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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

wat causes sor throat
Ezeama Reply
Streptococcus
Rajat
Streptococcus
Panda
Gram positive
shamim
streptococcus pyrogenes
Sherma
what z microbiology
Mwelwa Reply
microbiology is all about the scientific study of microorganisms, their life changes, their life span, structural punctuality and their phenomenon.
Ridwan
thanks
micah
Best scope in microbiology
Rahul
wat abut skin
Elyas
whatis scope
Amare
what happened when someone died and what happened to the blood
Franca Reply
nice question
Attari
when you die you have no memory and the blood dry off
Falere
what microorganisms is all about?
Ridwan
And how many does the microorganisms is classified?
Ridwan
How are microbs organized
Saskia
what is endoparasites and exo parasite and their example
OGEDE Reply
Endo : inside the body Exo/ecto : outside or on the body
Paul
examples please
OGEDE
Louse for exo/ecto Helminths (worms) for endo
Paul
what's prokaryotic
mohaiminul Reply
A prokaryotic cell is a cell with no membrane bounds organelles
Paul
what are the main effect of parasite?
yunusa Reply
nutritional group of micro organism
Mana Reply
what are the charateristic bacteria, eukaryotes, and viruses have in commom
Ami Reply
what type of bacteria ismor serious
Amare
D N A ar purno rup ki
Ruba Reply
বাংলায় দেখবো DNA এর পূর্রন্যরুপ কি
Ruba
what's microbiology
micah
micro biology is the study of micro organisms,those being unicellular multicellular or a cellular
aniisha
deoxyribonucleic acid is a long molecule that contains our unique genetic code.
aniisha
Does the parasite/parasitology are under microbiology or not
yunusa
Define bacteria
Kainat
Bacteria are a type of biological cell & they constitute a large domain of prokaryotic microorganisms.
raisa
what kind of microbiology
Mira
hello what is main function of T and B cells
Ishaq Reply
T cells are involved in cell-mediated immunity while B cells are primarily responsible for humoral immunity (relating to antibodies)
Janet
what is hepatitis B
Sunday
it's viral infection that attacks the liver and can cause both acute and chronic diseases. the virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids...
Dejene
What are fundamental experiment of microbiology?
Lucky Reply
study of microscopic organisms, unicellular and multicellular
Falere
what are the characteristics of bacteria, viruses, and eukaryotes
Ami
bacteria-are living organism. contain a peptidoglycan/lipopolysaccharide cell wall. VIRUS-are considered as organic structure which interact with living organism don't have acell wall. they have many differents like bacteria size -large(1000nm) virus size-smaller(20-400nm). bacteria ribosomes presen
Dejene
virus ribosomes absence. bacteria living organism. virus b/n living and non-living things
Dejene
eukaryotic cell has a true membrane bond nucleus and has other membranous organelles that allow for compartmenalization of function
Dejene
This answer is wrong
Jeffrey Reply
who discovered the growth curve
Joy Reply
Example of coccus bacteria
Nweke Reply
staphylococcus aureus
Elton
MRSA any bew information
Satish
pl. read any new information about MRSA
Satish
Any stru tural finding about novel corona virus
Satish
Examples of spiral bacteria
Nweke Reply
Example of Bacillus bacteria
Nweke
pusals
manikanta
another one
Nweke
Practice MCQ 4

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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