Acute inflammation of the gums. Symptoms of Acute and Chronic Gingivitis, Treatment and Prevention of Gum Disease in Adults

Gingivitis is an inflammation of the gum surface. The disease can occur in both acute and chronic forms. And most often it is acute gingivitis that is diagnosed, since it is quite easy to miss the onset of the disease.

Inflammation in an acute format is most often formed in people under 30 years of age and in childhood. Among the many pathologies of periodontal disease (these are the soft tissues surrounding the teeth), it is gingivitis that is diagnosed in almost 90% of all cases of seeking help. Especially often, acute gingivitis, in the absence of adequate therapy, turns into another disease - acute periodontal disease.

The reasons for the development of pathology

The most common reason for the onset of an acute illness is insufficiently thorough oral hygiene and, accordingly, incorrectly performed procedures for caring for the surface of the teeth.

The result is the formation of plaque, which becomes denser over time and eventually hardens to form tartar. Since dental plaque contains a huge number of pathogenic microbes, tartar is the same microorganisms, but tightly adhering to the surface of the teeth.

Among the general causes that can also cause acute gingivitis, the following chronic diseases can be distinguished:

Gingivitis is especially often a complication of diseases such as:

• rheumatism;
• deviations in blood sugar indicators;
• diseases of the gallbladder and liver;
• nephropathy and others.

In addition to obvious reasons, there are also predisposing factors that can provoke the development of the disease:

• wrong bite;
• mechanical injury to the gums;
• food particles left between the teeth;
• poor quality fillings;
• hormonal disbalance;
• decreased immune defense;
• smoking and abuse of alcoholic beverages;
• taking oral contraceptives.

Pathogenesis of acute gingivitis

What happens when the disease develops? With this disease, the area of \u200b\u200bthe gingival junction remains without disturbances. But at the same time, there is a strong swelling of the interdental papillae, which creates the effect of deepening the gingival sulcus.

Symptoms of acute pathology

Clinically acute gingivitis presents with typical signs of inflammation:

• swelling of the gums;
• hyperemicity of their surface;
• there is an increase in local temperature (in the mouth);
• pain syndrome;
• bleeding of the gingival surface;
• characteristic ulceration is sometimes observed;
• the formation of false peridontal pockets is possible;
• massive deposits of tartar are visible.

The general condition, as a rule, remains unchanged. Depending on the subtype of pathology, the location of the inflammation is also different:

• with papillary gingivitis, the interdental gingival papillae are affected;
• with a marginal form, inflammation affects the edge of the gums;
• simultaneous damage to the edge, papillae and the place of attachment of the gums to the tooth indicates the development of diffuse gingivitis.

Advice! Visually, with an acute form of the disease, the surface of the gums acquires a shiny bright red color. It becomes edematous and bleeds with almost every touch.

Forms of acute gingivitis

Depending on the location of the inflammation, the following types are distinguished:

According to the severity of the course, there are:

• light form;
• moderate severity;
• severe course of the disease.

There is also a division in form and gingivitis in an acute form can proceed as:

• catarrhal;
• ulcerative;
• hypertrophic.

Catarrhal acute form

In this case, of the main symptoms of the disease, only:

Acute ulcerative gingivitis

The following symptoms are typical for the disease:

• severe pain syndrome;
• death (necrosis) of the interdental gingival papillae;
• swollen lymph nodes.

In the absence of adequate therapy, craters are formed, at the base of which the gum bone is visible. Later, the disease becomes more severe. And the gloomiest prognosis is a fatal outcome.

Hypertrophic gingivitis

The condition is accompanied by a significant increase in the size of the gums. The person experiences severe pain and bleeding is observed at the slightest touch to the inflamed surface.

Diagnostics of the acute form of pathology

For the diagnosis of acute gingivitis, a visual examination is often sufficient:

• microbial plaque is observed on the surface of the teeth (both soft and already hard tartar);
• quite often signs of inflammation are combined with the initial form of caries;
• there are clinical symptoms of gum inflammation and its deformation;
• when probing, bleeding of the gums is observed.

With a severe course of the disease, general signs of intoxication of the body may appear.

Acute gingivitis treatment

Treatment of the disease is carried out depending on the reasons that provoked its onset, and the form of pathology.

With hormonal imbalance

Quite often, acute gingivitis develops during puberty, as well as during pregnancy and with the onset of menopause. Here, the cause of inflammation is exclusively hormonal changes and the appointment of specific treatment is not required.

