text:
Market power
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Competition law
Basic concepts
History of competition law
Monopoly
Coercive monopoly
Natural monopoly
Barriers to entry
Herfindahl–Hirschman Index
Market concentration
Market power
SSNIP test
Relevant market
Merger control
Anti-competitive practices
Monopolization
Collusion
Formation of cartels
Price fixing
Bid rigging
Product bundling and tying
Refusal to deal
Group boycott
Essential facilities
Exclusive dealing
Dividing territories
Conscious parallelism
Predatory pricing
Misuse of patents and copyrights
Enforcement authorities and organizations
International Competition Network
List of competition regulators
v
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In economics and particularly in industrial organization, market power is the ability of a firm to profitably raise the market price of a good or service over marginal cost. In perfectly competitive markets, market participants have no market power. A firm with total market power can raise prices without losing any customers to competitors. Market participants that have market power are therefore sometimes referred to as "price makers" or "price setters", while those without are sometimes called "price takers". Significant market power occurs when prices exceed marginal cost and long run average cost, so the firm makes profit.
A firm with market power has the ability to individually affect either the total quantity or the prevailing price in the market. Price makers face a downward-sloping demand curve, such that price increases lead to a lower quantity demanded. The decrease in supply as a result of the exercise of market power creates an economic deadweight loss which is often viewed as socially undesirable. As a result, many countries have anti-trust or other legislation intended to limit the ability of firms to accrue market power. Such legislation often regulates mergers and sometimes introduces a judicial power to compel divestiture.
A firm usually has market power by virtue of controlling a large portion of the market. In extreme cases—monopoly and monopsony—the firm controls the entire market. However, market size alone is not the only indicator of market power. Highly concentrated markets may be contestable if there are no barriers to entry or exit, limiting the incumbent firm's ability to raise its price above competitive levels.
Market power gives firms the ability to engage in unilateral anti-competitive behavior.[1] Some of the behaviours that firms with market power are accused of engaging in include predatory pricing, product tying, and creation of overcapacity or other barriers to entry. If no individual participant in the market has significant market power, then anti-competitive behavior can take place only through collusion, or the exercise of a group of participants' collective market power.
The Lerner index and Herfindahl index may be used to measure market power.
Contents
[hide]
1 Oligopoly
2 Monopoly power
3 Source
4 Measurement
5 Elasticity of demand
6 Nobel Memorial Prize
7 See also
8 References
9 Further references
Oligopoly[edit]
When several firms control a significant share of market sales, the resulting market structure is called an oligopoly or oligopsony. An oligopoly may engage in collusion, either tacit or overt, and thereby exercise market power. A group of firms that explicitly agree to affect market price or output is called a cartel.
Monopoly power[edit]
Monopoly power is an example of market failure which occurs when one or more of the participants has the ability to influence the price or other outcomes in some general or specialized market. The most commonly discussed form of market power is that of a monopoly, but other forms such as monopsony, and more moderate versions of these two extremes, exist.
A well-known example of monopolistic market power is Microsoft's market share in PC operating systems. The United States v. Microsoft case dealt with an allegation that Microsoft illegally exercised its market power by bundling its web browser with its operating system. In this respect, the notion of dominance and dominant position in EU Antitrust Law is a strictly related aspect.[2]
Source[edit]
A monopoly can raise prices and retain customers because the monopoly has no competitors. If a customer has no other place to go to obtain the goods or services, they either pay the increased price or do without.[3] Thus the key to market power is to preclude competition through high barriers of entry. Barriers to entry that are significant sources of market power are control of scarce resources, increasing returns to scale, technological superiority and government created barriers to entry.[4] OPEC is an example of an organization that has market power due to control over scarce resources — oil. Increasing returns to scale are another important source of market power. Firms experiencing increasing returns to scale are also experiencing decreasing average total costs.[4] Firms in such industries become more profitable with size.[4] Therefore over time the industry is dominated by a few large firms. This dominance makes it difficult for start up firms to succeed.[4] Firms like power companies, cable television companies and wireless communication companies with large start up costs fall within this category. A company wishing to enter such industries must have the financial ability to spend millions of dollars before starting operations and generating any revenue.[5] Similarly established firms also have a competitive advantage over new firms. An established firm threatened by a new competitor can lower prices to drive out the competition. Microsoft is a firm that has substantial pricing or market power due to technological superiority in its design and production processes.[4] Finally government created barriers to entry can be a source of market power. A prime example are patents granted to pharmaceutical companies. These patents give the drug companies a virtual monopoly in the protected product for the term of the patent.
