At the pharmacy office, we receive numerous queries related to oral hygiene. The pharmacist is a critical player in training and information in this area and gingivitis cases.
Gingivitis is the first stage of periodontal disease, which involves inflammation and, in more severe processes, infection, and can end up destroying the supporting tissues of the teeth, including the gums, the periodontal ligaments, and the dental sockets (alveolar bone). . Therefore, we can say that gingivitis not only affects the gums but also the supporting structure of the teeth, depending on the case.
Gingivitis begins its development by bleeding gums, usually after brushing; the gums appear bright reddish and are tender to the touch; Also, mouth ulcerations occur quickly.
Many people experience gingivitis to varying degrees. It usually develops during puberty or early maturity due to hormonal changes and can persist or recur frequently, depending on the health of the person’s teeth and gums and oral care, what to do
Table of Contents
Generally, gingivitis is caused by poor or inadequate oral hygiene. However, other factors, such as pregnancy, a suppressed immune system, uncontrolled diabetes, or misaligned teeth, irritate the gums. Stress is another of the reasons that can favor the appearance of gingivitis since nervous people when sleeping generate strong pressure on the teeth, weakening the gums and damaging them, creating a emaciating, ulcerative and necrotizing reaction. Certain medications, such as phenytoin, contraceptives, and heavy metals -lead and bismuth-are associated with the development of gingivitis.
Gingivitis is due to the lasting effects of plaque deposits, a sticky material made up of bacteria, mucus, and food debris that develops on expose areas of the tooth. This plaque is the leading cause of tooth decay, and if not clean properly, it turns into a hard deposit called tartar that gets trapped at the base of the tooth. Plaque along with tartar irritates and inflames the gums. Bacteria and toxins cause the gums to become inflamed, tender, and even infect. As gingivitis progresses, the inflammation spreads, and plaque penetrates deeper and deeper until the bone supporting the tooth is destroy. In this case, it is called periodontitis. If gingivitis is not treat, it can progress to periodontitis. The tooth will drop out or need to be extracted to its most severe degree. Gingivitis is reversible if treated professionally and with good oral care at home.
This section will describe the critical questions that the pharmacist can ask to advise appropriately.
Is There Swelling, Bleeding, Tenderness, and Tartar Buildup?
In this case -slight or moderate gingivitis- we will advise specific products for gingivitis and recommend a check-up with the dentist.
Is There a Movement of Teeth?
This is a case of severe gingivitis or periodontitis, which requires an urgent appointment with the dentist.
Have you stopped Smoking in the Last Three Months?
It is usual for people who have quit smoking to have gingivitis since tobacco masks oral problems. A few months after quitting smoking, it is not uncommon for gingivitis to develop.
Are you Pregnant?
Severe gingivitis or periodontal disease can increase the chances of developing preeclampsia in pregnant women, according to a study from the University of North Carolina, in Chapel Hill (United States). Women with periodontitis are twice as likely as healthy women to suffer from this disease. Researchers have suggested that a migration of the bacterial organism causing the oral infection to the placenta’s blood vessels or uterus is possible, with the generation of consequential damage.
Are you Taking any Medication?
As we have already described above, certain drugs enhance the appearance of gingivitis, such as phenytoin, contraceptives, and heavy metals, for example, lead and bismuth.
Do you have Braces?
It is proven that the gums become irritated with orthodontic appliances and even become inflame. For this reason, the toothpaste products use by people with orthodontics must be expressly indicate to improve the condition of the gums without damaging the enamel since some active ingredients can color the tooth.
Have you Had any Dental Whitening Treatment?
It is predictable that the gums are more sensitive after a professional teeth whitening treatment and may become irritated. This is because hydrogen peroxide at high concentrations in contact with the mucous membrane can cause irritation and even sores. For this reason, it is very important that after professional teeth whitening, we recommend specific products to strengthen the gums from the pharmacy.
Suitable Products and Treatment
The objective of treatment with specific products for gingivitis is to reduce inflammation and improve the condition of the gums. Gingivitis is reversible as long as the bacterial plaque around the teeth is remove. Plaque removal from inflame gums can be bothersome. Therefore, it is essential that the dentist or oral hygienist perform a complete cleaning of the oral cavity, so that from the beginning the elimination or substantial reduction of oral bacteria and calcified plaque deposits between the teeth is achieve.
