Local Contributory Factors Influencing Gingival Health

Gingivitis is the first stage in the disease process of the gingiva and is a reaction that the body has to the bacteria present in dental biofilm (plaque). Many local factors can increase plaque deposition and retention, inhibit plaque control, and contribute to the development of gingivitis and periodontitis; these factors are considered contributory because they do not by themselves initiate gingival inflammation.³ Some examples of local factors include calculus, anatomic factors, iatrogenic factors (caused by materials and techniques used in dentistry), and traumatic factors (such as food impaction or chemical injury). These local factors may contribute to the disease process of the gingiva. Within minutes after eruption or after all surfaces have been thoroughly cleaned, pellicle begins to form and is fully formed within 30-90 minutes.⁴ Biofilm accumulation occurs when bacteria attach to pellicle. Biofilm becomes increasingly more difficult to remove the longer it is attached to the tooth surface and eventually hardens into a calcified dental biofilm known as calculus. Proper oral hygiene can control many of these factors so that the disease process is never initiated or help reverse the process in those situations where the inflammatory process has already begun.