Measurement[edit]
Concentration ratios are the most common measures of market power.[6] The four-firm concentration ratio measures the percentage of total industry output attributable to the top four companies. For monopolies the four firm ratio is 100 per cent while the ratio is zero for perfect competition.[7] The four firm concentration domestic (U.S) ratios for cigarettes is 93%; for automobiles, 84% and for beer, 85%.[8]
Another measure of concentration is the Herfindahl-Hirschman Index (HHI) which is calculated by "summing the squares of the percentage market shares of all participants in the market".[8] The HHI index for perfect competition is zero; for monopoly, 10,000.
U.S. courts almost never consider a firm to possess market power if it has a market share of less than 50 percent.[9]
Elasticity of demand[edit]
Market power is the ability to raise price above marginal cost (MC) and earn a positive profit.[10] The degree to which a firm can raise price (P) above marginal cost depends on the shape of the demand curve at the profit maximizing output.[10] That is, elasticity is the critical factor in determining market power. The relationship between market power and the price elasticity of demand (PED) can be summarized by the equation:
P M C = P E D 1 + P E D . {\displaystyle {\frac {P}{MC}}={\frac {PED}{1+PED}}.}
Note that PED will be negative, so the ratio is always greater than one. The higher the P/MC ratio, the more market power the firm possesses. As PED increases in magnitude, the P/MC ratio approaches one, and market power approaches zero.[11] The equation is derived from the monopolist pricing rule:
P − M C P = − 1 P E D . {\displaystyle {\frac {P-MC}{P}}=-{\frac {1}{PED}}.}
Nobel Memorial Prize[edit]
Jean Tirole was awarded the 2014 Nobel Memorial Prize in Economic Sciences for his analysis of market power and economic regulation.
See also[edit]
Bargaining power
Imperfect competition
Market concentration
Natural monopoly
Predatory pricing
Price discrimination
Dominance (economics)
References[edit]
Jump up ^ Vatiero Massimiliano (2010). "The Ordoliberal notion of market power: an institutionalist reassessment". European Competition Journal. 6 (3): 689–707. doi:10.5235/ecj.v6n3.689.
Jump up ^ Vatiero M. (2009), "An Institutionalist Explanation of Market Dominances". World Competition. Law and Economics Review, 32(2):221–226.
Jump up ^ If the power company raised rates the customer either pays the increase or does without power.
^ Jump up to: a b c d e Krugman & Wells, Microeconomics 2d ed. (Worth 2009)
Jump up ^ Often such natural monopolies will also have the benefit of government granted monopolies.
Jump up ^ Samuelson & Nordhaus, Microeconomics, 17th ed. (McGraw-Hill 2001) at 183–184.
Jump up ^ Samuelson & Nordhaus, Microeconomics, 17th ed. (McGraw-Hill 2001) at 183.
^ Jump up to: a b Samuelson & Nordhaus, Microeconomics, 17th ed. (McGraw-Hill 2001) at 184.
Jump up ^ J. Gregory Sidak & Hal J. Singer, Überregulation Without Economics: The World Trade Organization’s Decision in the U.S.-Mexico Arbitration on Telecommunications Services, General Agreement on Trade in Services, GATS, 57 FED. COMM. L.J. 1, 34 (2004), http://www.repository.law.indiana.edu/cgi/viewcontent.cgi?article=1388&context=fclj.
^ Jump up to: a b Perloff, J: Microeconomics Theory & Applications with Calculus page 369. Pearson 2008.
Jump up ^ Perloff, J: Microeconomics Theory & Applications with Calculus Pearson 2008.
Further references[edit]
Brickley, Smith and Zimmerman. "7". Managerial Economics and Organizational Architecture (3rd ed.). McGraw-Hill. ISBN 978-0073375823.
"The Theory of Industrial Organization", Tirole, MIT Press 1988
[hide]
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Institutional economics
Institutional economists
Werner Abelshauser
Clarence Edwin Ayres
Joe S. Bain
Shimshon Bichler
Robert A. Brady
Daniel Bromley
Ha-Joon Chang
John Maurice Clark
John R. Commons
Richard T. Ely
Robert H. Frank
John Kenneth Galbraith
Walton Hale Hamilton
Orris C. Herfindahl
Albert O. Hirschman
Geoffrey Hodgson
János Kornai
Simon Kuznets
Hunter Lewis
Jesse W. Markham
Wesley Clair Mitchell
Gunnar Myrdal
Jonathan Nitzan
Warren Samuels
François Simiand
Herbert A. Simon
Frank Stilwell
George W. Stocking Sr.
Lars Pålsson Syll
Thorstein Veblen
Edward Lawrence Wheelwright
Erich Zimmermann
Key concepts and ideas
Accelerator effect
Administered prices
Barriers to entry
Bounded rationality
Conspicuous consumption
Conspicuous leisure
Conventional wisdom
Countervailing power
Effective competition
Herfindahl index
Hiding hand principle
Hirschman cycle
Instrumentalism
Kuznets cycles
Market concentration
Market power
Market structure
Penalty of taking the lead
Satisficing
Shortage economy
Structure–conduct–performance paradigm
Technostructure
Theory of two-level planning
Veblen goods
Veblenian dichotomy
Related fields
Behavioral Economics
Development economics
Economic sociology
English historical school of economics
French historical school
Historical school of economics
Legal realism
New Institutional Economics
Post-Keynesian economics
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text:
Oranges and Lemons
From Wikipedia, the free encyclopedia
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This article is about the nursery rhyme. For other uses, see Oranges and Lemons (disambiguation).
"Oranges and Lemons"
One of the 12 bells of St Leonard's, Shoreditch, removed for maintenance
Nursery rhyme
Published
c. 1744
"Oranges and Lemons" is a traditional English nursery rhyme and singing game which refers to the bells of several churches, all within or close to the City of London. It is listed in the Roud Folk Song Index as No 13190.
Contents
1 Lyrics
2 Earlier version
3 As a game
4 Origins and meaning
5 Melody
6 Cultural references
7 See also
8 References
9 External links
Lyrics[edit]
Oranges and lemons,
Say the bells of St. Clement's.

