Hormone-Induced Gingivitis

Hormone-Induced Gingivitis

What is hormone-induced gingivitis?

Hormone-induced gingivitis is a type of gingivitis that occurs specifically during changes in hormonal levels .  It is a very common condition that we see frequently in our office.  Hormone-induced gingivitis causes a patient to have gums that are swollen, red, tender, and bleed easily.   The tenderness and bleeding often make oral hygiene routines uncomfortable, and patients sometimes avoid proper brushing and flossing techniques because it hurts.  Healthy, natural gum tissues are light pink, relatively flat and tightly adhered to the teeth.  The appearance of bright red, puffy gums is unsightly, giving a diseased look to the mouth, and may cause embarrassment. 

What causes hormone-induced gingivitis?  

The name says it all: it is induced by hormones.  Rapid swings in hormone levels (most notably estrogen, progesterone, and chorionic gonadotropin) can have a profound effect on gum tissues.  Research has shown that these hormone levels cause two important changes to occur:

  1. Hormone changes affect the tiny blood vessels in the gum tissue, increasing the blood flow in this area (which can cause swelling) and changing the permeability of the blood vessels (which makes the tissue bleed more easily).

  2. Hormone changes also affect the types of bacteria present in gum tissues. Research shows that gum tissues in patients with hormone changes such as pregnancy or taking birth control pills have more dangerous bacteria than patients without hormone changes. By “more dangerous”, we mean stronger and more likely to cause gum disease.


Who is at risk for hormone-induced gingivitis?  

Hormone-induced gingivitis is common in children going through puberty, both girls and boys.  It is also prevalent in women at various stages of hormone changes, including menstrual cycles, the use of birth control pills, pregnancy, and menopause.  This higher risk for gum disease makes oral hygiene even more important than it already is.  People with poor oral hygiene are more likely to experience hormone-induced gingivitis than those with good plaque control and consistent oral hygiene habits.  People who have infrequent and inconsistent dental cleanings are also at an increased risk.

 

What can you do about hormone-induced gingivitis?

 

  • Practice perfect oral hygiene. Do not miss a single day of flossing! Use an electric toothbrush; they are shown to effectively remove more plaque than a manual toothbrush.

  • Add a mouthwash to your oral hygiene routine, and use it twice daily. In addition to an over-the-counter alcohol-free mouthwash, you can swish with warm salt water throughout the day. Some patients require a prescription mouthwash to get the inflammation under control.

  • Stay on schedule with professional dental cleanings. Your dental hygienist is able to remove bacterial buildup from areas you might be missing, even with good oral hygiene.

  • Consider increasing the frequency of professional dental cleanings. Many of our patients with severe gingivitis during puberty or pregnancy have their teeth cleaned every 3 months, instead of every 6 months. This reduces the severity of gingivitis by reducing the amount of bacterial buildup accumulated between cleanings.

  • Talk to Dr. Jason, Dr. Alex or Dr. Serena about other recommendations they may have to improve your gingivitis. There are many additional oral hygiene products available to help reduce gum inflammation. They will determine which one will be most beneficial for your unique situation.

 

Think you or your child may have hormone-induced gingivitis?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Periodontal Disease: What Does it Mean to be High Risk?

Periodontal disease: What does it mean to be high risk?

What is periodontal disease? 

Periodontal disease is a disease that affects the structures supporting the teeth, including both the gums and the jawbone.  Its primary cause is bacterial buildup on the teeth, and some people have a higher risk due to genetic factors, systemic disorders (such as diabetes), and habits (such as smoking or oral tobacco use). 

What are the stages of periodontal disease?

The earliest stage of periodontal disease is called gingivitis, which means inflammation of the gums.  Inflammation can involve one or more of the following:

  • A bright red color to the gums

  • Swollen or puffy gums

  • Gums that bleed easily when brushing, flossing or having teeth professionally cleaned

 How does periodontal disease happen?

Periodontal disease begins with the accumulation of bacteria and plaque on the teeth.  This can be due to poor oral hygiene, and it can also be due to the presence of very difficult-to-clean areas on your teeth.  When teeth are crooked or rotated, they collect more bacteria.  We all have different types of bacteria in our mouths, and some types are more destructive than others, meaning they are more likely to cause disease.  Research studies show that the types of bacteria that gather on crooked teeth are more likely to cause periodontal disease than the types of bacteria that collect on straight teeth.  Periodontal disease progresses as the bacteria and plaque harden on the teeth into tartar, which can only be removed with a professional cleaning.  If no professional dental care is completed, the tartar accumulation will grow, causing more inflammation and more serious damage to the gum and bone.  In severe periodontal disease, the supporting structures have become so damaged that they can no longer hold the teeth, which become loose and have to be extracted.

What does it mean if I am high risk?

If, during your evaluation, you presented with some signs of gingivitis, you would be classified as high risk for periodontal disease.  As stated earlier, gingivitis is the first step to periodontal disease, and if left untreated, it can lead to a progression of disease.  The good news is that in the early stages, periodontal disease is completely reversible!

Risk factors noted during a clinical evaluation:

  • Pockets measuring ›3mm

  • Poor oral hygiene

  • Crowded teeth

  • Prior periodontal disease

  • Bone loss

  • Mobility (loose teeth)

  • Gum recession

  • Mucogingival defect (gum tissue that is not attached to the bone underneath it)

  • Abnormal frenum attachments

What can I do about it?

  1. Have a professional dental cleaning. This removes the bacterial accumulation from the teeth, essentially giving you a “clean slate”.