The therapy includes:

• daily oral hygiene;
• sanitation of sore gums (rinsing) with a soda solution;
• taking vitamin complexes;
• removal of dental calculus by professional methods (mechanical method or the use of a laser);

Sanitary and hygienic treatment of the gum surface is recommended after removing tartar.

With a weakened immune defense

Therapy in this case is aimed at increasing immunity:

• administration of immunomodulatory agents is prescribed (a special category of medicines that enhance the phagocytic activity of the body);
• antibiotics are prescribed for admission (as prevention of a secondary infection);
• professional teeth cleaning is prescribed;
• sanitation with antiseptics (solutions of chlorhexidine, hydrogen peroxide, baking soda can be used here);

In addition, the intake of fortifying agents is prescribed (vitamin complexes, tincture of eleutherococcus and others). Sometimes the acute form of the disease occurs against the background of a healthy state of the teeth and the body as a whole. And only during a thorough examination can the causes of the disease be discovered:

• protruding seals;
• improper tooth growth;
• incorrectly performed prosthetics.

Treatment of pathology in this case involves the following steps:

• correction of the filling (if this is not possible, then a new one is installed);
• procedures are prescribed to correct abnormally growing teeth;
• correction of prostheses is carried out.

Advice! Sometimes the reason for the formation of acute gingivitis is the appearance of a "wisdom tooth". To facilitate teething, surgery may be prescribed to open the gums.

Additionally, it is prescribed to take fortifying drugs, vitamin complexes, daily sanitation of the oral cavity. This is especially important if orthodontic or surgical intervention has been performed.

As a complication of a common disease

It is systemic diseases that often cause the development of acute gingivitis. Sometimes the disease is a reaction to taking antibacterial drugs. This is explained by the fact that with prolonged use of antibiotics, the normal balance of microflora in the oral cavity is disturbed, which significantly increases the risk of infection.

Treatment in this case is carried out as follows:

• since in this case, acute gingivitis is a secondary infection, it is the underlying disease that must be treated;
• taking drugs that increase the body's immune defenses are prescribed;
• taking lactobacilli that restore the beneficial microflora of the oral cavity;
• sanitation of the mouth with antiseptics;
• taking vitamin complexes.

Advice! Acute gingivitis should be treated under medical supervision.

Acute infectious gingivitis

For acute gingivitis caused by a gum infection, it is necessary to identify the infectious agent. But in general, the treatment involves the following scheme:

Surgical treatment of acute gingivitis

Sometimes the pathology requires surgical treatment. In this case, the following methods can be used:

• Closed curettage. This is a procedure for removing calculus with hooks, curettes and specialized excavators.
• Open curettage. If it is not possible to remove tartar due to the fact that the deposits are located deep in the periodontal pocket due to severe gum swelling, an incision is made on the gum surface. This removes the tartar.

Prevention of acute gingivitis

Preventive measures are quite simple and if you follow the simplest rules, then the risk of developing pathology is significantly reduced. It is necessary to regularly visit the dentist's office, daily clean the surface of the teeth and carry out their professional cleaning at least twice a year.

Gingivitis(lat.Gingivitis) - inflammation of the gums. Gingivitis - the most common periodontal disease, occurs mainly in children, adolescents and people under 30 years of age.

What provokes Acute gingivitis:

Of general reasonsit should be noted a change in the reactivity (nonspecific resistance) of the body due to dysfunction of the endocrine, cardiovascular, circulatory systems, damage to various tissues and dysfunction of the gastrointestinal tract, hypovitaminosis, allergic, infectious diseases.

More often than others, gingivitis is caused by tartar, dental plaque, smoking, chemical irritation, and infection. Infectious gingivitis is the most relevant for children and adults. In children, they most often occur in the absence of proper hygiene. The fact is that the local immune defense is only being formed up to 7 years of age, and its formation ends completely only by the beginning of puberty, therefore, even in the absence of chronic inflammatory foci, the risk of developing gingivitis in children is higher. It is even higher in children with a focus of infection in the form of caries. It is the many untreated carious teeth that are a common cause of gingivitis.