You owe me five farthings,
Say the bells of St. Martin's.

When will you pay me?
Say the bells at Old Bailey.

When I grow rich,
Say the bells at Shoreditch.

When will that be?
Say the bells of Stepney.

I do not know,
Says the great bell at Bow.

Here comes a candle to light you to bed,
And here comes a chopper to chop off your head!
Chip chop chip chop the last man is dead[1]
Earlier version[edit]
Gay go up, and gay go down,
To ring the bells of London town.

Bull's eyes and targets,
Say the bells of St. Margret's.

Brickbats and tiles,
Say the bells of St. Giles'.

Halfpence and farthings,
Say the bells of St. Martin's.

Oranges and lemons,
Say the bells of St. Clement's.

Pancakes and fritters,
Say the bells of St. Peter's.

Two sticks and an apple,
Say the bells at Whitechapel.

Pokers and tongs,
Say the bells at St. John's.

Kettles and pans,
Say the bells at St. Ann's.

Old Father Baldpate,
Say the slow bells at Aldgate.

Maids in white Aprons
Say the bells at St Catherine's

Pan cakes and Fritters
say the bells of St Peters.

You owe me ten shillings,
Say the bells at St. Helen's.

When will you pay me?
Say the bells of Old Bailey.

When I grow rich,
Say the bells of Shoreditch.

Pray when will that be?
Say the bells of Stepney.

I am sure I don't know,
Says the great bell of Bow.

Here comes a candle to light you to bed,
And here comes a chopper to chop off your head.[2]
Section from a 19th-century engraving by Nathaniel Whittock from a drawing by Antony van den Wyngaerde (c. 1543–50), which shows the towers and spires of many of the churches mentioned in the rhyme
As a game[edit]
Playing the game. Picture by Agnes Rose Bouvier (1842–92)
The song is used in a children's singing game with the same name, in which the players file, in pairs, through an arch made by two of the players (made by having the players face each other, raise their arms over their head, and clasp their partners' hands). The challenge comes during the final lines:
Here comes a candle to light you to bed.
Here comes a chopper to chop off your head.
(Chip chop, chip chop, the last man's dead.)
On the last word, the children forming the arch drop their arms to catch the pair of children currently passing through, who are then "out" and must form another arch next to the existing one. In this way, the series of arches becomes a steadily lengthening tunnel through which each set of two players have to run faster and faster to escape in time.[1]
Alternative versions of the game include: children caught "out" by the last rhyme may stand on a pressure plate behind one of the children forming the original arch, instead of forming additional arches; and, children forming "arches" may bring their hands down for each word of the last line, while the children passing through the arches run as fast as they can to avoid being caught on the last word.[3] It was often the case, in Scottish playgrounds, that children would pair into boy and girl and the ones "caught" would have to kiss.[citation needed]
Origins and meaning[edit]
Illustration for the rhyme from The Only True Mother Goose Melodies (1833)
Various theories have been advanced to account for the rhyme, including: that it deals with child sacrifice; that it describes public executions; that it describes Henry VIII's marital difficulties.[1] Problematically for these theories the last two lines, with their different metre, do not appear in the earlier recorded versions of the rhyme, including the first printed in Tommy Thumb's Pretty Song Book (c. 1744), where the lyrics are:
Two Sticks and Apple,
Ring ye Bells at Whitechapple,
Old Father Bald Pate,
Ring ye Bells Aldgate,
Maids in White Aprons,
Ring ye Bells a St. Catherines,
Oranges and Lemons,
Ring ye bells at St. Clements,
When will you pay me,
Ring ye Bells at ye Old Bailey,
When I am Rich,
Ring ye Bells at Fleetditch,
When will that be,
Ring ye Bells at Stepney,
When I am Old,
Ring ye Bells at Pauls.[1]
There is considerable variation in the churches and lines attached to them in versions printed in the late eighteenth and early nineteenth centuries, which makes any overall meaning difficult to establish. The final two lines of the modern version were first collected by James Orchard Halliwell in the 1840s.[1]
Oranges and Lemons was the name of a square-four-eight-dance, published in Playford's, Dancing Master in 1665, but it is not clear if this relates to this rhyme.[1] Similar rhymes naming churches and giving rhymes to their names can be found in other parts of England, including Shropshire and Derby, where they were sung on festival days, on which bells would also have been rung.[1]
The identity of the churches is not always clear, but the following have been suggested, along with some factors that may have influenced the accompanying statements:[1]
St. Clement's may be St Clement Danes or St Clement Eastcheap both of which are near the wharves where merchantmen landed citrus fruits.
St. Martin's may be St Martin Orgar in the city, or St. Martin-in-the-Fields near Trafalgar Square.
St Sepulchre-without-Newgate (opposite the Old Bailey) is near the Fleet Prison where debtors were held.
St Leonard's, Shoreditch is just outside the old city walls.
St Dunstan's, Stepney is also outside the city walls
Bow is St Mary-le-Bow in Cheapside.
St. Helen's, in the longer version of the song, is St Helen's Bishopsgate, in the city.
Melody[edit]
StClementsDanes
The tune is reminiscent of change ringing, and the intonation of each line is said to correspond with the distinct sounds of each church's bells. Today, the bells of St. Clement Danes ring out the tune of the rhyme.[4]
Cultural references[edit]
The song is one of the nursery rhymes most commonly referred to in popular culture. These include George Orwell's Nineteen Eighty-Four (1949), where it is used as a snippet of nursery rhyme which embodies the forgotten past that protagonist Winston Smith yearns for. Various characters contribute snippets of the rhyme as the book goes on, and the last lines figure symbolically into the closing events of the second section.[5] A setting of the full Tommy Thumb's Pretty Song Book version for choir was written by Bob Chilcott. Entitled "London Bells", it is the third movement of "Songs and Cries of London Town".[6] Benjamin Till composed music based upon the nursery rhyme and it was performed in 2009 at St Mary Le Bow Church, London to honour 150 years of the great bell, Big Ben.[7] In the dystopian future of the video game Half-Life 2 (2004), oranges and lemons can be seen in graffiti on walls as symbols of the Resistance. This is a reference to the poem as it was used in Nineteen Eighty-Four.[8] In Neil Gaiman's The Graveyard Book (2008), two lesser villains recite the rhyme to summon the man Jack.[9] In the 1963 horror-comedy The Old Dark House, part of the rhyme is heard in a tape recording played backwards while trying to discover the identity of the secret killer. In the film It (2017), it is used as background music throughout the film, when the shape shifting antagonist is near.
The rhyme was also altered for the song "Clash City Rockers" by The Clash:
You owe me a move say the bells of St. Groove
Come on and show me say the bells of Old Bowie
When I am fitter say the bells of Gary Glitter
No one but you and I say the bells of Prince Far-I
No one but you and I say the bells of Prince Far-I
Throughout the 2015 horror series The Frankenstein Chronicles, the rhyme recurs several times, as the central character (played by Sean Bean) suffers mercury-induced hallucinations relating to a missing girl.[10]

