Gingivitis: Gum Inflammation That Cannot Be Ignored
Gingivitis is the initial and reversible stage of the inflammatory process that exclusively affects the gums. It is characterized by redness, swelling, and bleeding of the soft tissues around the tooth neck without disruption of the dentogingival attachment. According to data from the World Health Organization, it is one of the most common periodontal diseases, affecting up to 90% of the adult population at least once in their lifetime. The primary etiological factor is the accumulation of microbial biofilm (dental plaque) along the gumline. Without timely intervention and removal of the cause, inflammation progresses, which can lead to the destruction of the ligamentous apparatus and bone tissue—the development of periodontitis, the main cause of tooth loss in adults.
Causes and Classification: From Catarrhal to Ulcerative Necrotizing Gingivitis
The pathogenesis of the disease is directly related to the activity of opportunistic microflora, predominantly gram-negative anaerobic bacteria (Porphyromonas gingivalis, Prevotella intermedia), which colonize dental plaque. Local factors, such as supra- and subgingival calculus (tartar), carious cavities, overhanging filling edges, and orthodontic appliances, significantly aggravate the situation by hindering proper hygiene. Systemic risk factors include hormonal changes (puberty, pregnancy), diabetes mellitus, intake of certain medications (e.g., calcium channel blockers), as well as deficiencies in vitamins C and K.
The clinical classification of gingivitis according to ICD-11 and modern protocols involves division based on the course form and morphological changes. Acute and chronic gingivitis are distinguished. Based on the nature of the lesion, the following are differentiated: catarrhal gingivitis (hyperemia, edema), hyperplastic (hypertrophic) gingivitis (fibrous or granulomatous overgrowth of the gingival margin), and the most severe form—ulcerative necrotizing gingivitis (Vincent's gingivitis), characterized by ulceration, necrosis of the gingival papillae, severe pain, and halitosis.
Diagnosis and Clinical Presentation: Key Indices and Symptoms
Diagnosis in modern periodontology is based on clinical examination using objective indices. The dentist evaluates the Gingival Index (GI by Mühlemann) and the Community Periodontal Index of Treatment Needs (CPITN), which allow for a quantitative determination of the severity of inflammation. A mandatory step is probing the gingival sulcus with a periodontal probe to measure its depth (normally 1-3 mm) and assess the condition of the epithelial attachment. In gingivitis, the sulcus depth may be increased due to edema, but the integrity of the ligament is not compromised.
Patients most often complain of spontaneous gum bleeding during brushing or eating, hyperemia (persistent redness) of the mucosa, swelling of the gingival margin, and bad breath (halitosis). In the hyperplastic form, an aesthetic defect may arise, while the ulcerative necrotizing process is accompanied by pronounced pain, increased body temperature, and symptoms of intoxication. An important differential diagnostic sign is the absence of pathological tooth mobility and destruction of interdental septa on a radiograph (orthopantomogram), which distinguishes gingivitis from periodontitis.
Modern Treatment Principles: From Professional Hygiene to Surgery
The foundational and most effective method for treating catarrhal gingivitis is the complete removal of dental deposits. This is achieved through professional oral hygiene, including ultrasonic scaling (using piezoelectric scalers, e.g., Piezon Master) for calculus removal and Air Flow technology for removing pigmented plaque. The subsequent polishing stage using rubber cups and professional paste creates a smooth enamel surface that hinders bacterial readhesion.
In hyperplastic gingivitis, after eliminating the cause and anti-inflammatory therapy (applications of chlorhexidine, metronidazole gel), surgical correction of the gingival margin—gingivectomy—performed using a surgical laser or radioscalpel may be required to minimize blood loss and accelerate regeneration. Treatment of ulcerative necrotizing gingivitis (Vincent's) is comprehensive and includes mechanical debridement under anesthesia, local and systemic antibacterial therapy (metronidazole), and immune support.
Prevention and Conclusion: The Importance of Regular Monitoring
The prognosis for gingivitis is favorable provided the etiological factors are completely eliminated and hygiene is corrected. A key role in preventing relapse is played by patient motivation and education on individualized hygiene: proper brushing technique, use of interdental brushes, and a water flosser (irrigator). It is recommended to undergo professional hygiene procedures with the frequency determined by the periodontist (on average 1-2 times per year) and conduct regular monitoring of indices. Timely diagnosis and treatment of gingivitis is the direct path to preventing irreversible changes in the periodontium and preserving dental health for many years.
Conclusion and Message to Patients of Corona Dental in Barcelona
Although gingivitis is a common disease, its successful treatment and prevention require accurate diagnosis and an individualized approach. At the Corona Dental clinic in Barcelona, our certified periodontists and hygienists possess the necessary experience and use modern diagnostic equipment to assess the condition of your gums at the highest level.
The treatment process in our clinic is based on clear international protocols:
-
Comprehensive Diagnosis. During the initial consultation, the doctor will not only perform a visual examination but also conduct digital probing of periodontal pockets and, if necessary, take a panoramic X-ray (orthopantomogram) to assess bone tissue. This allows for precise differentiation between gingivitis and the initial stages of periodontitis.
-
Professional Hygiene. The foundation of treatment is the flawless removal of all dental deposits. We use a combination of ultrasonic scaling (e.g., with the Piezon® device) to break down calculus and Air Flow® technology with a special glycine-based powder for gentle and effective removal of biofilm and pigmentation. The procedure concludes with polishing and remineralizing therapy.
-
Individualized Treatment Plan. Depending on the form of gingivitis (catarrhal, hyperplastic), our doctor will create a personalized plan for you. It may include education on proper hygiene with the selection of tools (toothbrush, water flosser, toothpaste), prescription of local anti-inflammatory gels, or, in complex cases (hyperplasia), minimally invasive laser gum correction.
-
Control and Maintenance of Results. We do not limit ourselves to a single visit. We will schedule a mandatory follow-up examination in 2-4 weeks to assess the healing dynamics and adjust recommendations. For long-term gum health, a schedule of supportive professional cleanings (every 6-12 months) is developed.
Our goal is not merely to alleviate symptoms but to eliminate the cause of inflammation and provide you with the knowledge and tools to maintain your gum health in the future. If you notice signs of gingivitis, do not postpone your visit. By turning to Corona Dental, you will receive treatment that meets the highest European standards of dentistry in a comfortable atmosphere and with attention to every detail.
