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Photo of teeth with yellowing and red inflamed gums.
Redness and irritation of the gums are evidence of gingivitis.

Over time, chronic gingivitis can develop into the more serious condition of periodontitis ( [link] ). When this happens, the gums recede and expose parts of the tooth below the crown . This newly exposed area is relatively unprotected, so bacteria can grow on it and spread underneath the enamel of the crown and cause cavities . Bacteria in the gingival space can also erode the cementum , which helps to hold the teeth in place. If not treated, erosion of cementum can lead to the movement or loss of teeth. The bones of the jaw can even erode if the infection spreads. This condition can be associated with bleeding and halitosis (bad breath). Cleaning and appropriate dental hygiene may be sufficient to treat periodontitis. However, in cases of severe periodontitis, an antibiotic may be given. Antibiotics may be given in pill form or applied directly to the gum (local treatment). Antibiotics given can include tetracycline , doxycycline , macrolides or β-lactams . Because periodontitis can be caused by a mix of microbes, a combination of antibiotics may be given.

Diagram of a tooth with healthy gums. The crown is the part above the gums, the root is the part below the gums. The enamel is the outer layer, inside is the dentin and inside that is the pulp which contains the root canal, nerves, and blood vessels. Below the gums is bone. Gingivitis is the first stage of periodontal disease. This is when the gums become darker red and swollen. Periodontitis the gumsrecede and the enamel begins to break. In advanced periodontitis the gums recede even further and the tooth degenerates past the enamel and into the dentin and pulp.
(a) Healthy gums hold the teeth firmly and do not bleed. (b) Gingivitis is the first stage of periodontal disease. Microbial infection causes gums to become inflamed and irritated, with occasional bleeding. (c) In periodontitis, gums recede and expose parts of the tooth normally covered. (d) In advanced periodontitis, the infection spreads to ligaments and bone tissue supporting the teeth. Tooth loss may occur, or teeth may need to be surgically removed. (credit: modification of work by “BruceBlaus”/Wikimedia Commons)

Trench mouth

When certain bacteria, such as Prevotella intermedia , Fusobacterium species, and Treponema vicentii , are involved and periodontal disease progresses, acute necrotizing ulcerative gingivitis or trench mouth , also called Vincent's disease, can develop. This is severe periodontitis characterized by erosion of the gums, ulcers, substantial pain with chewing, and halitosis ( [link] ) that can be diagnosed by visual examination and X-rays. In countries with good medical and dental care, it is most common in individuals with weakened immune systems, such as patients with AIDS. In addition to cleaning and pain medication, patients may be prescribed antibiotics such as amoxicillin , amoxicillin clavulanate , clindamycin , or doxycycline .

Photo of inflamed gums that have receded showing more of the teeth length.
These inflamed, eroded gums are an example of a mild case of acute necrotizing ulcerative gingivitis, also known as trench mouth. (credit: modification of work by Centers for Disease Control and Prevention)
  • How does gingivitis progress to periodontitis?

Healthy mouth, healthy body

Good oral health promotes good overall health, and the reverse is also true. Poor oral health can lead to difficulty eating, which can cause malnutrition. Painful or loose teeth can also cause a person to avoid certain foods or eat less. Malnutrition due to dental problems is of greatest concern for the elderly, for whom it can worsen other health conditions and contribute to mortality. Individuals who have serious illnesses, especially AIDS, are also at increased risk of malnutrition from dental problems.

Additionally, poor oral health can contribute to the development of disease. Increased bacterial growth in the mouth can cause inflammation and infection in other parts of the body. For example, Streptococcus in the mouth, the main contributor to biofilms on teeth, tartar, and dental caries, can spread throughout the body when there is damage to the tissues inside the mouth, as can happen during dental work. S. mutans produces a surface adhesin known as P1, which binds to salivary agglutinin on the surface of the tooth. P1 can also bind to extracellular matrix proteins including fibronectin and collagen. When Streptococcus enters the bloodstream as a result of tooth brushing or dental cleaning, it causes inflammation that can lead to the accumulation of plaque in the arteries and contribute to the development of atherosclerosis , a condition associated with cardiovascular disease, heart attack, and stroke. In some cases, bacteria that spread through the blood vessels can lodge in the heart and cause endocarditis (an example of a focal infection).