In Doctor Who, revival series 6, episode 11 "The God Complex" (Air date: September 17, 2011), the character called Joe "quotes the finale of old English nursery rhyme 'Oranges and Lemons,' singing 'Here comes a candle to light you to bed, here comes a chopper to chop off your head!,' which echoes a moment in George Orwell's Nineteen Eighty-Four, where Winston Smith uses a snatch of the same rhyme to remind him of a forgotten and innocent past." [11]
In Ellen Raskin's Book, The Tattooed Potato and Other Clues, the protagonist, Dickory Dock, has a pocket watch that plays this nursery rhyme, and the song forms a major part of the storyline.
The first two strophes were used in the opening song of the film IT (2017 film), directed by Andy Muschietti). The song, composed by Benjamin Wallfisch, is entitled "Every 27 years".
See also[edit]
Wikisource has original text related to this article:
Oranges and Lemons
Dong, Dong, Dongdaemun, Korean nursery rhyme for playing a similar game to Oranges and Lemons
London Bridge Is Falling Down, another English nursery rhyme for playing a similar game to Oranges and Lemons
References[edit]
^ Jump up to: a b c d e f g h I. Opie and P. Opie, The Oxford Dictionary of Nursery Rhymes (Oxford University Press, 1951, 2nd edn., 1997), pp. 337–8.
Jump up ^ The Writer's Almanac with Garrison Keillor, June 29, 2011
Jump up ^ Oranges and Lemons (article in H2G2, an editable reference site hosted by bbc.co.uk).
Jump up ^ "St Clement Danes, The Strand London WC2 : tourist information from". TourUK. Archived from the original on 2012-02-22. Retrieved 2012-05-04.
Jump up ^ G. Orwell, 1984: a Novel (Signet Classic, 1990), pp. 178–9.
Jump up ^ "Chilcott: Songs and Cries of London Town – Oxford University Press". OUP. 2001-07-19. Retrieved 2012-05-04.
Jump up ^ "BBC – Today – Ringing the dust off London's bells". BBC News. 2009-07-10. Retrieved 2012-05-04.
Jump up ^ "Graffiti". Combineoverwiki.net. Retrieved 2014-06-29.
Jump up ^ Gaiman, Neil, The Graveyard Book, New York City: Harper Collins, 2008.
Jump up ^ BBC First Australia (2016-02-03), Trailer - The Frankenstein Chronicles - BBC First, retrieved 2017-06-28
Jump up ^ http://www.bbcamerica.com/anglophenia/2017/11/doctor-who-10-things-you-may-not-know-about-the-god-complex
External links[edit]
BBC School Radio online - Nursery Songs. "Oranges and Lemons" (with animation and lyrics)
The British Library Sound and Moving Images Catalogue - List Recording 1CD0323981 on Audio CD : Oranges & lemons. Tunes from the collection 'The Dancing Master' (includes notes by Annegret Fischer, and song texts)
Map of the likely church locations
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Nursery rhymes (list)
"A-Tisket, A-Tasket"
"Aiken Drum"
"Baa, Baa, Black Sheep"
"Did You Ever See a Lassie?"
"Hey Diddle Diddle"
"Hickory Dickory Dock"
"Hot Cross Buns"
"Humpty Dumpty"
"I'm a Little Teapot"
"It's Raining, It's Pouring"
"Jack and Jill"
"Little Bo-Peep"
"Little Boy Blue"
"Little Jack Horner"
"Little Miss Muffet"
"Mary Had a Little Lamb"
"Mary, Mary, Quite Contrary"
"Old King Cole"
"Old MacDonald Had a Farm"
"Old Mother Hubbard"
"Peter Piper"
"Polly Put the Kettle On"
"Poor Mary"
"Pop Goes the Weasel"
"Pussy Cat Pussy Cat"
"Rain Rain Go Away"
"Roses Are Red"
"Rub-a-dub-dub"
"Simple Simon"
"Sing a Song of Sixpence"
"Sticks and Stones"
"The Grand Old Duke of York"
"The Queen of Hearts"
"There Was a Man in Our Town
"There was an Old Woman Who Lived in a Shoe"
"Three Little Kittens"
"Twinkle, Twinkle, Little Star"
Clapping
"A Sailor Went to Sea"
"Down Down Baby"
"Mary Mack"
"Miss Susie"
"Miss Lucy"
"Pat-a-cake"
"Pease Porridge Hot"
"Pretty Little Dutch Girl"
"Stella Ella Ola"
Counting
"Duck, duck, goose"
"Eeny, meeny, miny, moe"
"One, Two, Buckle My Shoe"
"One, Two, Three, Four, Five"
"This Old Man"
"Tinker, Tailor"
Finger-
plays
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Gingivitis
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Gingivitis
A severe case of gingivitis
Specialty
Dentistry
[edit on Wikidata]
Gingivitis is a non-destructive disease that occurs around the teeth.[1] The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that is attached to tooth surfaces, termed plaque-induced gingivitis.
While some cases of gingivitis never progress to periodontitis,[2] data indicates that periodontitis is always preceded by gingivitis.[3]
