Gingivitis

Gingivitis involves inflammation of the gums surrounding the teeth. Due to this, the gums become soft and swollen and usually red instead of a healthy pink. The inflammation of the gums is a defense mechanism put up by the body's immune system to prevent the growth of bacteria which along with the remnant food particles and plaque form tartar. This cannot be removed by simple brushing or flossing.

What Causes Gingivitis Disease?

The primary cause of gum disease is plaque. However, there are various other reasons why gingivitis disease develops.

• Gums become sensitive when there are hormonal changes in the body, such as during puberty, pregnancy, menopause and menstruation. During pregnancy, hormonal changes and tartar induce excessive growth of gum tissues resulting in the formation of lumps commonly referred to as pregnancy tumors. These tumors prevent bacteria from being removed effectively during brushing, thus resulting in gingivitis disease.
  
  
• In post-menopausal women, a painful condition called desquamative gingivitis may develop, for reasons yet unknown. In this condition, the outer layers of the gums come away from the teeth and lose their solidity, resulting in the exposure of nerve-endings which causes acute pain.
  
  
• Long-term use of contraceptive pills can also result in gingivitis.
  
  
• Diseases that affect the immune system such as HIV or cancer may also affect the gums. Diabetes when uncontrolled, can affect the gums. On the other hand, gingivitis disease may also be a pointer to systemic disorders.
  
  
• Some medications can also cause gum disease as they restrict production of saliva which prevent the formation of tartar. Some medications used in the treatment of angina and seizures can cause abnormal growth of the tissues in the gums.
  
  
• Habits, such as smoking, do not facilitate the easy self-repair of the gums. A severe form of gingivitis, known as Trench mouth or ANUG (Acute necrotizing ulcerative gingivitis) is mostly found in the case of smokers. ANUG is also reported in the case of incapacitated persons under severe stress. Acute pain, swelling, bleeding and bad breath develop very quickly in this condition and also the gums turn grey.
  
  
• If gingivitis runs in the family, then there is a greater chance of a person getting it. Poor oral hygiene is a major contributor to gingivitis.
  
  
• Dental appliances not properly fitted or improper alignment of teeth may also cause gingivitis.
  
  
• Dietary imbalances, vitamin deficiencies, and drug reactions can also result in gingivitis.
  
  
• Gingivitis disease is also often caused by fungal and viral infections.
  
  

Symptoms of gingivitis

There is usually no pain associated with mild form of gingivitis. Hence it may go unnoticed. However, there are certain symptoms that warn that treatment for gingivitis is needed:

• When the gums are swollen, soft, or red.
  
  
• When gums bleed during, or after brushing.
  
  
• When bad breath or bad taste in the mouth persists even after brushing and flossing.
  
  
• When the gums recede.
  
  
• Deep pockets are formed between teeth and gums.
  
  
• Visible deposits of tartar.
  
  

If the dentist finds that someone is particularly prone to formation of plaque, he may recommend use of special implements to remove plaque, such as toothpicks, electric toothbrushes etc. This treatment for gingivitis would suffice when the gingivitis disease is in the early stages.

For reducing the pocket depth between teeth and gums, which can also cause gingivitis, dentists undertake root-planing and scaling. In addition dentists may also administer minocycline microspheres. For women who have desquamatic gingivitis, hormone replacement therapy could be beneficial. However, adverse effects of the therapy could prevent their recommendation. Instead, corticosteroid rinses and pastes which can be directly applied on gums may be more commonly recommended.

Pericoronitis is acute, painful inflammation of the gingival tissue over a partly erupted tooth (as in the case of a wisdom tooth). The treatment for this would include removal of the debris beneath the gingival flap and irrigation with saline. This may be followed up with extraction, particularly when there is recurrence of the episode.

Abscessed Tooth

A dental condition wherein the nerve or the dental pulp (inner part of tooth) gets infected is termed as abscessed tooth. The bacterial infection in the inner part of the tooth leads to collection of pus. Following a good oral hygiene regimen many help preventing dental abscess.

Tooth abscess types

Periodontal: occurs in the supporting bone and tissue structure of the teeth.

Periapical: found in the dental pulp.

Gingival: occurs in gum tissue, does not affect tooth or periodontal ligament.