Gingivitis is also common in children suffering from rheumatism, tuberculosis, diabetes mellitus, liver and gallbladder diseases, nephropathies, etc.
Violations in the body of a general nature are supported and aggravated by unfavorable local factors: poor oral hygiene and the accumulation of microflora in it, the formation of dental plaque, tartar, anomalies and deformations of the dentition, mechanical damage, chemical, radiation damage, etc. Local traumatic factors can be the immediate cause of gingivitis.
Inflammation in the gumsare evaluated according to the following signs: hyperemia, swelling, bleeding, ulceration, hypertrophy, localized or generalized nature of the lesion, acute or chronic course. Local causes of a limited lesion of 1-2 interdental papillae are dental deposits, carious cavities on contact surfaces, filling defects, filling errors, a movable temporary tooth, which, with the sharp edges of a partially resorbed root, injures the adjacent mucous membrane, causing inflammation of the gums in a limited area. The disease is diagnosed as papillitis (localized gingivitis).

Pathogenesis (what happens?) During Acute gingivitis:

By the nature of the changes, the following forms of gingivitis are distinguished: catarrhal, ulcerative, hypertrophic. According to the degree of involvement of parts of the gums in the inflammatory process, they are distinguished: light, when only the interdental gum (papilla) is affected, and severe, when not only the papilla is affected, but also the marginal and alveolar parts of the gums.

With gingivitis, the integrity of the tooth-gingival junction is not disturbed, however, due to the swelling of the interdental papillae, an increase in their volume, an apparent deepening of the gingival groove is created.

In a localized process, gum inflammation is defined in the area of \u200b\u200ba group of teeth. It is typical for a generalized process; the spread of inflammation to the mucous membrane of the alveolar process in the area of \u200b\u200ball teeth of the upper jaw and the alveolar part of all teeth of the lower jaw. In other cases, the disease is limited to one jaw (more often the lower one), and the inflammation of the gums proceeds with a predominance of the exudative component.

Symptoms of Acute Gingivitis:

Clinic for acute gingivitisgives the classic signs of inflammation: swelling, redness, local increase in gum temperature, soreness, disruption of the normal function of the gums. Against this background, bleeding of the gums and even ulceration are observed.

The general condition, with rare exceptions, is not disturbed. On examination, inflammation of the gum tissue is determined, which spreads either to the interdental gingival papillae (papillary gingivitis) or to the marginal gum (marginal gingivitis). The papillae, margin, and attached gums (diffuse gingivitis) may be affected. The intensity of inflammation varies from insignificant to pronounced. False periodontal pockets can occur due to swelling of the gums. The presence of deposits in the form of tartar or plaque is noted. In the acute form, the surface of the gums is smooth, shiny, bright red, edematous, bleeds easily during probing.

Distinguish:
Acute gingivitis due to dental plaque
This group of gingivitis includes forms that can be caused by: microbial infections, systemic factors, drug, mechanical, thermal and chemical damage.

Gingivitis simplex acuta (simple acute gingivitis)
Acute simple gingivitis is a form of gingivitis accompanied by the classic acute inflammatory response in response to physical and microbial damage.

Acute necrotizing ulcerative gingivitis
Also called Gingivitis acuta ulcerosa necroticans, it is characterized by pain, papillae necrosis and lymph node reactions. Progressive stages are characterized by the formation of craters with an open bone of the alveolar process. If untreated, this disease can go - through necrotizing ulcerative gingivo-periodontitis - into ulcerative stomatitis, and then, in the form of Cancer oris or Noma, lead to death. If the disease is not stopped in time, an irreversible process of tissue loss occurs.

Gingivitis specifica acuta (acute specific gingivitis)
Acute specific gingivitis includes specific infectious diseases of the gums as a result of exposure to tuberculosis bacteria, Candida albicans, Actinomyces israelii, Treponema pallidum.

Acute viral gingivitis
Gingivitis is caused by herpes simplex viruses, as well as Herpes zoster and cytomegaly.

Gingival abscess
Gingival abscess is an acute condition of the upper gums
and leads to purulent fusion of the interdental papillae and gingival tissue with the appearance of severe pain.

Complications and outcomes. Acute local gingivitis, if the cause that caused it is eliminated, may result in recovery. Acute generalized gingivitis with the elimination of the disease, a complication of which it is, also usually disappears. Chronic catarrhal, ulcerative and hypertrophic gingivitis are often the precursor to periodontitis.

Diagnostics of the acute gingivitis:

For gingivitis, regardless of the clinical and morphological form, the following are characteristic differential diagnostic signs:
- the disease is detected mainly in children and young people;
- the presence of non-mineralized dental deposits (microbial plaque, soft plaque, food debris) and supragingival tartar;
direct relationship between the indicators of the hygiene index and the severity of gingivitis;
- a frequent combination of gingivitis with focal demineralization (caries in the stage of spots in the cervical region);
- the presence of certain clinical and morphological manifestations of inflammation in the gum and its deformation;
- bleeding when probing in the gums, the absence of a gingival pocket;
- no destruction of interdental septa;
- the general condition of patients is not disturbed, with the exception of acute or exacerbated chronic catarrhal and ulcerative gingivitis, in which intoxication of the body is observed, depending on the severity and prevalence of the disease.