Gingivitis is reversible with good oral hygiene; however, without treatment, gingivitis can progress to periodontitis, in which the inflammation of the gums results in tissue destruction and bone resorption around the teeth. Periodontitis can ultimately lead to tooth loss.[4] The term means "inflammation of the gum tissue".
Contents
[hide]
1 Signs and symptoms
2 Cause
2.1 Risk factors
3 Diagnosis
3.1 Classification
4 Prevention
5 Treatment
6 Complications
7 See also
8 References
9 External links
Signs and symptoms[edit]
Gingivitis
The symptoms of gingivitis are somewhat non-specific and manifest in the gum tissue as the classic signs of inflammation:
Swollen gums
Bright red or purple gums
Gums that are tender or painful to the touch
Bleeding gums or bleeding after brushing and/or flossing
Bad breath (halitosis)
Additionally, the stippling that normally exists in the gum tissue of some individuals will often disappear and the gums may appear shiny when the gum tissue becomes swollen and stretched over the inflamed underlying connective tissue. The accumulation may also emit an unpleasant odor. When the gingiva are swollen, the epithelial lining of the gingival crevice becomes ulcerated and the gums will bleed more easily with even gentle brushing, and especially when flossing.
Cause[edit]
Because plaque-induced gingivitis is by far the most common form of gingival diseases, the following sections will deal primarily with this condition.
The cause of plaque-induced gingivitis is bacterial plaque, which acts to initiate the body's host response. This, in turn, can lead to destruction of the gingival tissues, which may progress to destruction of the periodontal attachment apparatus.[5] The plaque accumulates in the small gaps between teeth, in the gingival grooves and in areas known as plaque traps: locations that serve to accumulate and maintain plaque. Examples of plaque traps include bulky and overhanging restorative margins, claps of removable partial dentures and calculus (tartar) that forms on teeth. Although these accumulations may be tiny, the bacteria in them produce chemicals, such as degradative enzymes, and toxins, such as lipopolysaccharide (LPS, otherwise known as endotoxin) or lipoteichoic acid (LTA), that promote an inflammatory response in the gum tissue. This inflammation can cause an enlargement of the gingiva and subsequent formation. Early plaque in health consists of a relatively simple bacterial community dominated by Gram-positive cocci and rods. As plaque matures and gingivitis develops, the communities become increasingly complex with higher proportions of Gram-negative rods, fusiforms, filaments, spirilla and spirochetes. Later experimental gingivitis studies, using culture, provided more information regarding the specific bacterial species present in plaque. Taxa associated with gingivitis included Fusobacterium nucleatum subspecies polymorphum, Lachnospiraceae [G-2] species HOT100, Lautropia species HOTA94, and Prevotella oulorum (a species of Prevotella bacterium), whilst Rothia dentocariosa was associated with periodontal health.[6] Further study of these taxa is warranted and may lead to new therapeutic approaches to prevent periodontal disease.
Risk factors[edit]
Risk factors associated with gingivitis include the following:
age
osteoporosis
low dental care utilization (fear, financial stresses, etc.)
poor oral hygiene
overly aggressive oral hygiene such as brushing with stiff bristles
mouth-breathing during sleep
medications that dry the mouth
cigarette smoking
genetic factors
pre-existing conditions
Diagnosis[edit]
Gingivitis is a category of periodontal disease in which there is no loss of bone but inflammation and bleeding are present.
Each tooth is divided into four gingival units (mesial, distal, buccal, and lingual) and given a score from 0-3 based on the gingival index. The four scores are then averaged to give each tooth a single score.
The diagnosis of the periodontal disease gingivitis is done by a dentist. The diagnosis is based on clinical assessment data acquired during a comprehensive periodontal exam. Either a registered dental hygienist or a dentist may perform the comprehensive periodontal exam but the data interpretation and diagnosis are done by the dentist. The comprehensive periodontal exam consists of a visual exam, a series of radiographs, probing of the gingiva, determining the extent of current or past damage to the periodontium and a comprehensive review of the medical and dental histories.
