What can you eat with inflammation of the gums

Self-medication: inflammation of the gums

Gingivitis is the acute or chronic form of inflammation of the gums. It shows up in reddened and swollen gums, which when exposed to mechanical irritation, e.g. B. when brushing your teeth, starts to bleed.

"Do you have any idea what the reason for this inflammation of the gums is?" Is the question to start the conversation. Sometimes the symptoms can be traced back directly to a known cause. The customer remembers that the discomfort started after he ate a fresh, crispy bun, that it all started with burning his tongue and gums on tomato soup, or injuring his gums while brushing his teeth. Mechanical or thermal injuries lead to wounds that heal and become inflamed in the mouth when the germs of the oral flora act.

Oral cavity offers an ideal climate for bacteria

All simple inflammation of the gums (gingivitis simplex) are plaque-induced. The oral cavity offers bacteria comfortable living conditions, namely a warm and humid environment, frequent food supplies and solid surfaces to attach to. Plaque is the name given to the biofilm made of bacteria that settles on tooth surfaces. Even after optimal teeth cleaning, plaque formation begins within a few minutes to hours. Individual salivation and some other self-cleaning processes are not enough to prevent plaque from building up. Plaque can and must only be removed again and again through appropriate personal oral hygiene. If the bacterial film is not completely removed, changes in the marginal epithelium, the top layer of the mucous membrane on the inside of the gums, will occur within two to four days of the start of plaque formation. This triggers inflammatory processes that can eventually lead to chronic gingivitis, periodontitis and even tooth loss.

Rinse with antiseptic solution

A simple inflammation of the gums heals within three to four days. The most important measure to heal all gingivitis is proper oral hygiene. Thorough cleaning of the teeth and the interdental spaces after all meals with a toothbrush and toothpaste, dental floss, tooth sticks or possibly an interdental brush is necessary in order to limit the maintenance of the inflammation by germs of the oral flora. Since bleeding gums often occur when brushing their teeth, those affected brush their teeth only briefly and carefully. This procedure worsens the symptoms in the long run. In this way, an acute gingivitis can quickly become a chronic one.

The germ count in the oral cavity can be reduced even further if the mouth is rinsed with antiseptic gargle solutions. Chlorhexidine (minimum concentration 0.12%, e.g. Oral B® mouth rinse solution chlorhexidine, Chlorhexamed® forte solution 0.2%, Meridol® Chlorhexamed 0.2% solution), hexetidine (Hexoral®), povidone iodine ( Betaisodona® oral antiseptic) and hydrogen peroxide solution (3%).

Herbal astringents

Antiseptics can be used regularly to prevent gingivitis. In the case of chlorhexidine, however, the therapeutic concentration should not be used for longer than ten days, as prolonged use leads to reversible discoloration of the tongue and teeth and can cause changes in taste and numbness of the tongue. For long-term use in oral showers, lower doses (0.6%, Chlorhexamed® gum protection mouth rinse solution) are therefore used. The combination of amine fluoride and tin fluoride (Meridol® mouthwash solution) inhibits the plaque matrix formation. It can therefore also be used to prevent gingivitis. At the same time, tin has an anti-inflammatory effect in the gingiva.

Traditionally, astringents are also used for oral mucosal inflammation, with the idea that they seal the upper layers of the mucous membrane and inhibit secretion from the inflamed tissue. Sage oil (e.g. in Salviathymol®), rhubarb extract (in Pyralvex®), myrrh tincture (Inspirol® P forte) and ratanhi tincture (RatioSept® mouth and throat tincture) are available for local use.

Local anesthetics can be used for severe pain. Available are z. B. Polidocanol (Recessan®) and lidocaine (Dynexan® oral gel, in Kamistad® N gel). As soon as the symptoms occur more frequently or are severe, there is a reason to recommend a dental check-up. The customer will definitely benefit from professional teeth cleaning.

Special circumstances

The inflammatory reactions to dental plaque can be aggravated by some special living conditions. The extent of the inflammation is, among other things, influenced by sex hormones. As a result, inflammation of the gums occurs more frequently and is more severe during puberty, just before ovulation as part of the menstrual cycle, and during pregnancy. Badly adjusted diabetics, especially children with uncontrolled diabetes mellitus, also often have strong inflammatory reactions in the gum area. The same applies to patients with acute leukemia and a weakened immune system.

