Gingivitis is an inflammation of the gums whose persistence should raise concern about the risk of suffering a significantly more severe periodontal disease. It originates as the result of a change in the bacterial flora in dental plaque.
First stage on the way to periodontal diseases
Gingivitis is observed in 80% of adults1. It is characterized by an often-benign inflammation of the gums associated with swelling, redness, and bleeding during tooth brushing. It is often located between two teeth but it can spread, sometimes throughout the mouth2.
The oral microbiota has been disrupted
Poor oral hygiene is the primary risk factor. Insufficient brushing and flossing leads to the formation of dental plaque, with an accumulation of bacteria in the form of biofilms that trigger gum inflammation2-5. Beyond this automatic accumulation, studies have characterized a true change in the microbiota of dental plaque that accompanies the appearance of gingivitis4,6. At least eight taxons become particularly dominant, including TM7, Leptotrichia, Selenomonas, Streptococcus, Veillonella, Prevotella, Lautropia, and Haemophilus4,7. The changes observed in the microbiota of dental plaque may help predict the severity of gingivitis in an individual8.
Critical elimination of dental plaque
In general, this inflammation is reversible and recovery is without sequelae, with treatment based on the mechanical elimination of dental plaque through good oral hygiene5. On the other hand, without intervention, it can progress to more serious periodontal disease and potential tooth loss.
1- Haute Autorité de santé. Parodontopathies : diagnostic et traitements, mai 2002. https://www.has-sante.fr/portail/upload/docs/application/pdf/Parodontopathies_rap.pdf
2- Maladies parodontales. Union française pour la santé bucco-dentaire. http://www.ufsbd.fr/wp-content/uploads/2016/06/fiche-conseil-MALADIE-PARODONTALE.pdf
3- Arweiler NB. The Oral Microbiota. Adv Exp Med Biol. 2016;902:45-60
4- James O. Kistler et al. Bacterial Community Development in Experimental Gingivitis. PLoS ONE 2013 ;8: e71227
5- Zarco MF et al. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Diseases (2012) 18, 109–120
6- Diaz PI et al. Subgingival Microbiome Shifts and Community Dynamics in Periodontal Diseases. J Calif Dent Assoc. 2016 Jul;44(7):421-35.
7- Shi Huang et al. Preliminary characterization of the oral microbiota of Chinese adults with and without gingivitis. BMC Oral Health 2011, 11:33
8- Shi Huang et al. Predictive modeling of gingivitis severity and susceptibility via oral microbiota. The ISME Journal (2014) 8, 1768–1780