Current research shows that activity levels of the following enzymes in saliva samples are associated with periodontal destruction: aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), and acid phosphatase (ACP). Therefore, these enzyme biomarkers may be used to aid in the diagnosis and treatment of gingivitis and periodontitis.
A dental hygienist or dentist will check for the symptoms of gingivitis, and may also examine the amount of plaque in the oral cavity. A dental hygienist or dentist will also look for signs of periodontitis using X-rays or periodontal probing as well as other methods.
If gingivitis is not responsive to treatment, referral to a periodontist (a specialist in diseases of the gingiva and bone around teeth and dental implants) for further treatment may be necessary.
Classification[edit]
As defined by the 1999 World Workshop in Clinical Periodontics, there are two primary categories of gingival diseases, each with numerous subgroups:[7]
Dental plaque-induced gingival diseases.
Gingivitis associated with plaque only
Gingival diseases modified by systemic factors
Gingival diseases modified by medications
Gingival diseases modified by malnutrition
Non-plaque-induced gingival lesions
Gingival diseases of specific bacterial origin
Gingival diseases of viral origin
Gingival diseases of fungal origin
Gingival diseases of genetic origin
Gingival manifestations of systemic conditions
Traumatic lesions
Foreign body reactions
Not otherwise specified
Prevention[edit]
Gingivitis can be prevented through regular oral hygiene that includes daily brushing and flossing.[8] Hydrogen peroxide, saline, alcohol or chlorhexidine mouth washes may also be employed. In a 2004 clinical study, the beneficial effect of hydrogen peroxide on gingivitis has been highlighted.[9] The use of oscillation type brushes might reduce the risk of gingivitis compared to manual brushing.[10]
Rigorous plaque control programs along with periodontal scaling and curettage also have proved to be helpful, although according to the American Dental Association, periodontal scaling and root planing are considered as a treatment for periodontal disease, not as a preventive treatment for periodontal disease.[11] In a 1997 review of effectiveness data, the U.S. Food and Drug Administration (FDA) found clear evidence showing that toothpaste containing triclosan was effective in preventing gingivitis.[12]
Treatment[edit]
Gingivitis before (top) and after (bottom) a thorough mechanical debridement of the teeth.
Analgesic and antiseptic gum paint with applicator buds used in treatment of gingivitis
The focus of treatment is to remove plaque. Therapy is aimed at the reduction of oral bacteria and may take the form of regular periodic visits to a dental professional together with adequate oral hygiene home care. Thus, several of the methods used in the prevention of gingivitis can also be used for the treatment of manifest gingivitis, such as scaling, root planing, curettage, mouth washes containing chlorhexidine or hydrogen peroxide, and flossing. Interdental brushes also help remove any causative agents.
Powered toothbrushes work better than manual toothbrushes in reducing the disease.[13]
The active ingredients that "reduce plaque and demonstrate effective reduction of gingival inflammation over a period of time" are triclosan, chlorhexidine digluconate, and a combination of thymol, menthol, eucalyptol, and methyl salicylate. These ingredients are found in toothpaste and mouthwash. Hydrogen peroxide was long considered a suitable over-the-counter agent to treat gingivitis. There has been evidence to show the positive effect on controlling gingivitis in short-term use. A study indicates the fluoridated hydrogen peroxide-based mouth rinse can remove teeth stain and reduce gingivitis.[9]
Based on a limited evidence, mouthwashes with essential oils may also be useful, as they contain ingredients with anti-inflammtory properties, such as thymol, menthol and eucalyptol.[14]
The bacteria that causes gingivitis can be controlled by using an oral irrigator daily with a mouthwash containing an antibiotic. Either amoxicillin, cephalexin, or minocycline in 16 ounces of a non-alcoholic fluoride mouthwash is an effective mixture.[15]
Overall, intensive oral hygiene care has been shown to improve gingival health in individuals with well-controlled type 2 diabetes. Periodontal destruction is also slowed down due to the extensive oral care. Intensive oral hygiene care (oral health education plus supra-gingival scaling) without any periodontal therapy improves gingival health, and may prevent progression of gingivitis in well-controlled diabetes.