Malnutrition can lead to a restricted immune defense and an increased susceptibility to infections, which in turn leads to more frequent inflammation of the gums. It most commonly affects cases of anorexia nervosa and chronic alcohol abuse.

Chronic gingivitis caused by vitamin C deficiency (scurvy) is also known. However, more often than vitamin C deficiency, there are sensitive tooth necks and gingivitis caused by vitamin C overdoses.

In all cases, the fact that bacteria of the oral flora are the trigger for the inflammation and adequate oral hygiene with sufficient germ reduction remains the focus of the therapy. If possible, the underlying disease should of course be treated. In more severe cases, the affected patient will seek dental treatment.

Specific infections - cave!

Dental plaque germs are not always to blame for gingivitis. All unusual and serious complaints belong in the hands of a dentist. In the case of suddenly occurring, very painful inflammations with clearly visible foci of inflammation in the interdental spaces, invasive gram-negative, obligatory anaerobic bacteria such as spirochetes, fusobacteria and prevotella intermedia could be responsible. They trigger necrotizing and ulcerating gingivitis, which leads to severe tissue loss within a few hours and days. Risk factors here are poor oral hygiene, cigarette smoking, psychological stress, lack of sleep and immunodeficiency, e.g. B. HIV infection. Treatment should begin within 24 hours of the first symptoms to avoid gum loss. A targeted and repeated cleaning, especially of gingival pockets, first with ultrasound and then with hydrogen peroxide solution or chlorhexidine is necessary, usually together with an effective antibiotic.

Herpetic gingivostomatitis caused by herpes viruses is also very painful. The entire mouth and gums are littered with crater-shaped lesions that develop from small fluid-filled vesicles. In severe cases, treatment can be carried out with an antiviral. Rinsing with a povidone-iodine solution (Betaisodona® oral antiseptic) can usually have a good influence on the virus infection. At the same time, secondary infections are prevented in this way.

Often only individual erosions of the oral mucous membrane (aphthae) occur, which cannot be attributed to specific germs. Here one speaks of recurrent, benign aphthous ulcers. Immunological reactions are discussed as the cause. These benign aphthous ulcers heal within about two weeks without treatment. To reduce inflammation and pain, dentists can use cortisone ointments (triamcinolonaetonide in Volon® A adhesive ointment, prednisolone acetate in Dontisolon® D oral healing paste). Antiseptic douches can be used to avoid secondary infections.

The hand, foot and mouth disease also presents with aphthous rashes in the mouth. At the same time, oval to angular blisters with a red border form on the hands, feet and possibly on the thighs. The cause of this is the Coxsackie virus. Here, povidone-iodine solution (Betaisodona® mouthwash solution) is the product of choice.

Gingival hyperplasia

Inflammation of the gums is usually accompanied by an enlargement of the gingiva due to the formation of edema and increased blood flow. However, there are also forms of gingival hyperplasia that arise from the proliferation of collagenous connective tissue. These thickened gums are normal in color and have no tendency to bleed.

However, due to the overgrowth of gum tissue, the teeth are more difficult to clean and as a result the number of plaque-induced inflammation of the gums increases.

One of the causes of such gingival hyperplasia is a genetic component. In addition, adverse effects from the following drugs can be blamed for this:

  • Diphenylhydantoin (1 to 10%)
  • Cyclosporine A (4 to 16%)
  • Nifedipine, felodipine, amlodipine, nitrendipine (<1%, partly reversible after discontinuation).

With all thickening and other chronic tissue changes, it must always be remembered that excessive tissue growth can have a malignant character. Oral carcinomas are seldom painful at first, so early diagnosis is often delayed.

Periodontal disease

Periodontitis is when other parts of the tooth supporting apparatus (periodontium) are affected in addition to the gingiva, namely the alveolus, periodontal membrane, root cement or alveolar process bones. It develops from chronic gingivitis.

Periodontitis also manifests itself in reddening, swelling and a tendency to bleed of the gingiva. In the further course gum pockets form with loss of supporting tissue. As a late symptom, tooth mobility increases and tooth loss occurs. With systematic dental treatment and constant monitoring with professional teeth cleaning, the prognosis is usually favorable.

Pharmacist Dr. Kirsten Lennecke