Abscessed tooth causes

• A dental cavity when left untreated leads to spread of infection deep within the tooth and this may cause abscessed tooth.
  
  
• A broken tooth or cracked tooth can also cause abscessed tooth as the dental pulp is exposed to the environment.
  
  
• An infection between the gum and root of the tooth can also cause tooth abscess.
  
  
• Gum disease can also cause abscessed tooth.
  
  
• Gingivitis can also cause abscessed tooth.
  
  
• Trauma to tooth or mouth.
  
  
• Weak immune system.
  

Abscessed tooth symptoms

Typical symptoms of an abscessed tooth include swelling, toothache, bad breath, inflammation of the gum tissue, sensitivity in tooth and swollen neck glands. A dentist will physically examine it and might order a tooth xray.

Abscessed tooth treatment

Abscess is drained through the procedure of root canal. A crown is placed on the tooth to protect it. Affected tooth may be extracted. Incision into the swollen gum may treat the condition. Antibiotics prescribed prevent infection and pain relievers help relieve pain.

Dental Abscess prevention

Brush teeth twice a day. Eat a balanced diet low in sugar. Use dental floss to clean in between teeth. Visit dentist for regular dental check. Use fluoridated drinking water.

Dysgeusia

Dysgeusia refers to a distortion in the sense of taste that leaves a persistent foul, metallic taste in the mouth. The taste could even be described as bitter and rancid that stays on and disturbs the desire to eat.

Dysgeusia, if sustained, can have an impact on the quality of life of patients. It can lead to problems like loss of appetite, malnutrition and depression. Dysgeusia can occur at any age. However, taste disturbances are common among the elderly taking multiple medications. Our taste buds are found on the tongue and on the roof of the mouth. They contain cells that collect taste information and send it to the brain. The sense of taste is closely associated with the sense of smell. Some people with Dysgeusia also have an altered sense of smell that affects sense of taste. This is because most of the taste sensations are controlled by nerve cells involved with smell.

Dysgeusia could be caused by several conditions ranging from simple cold and dental problems to serious ones like cancer treatment that alters an individual's sense of taste. Some of the causes are listed below.

• Deficiency of zinc or vitamins in the body
  
• Problem related to the brain or entire nervous system
  
• Chemotherapy treatment
  
• Excessive smoking
  
• Brain tumor
  
• Cold, ear infections and dental related problems like gingivitis, tooth abscess
  
• Certain medications
  
• Copper, lead or mercury poisoning
  
• Gastric reflux
  
• Jaundice

Diagnosis of Dysgeusia

Dysgeusia is most often diagnosed during a clinical examination. The physician will make note of the history of the patient and will also enquire about the present medical condition that may be causing taste distortion. He may order few blood tests to assess zinc and other vitamin deficiencies that might be causing metallic taste. There are certain 'taste tests' to identify the sense of taste and smell. Taste tests allow the patient to respond to different concentrations of a substance. Sometimes a chemical that releases sour, sweet, bitter and salty taste is directly applied on the tongue that helps in determining if Dysgeusia is present or not.

If the Dysgeusia is related to neurological condition that has damaged the nerves of mouth or head, CT scan and other imaging tests are performed to assess the extent of damage.

Treatment of Dysgeusia

Many a times, Dysgeusia is reversible. Treatment for the condition depends upon the underlying disease that is causing the metallic taste. Dysgeusia disappears on its own if it is caused by minor problems like cold and dental infections. However, Dysgeusia may almost become untreatable, if it is caused by nerve damage.

If, certain medication is causing the bitter taste in the mouth, the doctor may alter the dosage or prescribe alternate medicine to provide relief. Recent studies show that artificial saliva and mouth wash containing pilocarpine gives much needed relief in cases of medicine-induced Dysgeusia.

Some simple remedies to improve the saliva flow in the mouth also go a long way in treating taste distortion. Chewing on breath mints, sugarless gum, or lozenges will encourage saliva and remove the bitter taste in the mouth.

Most patients suffer from Dysgeusia due to zinc deficiency. Such patients are treated with zinc supplementation.

Few natural remedies like rinsing the mouth with salt solution, brushing twice or thrice a day, consuming citrus fruits, adding more seasoning and spice to the food, and drinking more water are simple measures that help in treating Dysgeusia.