Complications[edit]
Recurrence of gingivitis
Periodontitis
Infection or abscess of the gingiva or the jaw bones
Trench mouth (bacterial infection and ulceration of the gums)
Swollen lymph nodes
Associated with premature birth and low birth weight[16]
See also[edit]
Dentistry portal
Periodontitis
"Full width gingivitis" of orofacial granulomatosis.
Desquamative gingivitis
References[edit]
Jump up ^ The American Academy of Periodontology. Proceedings of the World Workshop in Clinical Periodontics. Chicago:The American Academy of Periodontology; 1989:I/23-I/24.
Jump up ^ Ammons, WF; Schectman, LR; Page, RC (1972). "Host tissue response in chronic periodontal disease. 1. The normal periodontium and clinical manifestations of dental and periodontal disease in the marmoset". Journal of periodontal research. 7 (2): 131–43. doi:10.1111/j.1600-0765.1972.tb00638.x. PMID 4272039.
Jump up ^ Page, RC; Schroeder, HE (1976). "Pathogenesis of inflammatory periodontal disease. A summary of current work". Laboratory Investigation. 34 (3): 235–49. PMID 765622.
Jump up ^ "Parameter on Plaque-Induced Gingivitis". Journal of Periodontology. 71 (5 Suppl): 851–2. 2000. doi:10.1902/jop.2000.71.5-S.851. PMID 10875689.
Jump up ^ Research, Science and Therapy Committee of the American Academy of Periodontology (2001). "Treatment of Plaque-Induced Gingivitis, Chronic Periodontitis, and Other Clinical Conditions". Journal of Periodontology. 72 (12): 1790–1800. doi:10.1902/jop.2001.72.12.1790. PMID 11811516.
Jump up ^ Kistler, James O.; Booth, Veronica; Bradshaw, David J.; Wade, William G.; Glogauer, Michael (14 August 2013). "Bacterial Community Development in Experimental Gingivitis". PLoS ONE. 8 (8): e71227. doi:10.1371/journal.pone.0071227.
Jump up ^ Armitage, Gary C. (1999). "Development of a Classification System for Periodontal Diseases and Conditions" (PDF). Annals of Periodontology. 4 (1): 1–6. doi:10.1902/annals.1999.4.1.1. PMID 10863370. Archived from the original (PDF) on 2010-06-12.
Jump up ^ Sambunjak, D.; Nickerson, J. W.; Poklepovic, T.; Johnson, T. M.; Imai, P.; Tugwell, P.; Worthington, H. V. (2011). Johnson, Trevor M, ed. "Flossing for the management of periodontal diseases and dental caries in adults". The Cochrane Library (12): CD008829. doi:10.1002/14651858.CD008829.pub2. PMID 22161438.
^ Jump up to: a b Hasturk, Hatice; Nunn, Martha; Warbington, Martha; Van Dyke, Thomas E. (2004). "Efficacy of a Fluoridated Hydrogen Peroxide-Based Mouthrinse for the Treatment of Gingivitis: A Randomized Clinical Trial". Journal of Periodontology. 75 (1): 57–65. doi:10.1902/jop.2004.75.1.57. PMID 15025217.
Jump up ^ Deacon, Scott A; Glenny, Anne-Marie; Deery, Chris; Robinson, Peter G; Heanue, Mike; Walmsley, A Damien; Shaw, William C (2010-12-08). Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd. doi:10.1002/14651858.cd004971.pub2. PMID 21154357.
Jump up ^ American Dental Hygienists’ Association Position Paper on the Oral Prophylaxis Archived 2012-06-26 at the Wayback Machine., Approved by the ADHA Board of Trustees April 29, 1998
Jump up ^ FDA Triclosan: What Consumers Should Know Accessed 2010-08-12
Jump up ^ Yaacob, M; Worthington, HV; Deacon, SA; Deery, C; Walmsley, AD; Robinson, PG; Glenny, AM (17 June 2014). "Powered versus manual toothbrushing for oral health". The Cochrane Database of Systematic Reviews. 6: CD002281. doi:10.1002/14651858.CD002281.pub3. PMID 24934383.
Jump up ^ Stoeken, Judith E.; Paraskevas, Spiros; Van Der Weijden, Godefridus A. (2007). "The Long-Term Effect of a Mouthrinse Containing Essential Oils on Dental Plaque and Gingivitis: A Systematic Review". Journal of Periodontology. 78 (7): 1218–28. doi:10.1902/jop.2007.060269. PMID 17608576.
Jump up ^ WebMD http://www.webmd.com/oral-health/antibioticsantimicrobials-for-gum-disease
Jump up ^ Saini, Rajiv; Saini, Santosh; Saini, Sugandha R. (2010-01-01). "Periodontitis: A risk for delivery of premature labor and low-birth-weight infants". Journal of Natural Science, Biology, and Medicine. 1 (1): 40–42. doi:10.4103/0976-9668.71672. ISSN 0976-9668. PMC 3217279  . PMID 22096335.
External links[edit]
Classification
V · T · D
ICD-10: K05.0-K05.1
ICD-9-CM: 523.0-523.1
MeSH: D005891
DiseasesDB: 34517
External resources
MedlinePlus: 001056
eMedicine: article/763801

