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Chronic Gingivitis in Children and Adolescents

Children and adolescents are commonly diagnosed with gingivitis, especially around puberty. Periodontal disease (PD), a severe form of gum disease that destroys the gums and supporting structure of teeth, appears less in children than adults. Gingivitis is the mildest form of gum disease characterized by the inflammation of gingival tissues without loss of attachment or bone. The disease is more likely to affect children than PD.

In short, gingivitis develops in response to bacteria that live in biofilms at the gingival margin and in the spaces between teeth and surrounding gum tissues (sulcus). The condition is also reversible, so the supporting structures of teeth are not permanently damaged.

“Among children between 6 and 11 years of age, the prevalence of gingivitis is about 73 percent.”

Puberty-Associated Gingivitis

Younger children, especially those who still have baby (primary) teeth, acquire less plaque buildup than adults and are less likely to develop gingivitis. Although, the prevalence of the disease continues to increase with age, starting around age 5.

Once an adolescent hits puberty, between 10 and 16 years of age, the prevalence of gingivitis is close to 100 percent. The risk declines slightly and stays constant once they reach adulthood. Puberty-associated gingivitis is caused by changes in hormones, similar to the hormonal changes that occur during pregnancy.

“Girls have the highest risk of developing gingivitis at age 10, while boys are more prone to developing the disease at age 13.”

Causes and Risk Factors

During the early stages of life, children should pay close attention to their dental health to prevent gingivitis during puberty. Many of the risk factors associated with gingivitis are also preventable with lifestyle changes. Common causes of this disease include:

Poor Oral Hygiene

Neglected brushing and flossing can lead to gingivitis. So, dentists recommend brushing and flossing twice a day to help prevent gum disease, tooth decay, and other oral diseases.

Plaque Buildup

Gingivitis forms due to the long-term buildup of plaque, which is a sticky film that contains cavity-causing bacteria. As a result, if you do not remove dental plaque completely, the gums can become irritated and inflamed.

Hormonal Changes

Puberty and menstruation can increase inflammation and gum sensitivity. In addition, if a woman has gingivitis while pregnant, the disease can be transferred to the baby.

Tobacco Use

Tobacco is one of the primary causes of gum disease. Teenagers who smoke or chew tobacco are seven times more likely to develop gum disease than non-smokers. However, those who have never smoked tobacco have the lowest risk of developing gingivitis.

Stress

Constant stress weakens the immune system and increases inflammation. Further, high-stress levels in combination with poor oral hygiene can lead to gum disease over time.

Poor Nutrition

Poor nutrition makes it difficult for the body to fight infections, which puts children at a higher risk of developing gum disease. The buildup of dental plaque is also more likely, especially when consuming sugary foods and drinks as a child.

Signs & Symptoms

Clinical signs of gingivitis in children and adolescents include:

  • Bleeding gums on probing (erythema)
  • Gum swelling (edema)
  • Dusky or dark red gums
  • Tender or puffy gums
  • Receding gums, which is when tooth roots become exposed, making them look longer
  • Bleeding between gums when brushing or flossing
  • Bad breath that remains even after brushing your teeth

Prevention Tips and Treatment Options

The best way to prevent gingivitis in children is by establishing brushing and flossing habits early. More specifically, children and adolescents should brush at least twice a day with fluoride toothpaste and floss before going to sleep. In addition, visiting a pediatric dentist every six months for professional teeth cleanings, x-rays, and dental exams is also necessary.

Gingivitis is a reversible disease, but if it isn’t caught early enough by a professional, it becomes persistent into adulthood. Untreated gingivitis can turn into periodontal disease (PD), a severe form of gum disease. At this stage, surgery is the only procedure that can treat PD because it severely damages the teeth, gums, and surrounding bones.

Professional Teeth Cleanings

In addition to routine brushing and flossing at home, plaque that lives in hard-to-reach areas must be removed twice a year during routine teeth cleanings. During the appointment, a pediatric dentist examines your child’s teeth. They also clean his or her mouth and teeth using small instruments. In essence, these instruments remove plaque that you cannot remove with a standard toothbrush.

If the gingivitis hasn’t persisted, no further treatment is needed. However, if the disease forms into pediatric periodontal disease, more invasive treatments or surgery may be necessary.