Treatment for Acute Gingivitis:

Acute gingivitis treatment- this is, first of all, the elimination of the reasons that caused it. Treatment of teeth and dentition is carried out. General treatment includes the treatment of chronic diseases of the gastrointestinal tract and the endocrine system, as well as strengthening the protective properties of the body.

In the course of treatment, plaque and tartar are necessarily removed, especially the internal one, located between the tooth and the gum. Then the gums are treated with medication to relieve inflammation. The drugs used have an analgesic, antibacterial, anti-inflammatory and tissue regeneration stimulating effect. These drugs are used topically in the form of irrigations, applications, oral baths, etc.

Prevention of Acute Gingivitis:

For the prevention of gingivitis, the following simple rules must be followed:

Get regular checkups with your dentist.
- Remove dental plaque daily with toothpaste and silk floss.
- Brush your teeth at the dentist every 3-6 months.

Description:

Acute is an inflammatory disease of the gums that often occurs in young people under 30 and in children. Among all periodontal diseases (soft tissues around the teeth), more than 90% of the total population suffers from gingivitis. A complication of gingivitis without proper treatment becomes acute, or chronic, and in which healthy teeth fall out.

Causes of acute gingivitis:

One of the most common causes of gingivitis is inadequate oral hygiene and inappropriate dental care. As a result of this, plaque is first formed on the teeth, which over time turns into dense deposits or stones. Dental calculus is nothing more than microorganisms that adhere tightly to the teeth, also called dental plaque.

In addition, the following causes of gingivitis and predisposing factors that can cause the disease are distinguished:
Malocclusion.
Mechanical trauma and the presence of herpetic, candidal stomatitis on the tongue.
Leftover food between teeth.
Leaking fillings on the teeth.
Hormonal imbalance in the body.
Chronic diseases.
Reduced immunity.
Avitaminosis.
Stress and psychosomatic illness.
Allergic diseases.
Bad habits.
Taking oral contraceptives.
The presence of heavy metal salts in food.

Symptoms of acute gingivitis:

Acute gingivitis is characterized by the following symptoms:
Inflammation of the gums.
Redness and tenderness of the soft tissues around the teeth.
Swelling and deepening of the gingival sulcus (gingival pocket formation). (especially when brushing your teeth).
Increased sensitivity of the gums.
Difficulty in the act of chewing and swallowing.

If you find yourself experiencing symptoms of gingivitis, immediately seek the advice of your dentist, whose task is to establish the causes, form of the disease and prescribe appropriate treatment.

With this disease, & nbsp & nbsp is also characterized by the presence of & nbsp & nbsp - red, inflamed, edematous gums, when pressed on which blood and pus can be released.

Treatment for acute gingivitis:

For treatment are prescribed:

The mistake of many patients is that they begin to heal themselves by visiting dental forums, which, in the end, can lead to a chronic process and irreversible consequences.

Treatment of gingivitis begins with the elimination of all the causes and factors that caused the disease. In most cases, the oral cavity is sanitized, especially in children. These measures include treatment, cleaning teeth from plaque (plaque and stones), replacing filling material.

In addition to local procedures, it is necessary to sanitize chronic foci of infection in the body and take a number of measures that increase overall immunity. For this, antibiotics are used (read in detail about the treatment of gingivitis with antibiotics), antifungal agents, as well as immunomodulators and antioxidants. As for the treatment of ginigvitis in pregnant women, it has some peculiarities. Treatment of gingivitis at home, or folk remedies is possible after consultation with your doctor.

Content

According to statistics, about 70% of Russians suffer from bleeding gums. This is the main symptom of a dental disease - gingivitis. The problem is more common in children under 7 years of age and pregnant women. A balanced diet and properly selected oral care products help to avoid the disease.

What is gingivitis

The mucous membrane of the gums contains a large number of nerve endings and blood vessels. When exposed to irritants, damage, trauma, pain and bleeding occur.

Inflammation of the lining of the gums is called gingivitis.

The disease is characterized by swelling, bad breath. In the photo, soft tissues appear reddened, and white or gray plaque is observed around the tooth. Microbes provoke inflammation. They release toxins and enzymes that irritate the oral mucosa.

