Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Gingivitis is considered to be a bacterial infection of the gums. The exact reason why gingivitis develops has not been proven, but several theories exist.
For gingivitis to develop, plaque must accumulate in the areas between the teeth. This plaque contains large numbers of bacteria thought to be responsible for gingivitis. But it is not simply plaque that causes gingivitis. Almost everyone has plaque on their teeth, but only a few develop gingivitis.
It is usually necessary for the person to have an underlying illness or take a particular medication that renders their immune system susceptible to gingivitis. For example, people with leukemia and Wegener's granulomatosis can have changes in the blood vessels of their gums that allow gingivitis to develop. Other people with diabetes, Addison disease, HIV, and other immune system diseases have weaker ability to fight bacteria invading the gums. Persons with Sjögren's syndrome have chronic dryness of the mouth that predisposes them to develop gingivitis.
Sometimes hormonal changes in the body during pregnancy, puberty, and steroid therapy leave the gums vulnerable to bacterial infection.
A number of medications used for seizures, high blood pressure, and organ transplants can suppress the immune system and change the structure of the gums enough to permit bacterial infection.
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