After a professional dental cleaning, proper oral hygiene is necessary to improve results, reducing bleeding and gingival sensitivity in one or two weeks. To reduce plaque and help treat gingivitis, specific toothpaste and mouthwashes for gum care are recommend, contributing significantly to relieving discomfort.
The products indicate to improve gingivitis must be formulate with active ingredients that combat the three main problems associate with initial periodontitis: plaque, bleeding, and inflammation.
Anti-plaque Active Ingredients
Triclosan. It is a phenolic derivative with a highly substantive antibacterial action since it remains for 14 hours. Highly indicated in patients with periodontal disease due to its anti-plaque and antichloristic action. It is an active ingredient that can be use daily since it does not stain teeth, although its anti-plaque effort is somewhat less than chlorhexidine. The union of triclosan with copolymers of methoxy ethylene and maleic acid or zinc compounds, zinc sulfate, or citrate is very effective.
Hexetidine. Hexetidine is a widely use cationic antiseptic active ingredient with anti-plaque action that increases effectiveness if combined with zinc salts.
Zinc salts. They are zinc citrate, sulfate, chloride, and lactate. Zinc salts have an anti calculus effect that minimizes the calcification of the bacterial mass, preventing the formation of plaque. Their action is enhanced if they bind to triclosan or hexetidine.
Sodium fluoride. Fluorine salts transform hydroxyapatite into fluorapatite. This transformation is achieved while the teeth are in the formative phase of calcification. It acts by demineralizing the dental pieces, thus improving the resistance of the enamel against bacterial action and preventing the formation of cavities. In addition, fluoride is a substance that reduces dentin sensitivity and has an action against bacterial plaque. Therefore, fluorine salts must be present in all products intended for oral care.
Xylitol. It is an active ingredient that protects tooth enamel by reducing the adhesiveness of plaque to the tooth.
Cetylpyridinium chloride. In recent years, laboratories have eliminated this quaternary ammonium compound from their formulations, despite its anti-plaque action.
Vitamin E. Due to its anti-free radical capacity, it protects the gums from bacterial action, preventing plaque formation.
Gingival Anti-bleeding Active Ingredients
In this group are:
zinc sulfate. It is a good astringent that attenuates the congestive process and improves the condition of the gums.
Sage. It is an antihemorrhagic and antibacterial plant that reduces gingival bleeding and prevents the formation of bacterial plaque.
Anti-inflammation Active Ingredients
Inflammation of the gums is one of the most characteristic signs of gingivitis. To combat it, we have the following assets:
Enoximone. Of excellent efficiency in congestive processes, it improves the state of inflamed and redden gums. The concentrations at which it is formulate range between 0.2% and 1%.
Allantoin and dexpanthenol. They are active ingredients widely used to improve the condition of the gums due to their decongestant action.
Plant extracts. Among the most used are chamomile, aloe Vera, and echinacea.
Tips from the Pharmacy
Healthy gums are pink and firm in appearance. Good oral hygiene is the best prevention against gingivitis because it removes the plaque that causes this disorder. Teeth should be brush at least twice a day and gently flossed at least once. People prone to gingivitis should brush and floss their teeth after every meal and before bed. We can advise the appropriate technique for brushing and flossing from the pharmacy.
In the case of people who suffer from chronic gingivitis, it is essential that they use brushes with soft bristles and always use specific toothpaste since they are much less invasive and do not cause bleeding.
Every three to six months, professional cleaning by a dentist or dental hygiene expert will remove plaque and tartar in hard-to-reach areas more susceptible to periodontal disease. Your dentist may recommend special oral hygiene instruments or tools for people who are particularly prone to the development of plaque deposits. Its use complements but does not replace thorough brushing and the use of dental floss. Appliances and tools may include special toothpicks and brushes, water irrigation devices, etc. We must complement the sale of these products from the pharmacy with good advice on their use.
The treatment of severe gingivitis and periodontitis is based on the decomposition of damaged tissues, restoring the integrity of the affected sectors to alleviate the discomfort they cause. It is a task that concerns the dentist exclusively. In this article, you find treatments and tips. We hope you find this article very informative and use full.