January 07, 2021
The human body has its own mechanisms in order to eliminate harmful microbes or the unwanted stimuli that harm the body. Any injury, defect or disturbance in our cells is combated with a mechanism known as inflammation. Inflammation is marked by a certain redness, swelling, warmth, pain and a loss of function at the site where the cells are injured. These features arise during the battle between our body's cells and the harmful foreign bodies that are causing all the hindrance. In Greek, the word 'itis' means inflammation. Hence, when any region of the body is inflamed, the suffix of -itis is added ahead of that region's name.
The mucosa represents the lining of the inner skin of various internal organs and body systems. This lining has multiple functions but is primarily recognized as a protective layer that fights off any harmful pathogens from invading our vital organs. The oral cavity too is lined by the mucosa. This can be seen at the inner portion of the cheeks, lips, floor of the mouth, tongue and gingiva (gums). The mucosa consists of cells that are able to replicate at a faster rate. This means that an injury can be quickly healed due to the action of these cells. However, the real problem arises when their rate of replication is adversely affected and the regions where the mucosa is present develops painful sores and patches.
The attack on the mucosa means that the body will try to fight the root cause. In the process, this area will get inflamed. This is called mucositis (mucosa + itis). Mucositis in the mouth can occur due to a number of reasons. It can be because of improper nutrition, less intake of fluids, poor oral hygiene, underlying disease or condition, radiation or chemotherapies during cancer treatment, etc. In the oral cavity, mucositis can lead to sore ulcers, white or red colored patches or lesions, swollen lips, pus discharge in the area of mucositis, bleeding, difficulty in swallowing food, difficulty in speech, dry mouth, etc. This long list of features of mucositis leads the patient to a gnawing sensation of pain and discomfort and can be aggravated if they consume alcohol, tobacco or smoke during this phase.
Mucositis leaves the body unshielded. The chance of getting an infection by virus, fungi or bacteria also increases. Hence, it is necessary to take the required measures to decrease the severity of the disease. The first step is to reduce the pain and swelling by taking analgesics and applying topical (local) medications in the form of gels. These agents cover the nerve endings that sense the pain and also provide a cooler effect in the mouth. The dentist will also tell the patient to consume more green leafy vegetables, cold foods and increase the uptake of water. An anti-allergic medication maybe prescribed if the source of mucositis is known. The intake of vitamins and proteins is of prime importance as they take part in the healing process.
Apart from the above-mentioned measures, special emphasis is laid on enhancing the oral health status. This is done by regular rinsing of the mouth with salt water, using soft bristles toothbrush with toothpastes that do not contain abrasives, and using a mouthwash. The mouthwash should be taken based on the recommendations of the dentist as some mouthwashes contain agents that add to the irritation of mucositis. Finally, the patient should ensure that he or she brushes twice daily in order to decrease the accumulation of microbes.
The lining of mucosa is also found on the gingiva. There are times when the gingiva too gets inflamed. This condition is called gingivitis (gingiva + itis). Gingivitis occurs mainly as a result of improper oral hygiene. The accumulation of plaque on the teeth due to false toothbrushing techniques or not brushing at all leads to the microorganisms in the plaque pentrating the gingiva and harming it. The inflammation seen in gingivtis is also an indication that the infection is approaching the underlying ligament (periodontal ligament) that holds the tooth in its socket. Severe cases of gingivitis can lead to recessing of the gingiva from its normal position where it is attached to the tooth. Ulcerations on the gum and bad breath are commonly associated with gingivitis. Just like mucositis, gingivitis can worsen if the patient consumes alcohol or smokes tobacco.
Gingivitis is a reversible condition. If detected early, a scaling and root planning therapy (professional teeth cleaning with the help of an ultrasonic device) at the dental clinic will reduce the swelling of the gums. However, it is important to note that this condition can occur again if proper oral hygiene is not maintained. Gingivitis can be as a result of bone defects, underlying diseases or genetic acquisition. Apart from scaling and root planning, gingivitis can be reduced and more importantly, avoided, through proper oral hygiene techniques. These are the same techniques that are mentioned above for the cure and prevention of mucositis.
Gingivitis and Mucositis tell a lot about the patient's awareness of maintaining a proper oral health. Unless and until the inflammation is due to reasons apart from poor oral hygiene maintenance, everyone should know about the hazards they might face if regular cleansing of the mouth is not maintained.