Let me tell you a fun little story about how we came to know what causes gingivitis and how to best treat it.
In my field of periodontics prior to 1965 it was not universally agreed that gingivitis and periodontal disease (periodontitis) were caused by bacteria. Many scientists understood this, but because there was so much room for doubt the public was really in the dark. Floss was almost none existent in those days and brushing your teeth was certainly encouraged before going out on dates.
Then a dental researcher by the name of Harald Löe had an idea for a study. He wanted to demonstrate clearly the relationship between bacteria and gingivitis in order to help the public understand the importance of daily oral hygiene.
So here is what Dr. Löe did. First he recruited 12 dental students along with some staff members at his dental college in Denmark. Next he had his nurse (she wasn’t actually trained as a dental hygienist) clean their teeth. Following this each one brushed and flossed twice a day until they could pass a dental examination where gum health was near perfection and no bacterial plaque was detectable.
Then came the fun part for the participants. Once health was demonstrated they were instructed to stop all oral hygiene. Each day plaque was scraped off their teeth and looked at under a microscope. Scientists watched as bacterial colonies grew. By the fourth day the gingiva (scientific name for gums) showed early signs of inflammation. Between days 10 and 20 every participant developed obvious gingivitis. On the microbiology side of the study scientists saw that bacterial colonies looked completely different by the end of the experiment. In fact they described three different phases as the plaque matured.
After each participant had developed gingivitis he or she was allowed to resume oral hygiene. (I imagine they never wanted to repeat this experiment again and performed excellent oral hygiene for the rest of their lives). After a few short days gingival health returned. The published article was entitled “Experimental Gingivitis in Man” and it became the most cited study in the dental literature for decades following.
So here is what you need to understand about gingivitis.
- Gingivitis is caused by plaque.
- If plaque is not removed, in time it calcifies to become a hard substance called “calculus.” This is why you periodically need to see your dentist or dental hygienist.
- The control of gingivitis is predominantly in your hands. In fact unless you want to have your teeth cleaned professionally on a weekly basis, this study indicates you will have some level of gingivitis if you don’t brush and floss routinely.
What about Periodontal Disease? This is where the infection is now affecting the health of the bone surrounding the teeth. Good oral hygiene is no longer enough. Much can be done to treat this condition, but now professional help is imperative. You can’t fix this one alone.