its progression to periodontitis, start with the plaque
that forms mostly at the base of the visible part of the teeth. This plaque is caused by food debris and bacteria that grow on it. Tooth brushing removes plaque and thereby constitutes a preventive measure against gingivitis. However, some plaque is likely to remain in spite of brushing one's teeth. This plaque hardens and then is called calculus.
Because of its hardness, calculus will often result in a mechanical
irritation of the gums. Additionally, calculus provides an area on which
more bacteria easily grow. Like coral reefs, plaque and calculus will, if not removed, continue to grow and form deep pockets at the base of the teeth that will sooner or later fill with pus.
While plaque can be avoided to some extend by brushing teeth, calculus can only be removed with sharper objects. Obviously, in order not to carry more pathogens into the open wounds, these tools must be professionally sterilized. This requirement, and the danger of accidental deep wounds, is the main reason why there are no public health campaigns to make use of such tools oneself. Instead, in advanced countries like the US and Western European nations, there are public health campaigns that urge the public to visit a dentist regularly for calculus removal (professional cleaning).
In cases of light gingivitis, the gums may heal all by themselves after
pockets of calculus are removed. In more advanced cases of gingivitis, or in cases of periodontal disease (periodontitis), or in cases where
gingivitis is accompanied by some systemic illness, a dentist will likely prescribe a broad-spectrum antibiotic to support the body in getting rid of the pathogens that caused the gum infection.
Left untreated, gingivitis will, if a patient lives long enough, develop
into periodontitis, which will lead to teeth falling out, as well as
possible systemic complications. Gingivitis also makes dental caries much more likely, which also leads to the loss of teeth.
Both diabetes and pregnancy are conditions that can cause increased
susceptibility to gingivitis.
