Teeth are held in their sockets by the simultaneous action of bone, ligaments and gums.
If the balance between these components is disturbed, then there is a risk that the tooth is more prone to develop certain pathologies.
Among the local and general factors that can influence this balance are the following:
Mechanical trauma – untimely brushing, fillings with unfinished edges, scaling with excessive lateral pressure or incorrectly adapted prosthetic work can have a destructive effect on the ligaments supporting the teeth in the sockets.
The situations mentioned above can also lead to inflammation of the gums, which, with poor hygiene and exposure to bacteria in the oral environment, can lead to chronic gingivitis which can develop into periodontitis, at which point inflammation and resorption are transmitted to the bone.
Once the damage reaches the bone, the resorption is definitive and no further intervention is possible to restore it.
Eroding agents – consumption of acidic drinks or fruit juices leads to a lowering of the pH of the oral cavity.
Enamel tends to solubilize in acidic environments.
From its initially hard and tough structure, enamel becomes softer and may lose its characteristic prismatic structure.
This can lead to non-carious lesions, produced by chemical, erosive phenomena, which weaken the tooth and, over time, can cause dentine hypersensitivity.
In addition to these factors mentioned above, gingival inflammation can also occur naturally, in the process of the body’s natural evolution, in certain particular conditions.
Pregnancy gingivitis
It is associated with increased secretion of estrogen hormones, beginning in the 2nd and 3rd months and peaking in the 8th month.
Towards the end of the eighth and beginning of the ninth month, symptoms and signs slowly subside. It is not a rule that all pregnant women have this gum change. Hygiene plays a determining role in the appearance, maintenance and evolution of the pathology.
In pregnancy gingivitis there is swelling of the free gingival margins, oedema, bleeding when brushing, during chewing or sometimes spontaneously and pain.
Due to these last symptoms, the mother-to-be avoids brushing her teeth and gums effectively in order not to cause bleeding. Thus, bacterial plaque deposits will increase.
Also, the immune system of pregnant women is not so efficient, so the saliva constituents responsible for maintaining a balance of bacterial flora may give way to bacteremia. Thus, gingivitis can progress to ulcerative and desquamative forms.
Menopausal gingivitis
Occurs with the onset of physiological menopause, following hysterectomy or irradiation of the area. It is accompanied by pain when chewing, dry sensation of the mucous membranes and the gums are edematous and swollen. If the patient wears removable dentures, they will lose their adaptation to the supporting areas.
Puberty gingivitis
Can occur in both girls and boys in the 10-15 age range. It is accompanied by gingival oedema, especially in areas where hygiene is not observed. It usually disappears after the end of puberty but can take on aggressive forms if the patient does not maintain proper hygiene.
Gingivitis during the menstrual cycle
It may accompany a regular menstrual cycle, marking hormonal changes, or it may be a sign of ovarian dysfunction.
Physiological gingivitis is a form of gum inflammation that occurs at certain times of life, such as pregnancy, menopause, puberty and the menstrual cycle. These conditions are influenced by hormonal factors and may present symptoms such as swelling, bleeding and pain in the gums.
Pregnancy gingivitis is a common condition among pregnant women and is associated with increased secretion of estrogen hormones.
It starts in months 2-3 of pregnancy and peaks in the eighth month.
Symptoms and signs of this gingivitis may subside during the eighth and early ninth month. However, not all pregnant women develop this gum change and oral hygiene plays an important role in the onset, maintenance and progression of this condition.
Pregnancy gingivitis is characterized by swelling of the gum margins, oedema, bleeding when brushing or chewing and pain. Because of these symptoms, pregnant women may avoid effective oral hygiene to prevent bleeding.
This can lead to increased bacterial plaque deposits. Also, the immune system of pregnant women is not as effective, which can favor the growth of bacteria in the oral cavity. Thus, gingivitis can develop into ulcerative and scaling forms.
Menopausal gingivitis occurs with the onset of physiological menopause, after hysterectomy or irradiation in the area. It is accompanied by pain when chewing, dry feeling of the mucous membranes and swelling of the gums. In the case of wearers of removable dentures, they may lose their adaptation to the supporting areas.
Puberty gingivitis can occur in both girls and boys between the ages of 10 and 15.
It manifests itself as gingival oedema, especially in areas where oral hygiene is not observed. Puberty gingivitis usually disappears after the end of puberty, but can take aggressive forms if the patient does not maintain proper oral hygiene.
Gingivitis during the menstrual cycle may accompany a regular menstrual cycle and may mark hormonal changes or be a sign of ovarian dysfunction. It may have similar symptoms to other gingivitis, such as swelling and bleeding gums.
It is important to pay close attention to oral hygiene and follow a regular brushing and flossing schedule to prevent or control physiological gingivitis.
In addition, regular visits to the dentist for assessment and professional cleaning can help maintain healthy gums.
In the treatment of physiological gingivitis, different therapeutic methods can be used depending on the severity and progression of the condition. These may include:
Education and training on proper oral hygiene: Patients need to be informed about proper tooth brushing techniques and flossing to remove plaque and prevent its build-up around the gums.
Professional scaling and brushing: In more severe cases of physiological gingivitis, plaque and tartar removal may be necessary through professional scaling and brushing by a dentist or dental hygienist.
Drug treatment: In some cases, medication in the form of special gels, solutions or toothpaste containing active ingredients with antimicrobial or anti-inflammatory properties may be used to reduce inflammation of the gums and control bacterial infection.
Correction of predisposing factors: If physiological gingivitis is caused or aggravated by factors such as unfinished edges of dental fillings or incorrectly fitted prosthetic work, these factors should be corrected to restore balance in the oral cavity.
Regular monitoring: Patients with physiological gingivitis should undergo a regular monitoring program to assess the condition of the gums and intervene if relapse or progression to more severe forms of periodontal disease occur.
In conclusion, physiological gingivitis is a form of gum inflammation that occurs during certain periods of life, such as pregnancy, menopause, puberty and the menstrual cycle, due to hormonal influences. It is essential to pay special attention to oral hygiene and follow professional recommendations to prevent and control these conditions. Regular consultation with a dentist is also important for proper monitoring and treatment of physiological gingivitis.