[show]
v
t
e
Dentistry involving supporting structures of teeth (Periodontology)
Anatomy
Periodontium
Alveolar bone
Biologic width
Bundle bone
Cementum
Free gingival margin
Gingiva
Gingival fibers
Gingival sulcus
Junctional epithelium
Mucogingival junction
Periodontal ligament
Sulcular epithelium
Stippling
Disease
Diagnoses
Chronic periodontitis
Localized aggressive periodontitis
Generalized aggressive periodontitis
Periodontitis as a manifestation of systemic disease
Periodontosis
Necrotizing periodontal diseases
Abscesses of the periodontium
Combined periodontic-endodontic lesions
Infection
A. actinomycetemcomitans
Capnocytophaga sp.
F. nucleatum
P. gingivalis
P. intermedia
T. forsythia
T. denticola
Red complex
Entamoeba gingivalis
Trichomonas tenax
Other
Calculus
Clinical attachment loss
Edentulism
Fremitus
Furcation defect
Gingival enlargement
Gingival pocket
Gingival recession
Gingivitis
Horizontal bony defect
Linear gingival erythema
Occlusal trauma
Periodontal pocket
Periodontal disease
Periodontitis
Plaque
Vertical bony defect
Treatment and prevention
Periodontal examination
Ante's law
Brushing
Bleeding on probing
Chlorhexidine gluconate
Flossing
Hydrogen peroxide
Mouthwash
Oral hygiene
Tetracycline
Triclosan
Host modulatory therapy
Treatment
Conventional therapy
Debridement
Scaling and root planing
Full mouth disinfection
Full mouth ultrasonic debridement
Surgery
Apically positioned flap
Bone graft
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Crown lengthening
Open flap debridement
Gingival graft
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Guided bone regeneration
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Tools
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Probe
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Frank Beube
Per-Ingvar Brånemark
Robert Gottsegen
Gary Greenstein
Jan Lindhe
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Willoughby D. Miller
Carl E. Misch
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Jay Seibert
Jørgen Slots
Paul Roscoe Stillman
Dennis P. Tarnow
Hom-Lay Wang
James Leon Williams
W. J. Younger
Other specialties
Endodontology
Orthodontology
Prosthodontology
[show]
v
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e
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Benign: Basal cell adenoma
Canalicular adenoma
Ductal papilloma
Monomorphic adenoma
Myoepithelioma
Oncocytoma
Papillary cystadenoma lymphomatosum
Pleomorphic adenoma
Sebaceous adenoma
Malignant: Acinic cell carcinoma
Adenocarcinoma
Adenoid cystic carcinoma
Carcinoma ex pleomorphic adenoma
Lymphoma
Mucoepidermoid carcinoma
Sclerosing polycystic adenosis
Sialadenitis
Parotitis
Chronic sclerosing sialadenitis
Sialectasis
Sialocele
Sialodochitis
Sialosis
Sialolithiasis
Sjögren's syndrome
[show]
Orofacial soft tissues – Soft tissues around the mouth
Actinomycosis
Angioedema
Basal cell carcinoma
Cutaneous sinus of dental origin
Cystic hygroma
Gnathophyma
Ludwig's angina
Macrostomia
Melkersson–Rosenthal syndrome
Microstomia
Noma
Oral Crohn's disease
Orofacial granulomatosis
Perioral dermatitis
Pyostomatitis vegetans
[show]
Other
Eagle syndrome
Hemifacial hypertrophy
Facial hemiatrophy
Oral manifestations of systemic disease
[show]
v
t
e
Inflammation
Acute
Plasma-derived mediators
Bradykinin
complement
C3
C5a
MAC
coagulation
Factor XII
Plasmin
Thrombin
Cell-derived mediators
preformed:
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biogenic amines
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Serotonin
synthesized on demand:
cytokines
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IL-8
TNF-α
IL-1
eicosanoids
Leukotriene B4
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Nitric oxide
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Epithelioid cell
Giant cell
Granuloma
Processes
Traditional
Rubor
Calor
Tumor
Dolor
Functio laesa
Modern
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Vasodilation
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Exudate
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Chemotaxis
Specific
locations
Nervous
CNS
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Myelitis
Meningitis
Arachnoiditis
PNS
Neuritis
eye
Dacryoadenitis
Scleritis
Episcleritis
Keratitis
chorioretinitis
Retinitis
Chorioretinitis
Blepharitis
Conjunctivitis
Uveitis
ear
Otitis externa
Otitis media
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Mastoiditis
Cardiovascular
Carditis
Endocarditis
Myocarditis
Pericarditis
Vasculitis
Arteritis
Phlebitis
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upper
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Rhinitis
Pharyngitis
Laryngitis
lower
Tracheitis
Bronchitis
Bronchiolitis
Pneumonitis
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Digestive
mouth
Stomatitis
Gingivitis
Gingivostomatitis
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Tonsillitis
Sialadenitis/Parotitis
Cheilitis
Pulpitis
Gnathitis
tract
Esophagitis
Gastritis
Gastroenteritis
Enteritis
Colitis
Enterocolitis
Duodenitis
Ileitis
Caecitis
Appendicitis
Proctitis
accessory
Hepatitis
Ascending cholangitis
Cholecystitis
Pancreatitis
Peritonitis
Integumentary
Dermatitis
Folliculitis
Cellulitis
Hidradenitis
Musculoskeletal
Arthritis
Dermatomyositis
soft tissue
Myositis
Synovitis/Tenosynovitis
Bursitis
Enthesitis
Fasciitis
Capsulitis
Epicondylitis
Tendinitis
Panniculitis
Osteochondritis: Osteitis/Osteomyelitis
Spondylitis
Periostitis
Chondritis
Urinary
Nephritis
Glomerulonephritis
Pyelonephritis
Ureteritis
Cystitis
Urethritis
Reproductive
female
Oophoritis
Salpingitis
Endometritis
Parametritis
Cervicitis
Vaginitis
Vulvitis
Mastitis
male
Orchitis
Epididymitis
Prostatitis
Seminal vesiculitis
Balanitis
Posthitis
Balanoposthitis
pregnancy/newborn
Chorioamnionitis
Funisitis
Omphalitis
Endocrine
Insulitis
Hypophysitis
Thyroiditis
Parathyroiditis
Adrenalitis
Lymphatic
Lymphangitis
Lymphadenitis
Retrieved from "https://en.wikipedia.org/w/index.php?title=Gingivitis&oldid=819892346"
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values: التهاب اللثة – Arabic

values: Гингивит – Bulgarian

values: ހިރުގަނޑު ދުޅަވުން – Divehi

values: Ουλίτιδα – Greek

values: التهاب لثه – Persian

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Gingivite – French
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values: Լնդաբորբ – Armenian

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Jenjivito – Ido
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Gengivite – Italian
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values: דלקת חניכיים – Hebrew

values: გინგივიტი – Georgian

values: Гингивит – Kazakh

values: Бүйлөнүн сезгениши – Kyrgyz

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https://no.wikipedia.org/wiki/Gingivitt
Gingivitt – Norwegian
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no
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https://uz.wikipedia.org/wiki/Gingivit
Gingivit – Uzbek
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Gengivite – Portuguese
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values: Гингивит – Russian

values: Гингивитис – Serbian

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Gingivit – Swedish
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values: ஈறு அழற்சி – Tamil

values: Гінгівіт – Ukrainian

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