  2. Change your oral hygiene routine as directed by your dentist or hygienist. This may involve different toothbrushing techniques, an electric toothbrush, consistent flossing, interdental brushes, etc . . .

  3. If prescribed by your dentist, begin an antibiotic mouthrinse daily. The more bacteria you kill, the less there are to accumulate on your teeth.

  4. Return for a follow-up professional cleaning in 6-8 weeks. This allows us to assess the home care, suggest any positive changes to be made, and again remove bacteria that have accumulated.

What if I don’t do anything?

Without treatment, bacterial levels will increase, causing more accumulation of plaque and tartar.  More plaque and tartar causes more inflammation and response from the gums and bone.  As the bone migrates away from the tartar buildup, which it considers a foreign substance, the support for the teeth is slowly lost.  In a worst case scenario, untreated periodontal disease eventually leads to loss of all teeth and loss of the underlying jawbone, which makes future treatment with either dentures or dental implants less predictable.

Need more information?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Bad Breath

Bad_breath_origin.jpg

Bad Breath

It would not be a stretch to say that every single person has experienced bad breath at some point in his or her life.  We are all susceptible to “morning breath” or “garlic breath”, which are neither surprising nor difficult to fix.  Many people suffer from persistent bad breath which seems difficult to cure.  As with most things, finding the cause of the problem will lead us much closer to a solution.  Let’s take a look at the most common causes of bad breath.

What causes bad breath?

When you get to the bottom of bad breath, most of it is caused by bacteria.  Over ninety-percent of bad breath originates in the mouth.  The rest stems from problems in the nose, throat, lungs, or GI tract.  These problems include postnasal drip, sinus infections, tonsil stones, bronchitis and other lung infections, H. pylori infections and GERD (gastroesophageal reflux disease).  These possible causes of halitosis are greatly outnumbered by problems in the oral cavity.  While you should be aware of them and inform your doctor or dentist of the presence of any of these issues, it is important to have your dentist rule out a more likely intraoral issue first.  

 

What happens in the mouth to cause bad breath?

 

  • Cavities – Cavities, especially big ones, harbor lots of bacteria. When a cavity has gotten big enough to create a hole in the tooth, it collects food particles and plaque in addition to the bacteria that caused the cavity. Think of it like a tiny kitchen trashcan. It stinks! Having the cavity fixed is like emptying the trashcan.

  • Gum (periodontal) disease – Periodontal disease affects the gum and bone supporting the teeth. In most cases, a pocket is formed where the gum and bone detach from the tooth surface. These pockets are also like the above-mentioned tiny trashcans, collecting plaque, bacteria, food particles, etc . . . Having the proper periodontal treatment to reduce the depth of these pockets will minimize the size of the trashcan.

  • Food impaction – Perfectly shaped and aligned teeth and gums do not provide spaces for food to get caught. But let’s face it: no one is perfect. Food impaction is the term dentists use for an area in your mouth that is consistently embedded with food debris. If not properly cleaned out, it leads to more than just bad breath. It can cause cavities and gum disease in that area. If you do not feel that you are able to adequately and consistently clean an area of food impaction, please ask Dr. Aanenson about your options to change the shape of the teeth so that food does not continue to be caught.

  • Tongue – Tongues are bumpy. The bumps are called papillae. The papillae vary in size and purpose. There are some located near the back of the tongue that can be large and create lots of nooks and crannies for bacteria to collect around. This is where cleaning your tongue can reduce bad breath. For some people, simply swishing a mouthrinse can effectively clean your tongue. For others, it may be necessary to brush the surface of your tongue. And for still others, a tongue scraper is useful in cleaning any bacterial havens on your tongue.

  • Surgical wounds – When you have surgery in your mouth, there is usually something that can allow for the accumulation of bacteria like an extraction socket or stitches. Because surgical sites usually hurt, it is difficult to keep them clean. Your dentist will give you instructions on keeping the site clean, as well as some adjuncts for your post-surgical oral hygiene like a very soft bristled toothbrush or an antibiotic solution to apply to the site with a Q-tip. Thankfully, this is a temporary problem. Follow the post-op instructions closely so healing occurs as quickly as possible.

  • Dry mouth – Saliva plays a big role in fighting bacteria; therefore, it plays a big role in fighting bad breath. If you do not have enough saliva, your dry mouth puts you at risk for bad breath and various oral diseases. It can cause bad breath by allowing an accumulation of bacteria. You can read more about dry mouth here.

 

What can I do about bad breath?

 

  • See your dentist – It is important to rule out cavities & gum disease as the cause of bad breath because they can progress and lead to many long-term health concerns. If you do have any oral disease, proceed with treatment as soon as possible.

  • Practice great oral hygiene – Keeping your teeth clean means reducing the amount of bacteria in your mouth, and therefore reducing bad breath. Add an alcohol-free mouthwash to your daily regimen. This helps remove bacteria from all areas of your mouth. It is important to use an alcohol-free mouthwash because alcohol has a drying effect. Dry=bad. Also add brushing your tongue or using a tongue scraper to your oral hygiene routine.

  • Take steps to improve dry mouth – Discuss the various options with your dentist. Treatment may include using a salivary supplement, an antioxidant mouth gel, or a prescription mouthwash.

  • Chew sugar-free gum, preferably containing xylitol – Chewing gum stimulates saliva, which fights bacteria. The flavor of the gum may provide a brief, minty odor to your breath, and the improved salivary flow will keep the bad breath at bay.

  • Avoid substances that have a drying effect on your mouth – Cigarettes and alcohol both reduce salivary flow and predispose you to dry mouth.

 

Think you may have bad breath?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!