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While poor oral hygiene is the main contributing factor for gingivitis, there are certain other factors that play a role in the occurrence of gingivitis.
• Plaque & Tartar - Gingivitis starts with plaque. Plaque is an invisible, sticky film that forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Plaque can be easily removed by brushing your teeth but it keeps reforming within 24 hours. Tartar (calculus) is the white substance seen under your gum line. This is formed when plaque stays on your teeth for more than two or three days and hardens. You cannot get rid of tartar by brushing and flossing and will need professional cleaning to remove it. The bacteria in plaque and tartar irritate the gingiva (gums) around the base of your teeth and cause the gums to swell and become infected.
• Drugs & Medication - Saliva has a cleansing effect on your teeth and helps inhibit bacterial growth. Many prescription and over-the-counter antidepressants and cold remedies contain ingredients that decrease your body's production of saliva leading to dry mouth. This leads to plaque and tartar build up. There are other drugs like anti-seizure medications, calcium channel blockers and drugs that suppress your immune system that can cause an overgrowth of gum tissue making it difficult to remove plaque.
• Viral & fungal infections – Certain viral and fungal infections can also affect your gums. Acute herpetic gingivostomatitis is an infection caused by the herpes virus and usually leads to gum inflammation. Oral thrush, which results when a fungus normally found in your mouth grows out of control, can also spread to the gums and cause gingivitis
• Other diseases & conditions – If you have other health conditions, they could lead to gingivitis, too. Some of the other conditions include diabetes (elevated blood sugar levels can damage many parts of your body), a weak immune system (susceptibility to all kinds of infections), leukemia (leukemic cells invade the gum tissue), oral lichus planus (a chronic inflammatory disease).
• Hormonal changes – Hormonal changes during pregnancy can make you more susceptible to the accumulation of plaque and tartar leading to gingivitis. Morning sickness (nausea and vomiting) may make it difficult for you to brush your teeth properly thereby compounding the problem. Menopause can cause a condition called desquamative gingivitis in which the outer layers of the gums separate from the underlying tissue exposing nerve endings.
• Impacted Tooth - Gingivitis can develop in the gums surrounding the crown of an impacted tooth (a tooth that has not fully emerged). In this condition, called pericoronitis, the gum swells over the tooth that has not fully emerged. The flap of gum over the partially emerged tooth can trap fluids, bits of food, and bacteria. Pericoronitis most commonly occurs with wisdom teeth, particularly the lower wisdom teeth. Infections can develop and spread to the throat or cheek.
• Poor nutrition - A diet deficient in calcium, vitamin C and B vitamins will lead to periodontal disease. Calcium is important to maintain the strength of your bones including the bones that support your teeth. Vitamin C helps to keep the connective tissues strong.
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