Questions & Answers

microbial genetics mcqs
kajal Reply
what is the importance of learning microbiology in nursing?
Grace Reply
it's about child-care?
the way of common children disease? hmm 🤔🤔
how do you mean child care?
Was ist die Wichtigkeit beim Lernen von Mikrtobiologie in der Pflege? Es ist notwendig dass die Schwestern allgemein und auch die Kinderschwestern eine Ausbildung in der Mikrobiologie erfahren. Sie sind in ihrem Beruf gefo
you need to know the truth about diseases. the microbes are have immunity to some pharmacy.
is base pairing rule states that adenine pair with thymine cytosine pair with guannie what will be the complementry strand to acggt
KooL Reply
introduction to microbiology
Shweta Reply
Study the life of microorganisms present in the environment their survivals etc..
Microscopic organisms, commonly known as microorganisms or microbes, are found all around us and even inside our bodies. The category 'Microbes' includes a massive range of organisms including bacteria, fungi, viruses, algae, archaea and protozoa.
fermented foods likely benefited ancestors to preserve foods and make other foods like milk, cheese, and bread using microbes.
Zinnia Reply
the evidence that I would support the statement regarding ancient people ideas that disease was transmitted by things they could not see is by the discoveries under a microscope. Many microbiologists have discovered certain diseases caused by microbes.
plz give the information about glyoxylate cycle
kamini Reply
what type of information?
I need medical microbiology mcqs books for Mbbs
for pakistani mbbs or other?
what is microbial soup?
Osborn Reply
😃😂funny question isn't it?!!! sorry for inconvenience 😊
most bacterial pathogens that cause disease in humans are classified in terms if their preferable ph as
Beesan Reply
what is micro
Kabul Reply
extremely small in size
almost invisible to the naked eye
invisible sized objects
invisible sized object or specimens.which is used to see in only the microscope that specimens or objective called the micro
small organism that can be seen by use of Microbes
why do you need to study microorganisms
what is microbiology?
Green Reply
microbiology is a branch of biology .it deals with the study of microorganisms life cycle , uses, disadvantages,and it impact in any other fields .which is used to view in microscope .
Microbiology is the study of microorganisms, those being unicellular, multicellular, or acellular. Microbiology encompasses numerous sub-disciplines including virology, bacteriology, protistology, mycology, immunology and parasitology. 
In short , it is the study of micro organisms and types , characteristics.
can you explain the structure of rna in detail
Dhanalakshmi Reply
RNA is of many types....like mRNA,tRNA,rRNA,snRNA,guideRNA..etc .
but generally RNA is single stranded
It contains adenine guanine cytosine , instead of thymine it contains uracil.
ribonucleic acid present in RNA.. where as in DNA it is deoxyribonucleic acid...and ribonucleotide is present in RNA
RNA is a blue print of DNA. it has the information from DNA....and we can predict the base panirs in DNA if we have the RNA....copy of that DNA
can either have positive or negative polarity
Diatoms need..... With the help of which they can construct their beautiful cell wall
Prathmesh Reply
Microbial growth curve shows a.... Curve.
Shambhuraj Reply
diminishing curve
It represents the decreasing growth of an organism.
what is meant by reverse isolation in tuberculosis treatment?
Swetha Reply
why do we study microbiology
Microbiology is the way of gaining knowledge about those organisms which are surround us but we can't see them with our naked eye,such organisms called microorganisms..We can see them only under microscope.
from our birth to death microorganisms are with us in the environment as well as on our body which are called Microflora.
Microfloras are non pathogenic
Practice MCQ 4

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