Why is gum disease dangerous?

The long-term influence of microorganisms on the soft tissues of the mouth leads to the chronicity of the inflammatory process. Against the background of prolonged gingivitis, the following complications are possible:

• periodontitis;
• loss of a tooth;
• erosion of soft tissues;
• stomatitis;
• sepsis;
• glossitis;
• the formation of foci of necrosis;
• infection of the roots of the teeth and jaw bones;
• development of hematogenous infections - glomerulonephritis, endocarditis.

Classification of pathology

Depending on the duration of the course, such forms of gingivitis are distinguished:

• Sharp.It is characterized by severe symptoms. After eliminating the cause of the inflammation, the gums are completely restored.
• Chronic. The clinical picture is erased. Irreversible changes form in the gums.

A subtype of chronic gingivitis is a hypertrophic form. It is characterized by abnormal proliferation of the mucous membrane and is divided into two subspecies:

• Edematous. Blood circulation in the gums increases, they increase in size. The process is considered to be partially reversible. With proper treatment, tissue growth can be halted.
• Fibrous.Part of the mucous membrane is replaced by connective tissue. Pathological changes are irreversible.

By the number of foci of inflammation, the disease is:

• Local- the mucous membrane is injured near one or two teeth.
• Generalized- the entire jaw is damaged.

According to the form of inflammation, the following types of gingivitis are distinguished:

• Catarrhal.Occurs in 95% of cases. Only the mucous membrane of the gums is damaged, the bone tissue remains intact.
• Atrophic. A rare form of the disease. Leads to a decrease in the volume (atrophy) of the gums. A common cause of occurrence is insufficient blood supply to soft tissues.
• Ulcerative necrotizing gingivitis.Consequence of an untreated catarrhal form. On the inner surface of the jaw, foci of necrosis and small ulcers are formed.

The following subspecies of the disease are classified separately:

• Juvenile- inflammation of the gums in adolescents 12-18 years old. Appears against the background of puberty, in the absence of adequate oral hygiene.
• Prepubertal. Appears in children 7-12 years old with reduced immunity, lack of vitamins.
• Herpetic. The inflammatory process is caused by the herpes virus.
• Gingivitis of pregnant women - associated with hormonal changes in the body.
• Desquamative - partial mucosal rejection. Ulcers appear on the gums, which burst and form ulcers. The etiology of the disease is unknown.

Signs of gingivitis

The chronic catarrhal form of the disease is characterized by redness and bleeding of the gums when brushing teeth or after eating solid foods.

Hypertrophic gingivitis causes soft tissue swelling.

In this case, the gums remain dense, but a false periodontal pocket is formed. Acute gingivitis occurs with a pronounced clinical picture. In addition to bleeding, the following symptoms are possible:

• hyperemia of the oral mucosa;
• fetid odor from the mouth;
• plaque on the tongue and palate;
• increased body temperature;
• weakness;
• loss of appetite;
• metallic taste;
• the presence of ulcers, abscesses in the mouth.

In adults

The intensity of symptoms depends on the degree of development of the disease:

• With a mild form, the changes are invisible: there is no hyperemia, the gums bleed a little.
• If gingivitis is moderate, red gums swell, painful sensations appear after brushing teeth, reaction to cold or hot food. My mouth smells unpleasant.
• The severe form is characterized by an increase in all symptoms. Other parts of the oral cavity are involved in the pathological process: bubbles or ulcers are visible on the inside of the cheeks and lips, the palate is covered with a green-gray coating. Gums hurt and bleed when touched.

In children

Pathology at an early age occurs against the background of teething, and in puberty due to insufficient oral hygiene.

Symptoms in adolescents are similar to those in adults.

In children under 3 years of age, the following signs are additionally present:

• increased body temperature (up to 37-37.5 ° C);
• tearfulness;
• refusal to eat;
• poor sleep;
• the appearance of pink saliva;
• fetid odor from the mouth.

Why are the gums inflamed?

In adolescents, gingivitis of a bacterial nature is more common. Low immunity, viral infections, and a lack of vitamins contribute to the development of the disease.

Inflammation of the gums is possible against the background of puberty, allergies, orthodontic appliances to straighten the teeth.

In adults, the reasons are external and internal. The first group includes:

• violation of oral hygiene;
• advanced caries;
• tartar;
• rejection of implants;
• improper nutrition;
• smoking;
• alcohol abuse;
• violation of nasal breathing, snoring.

Internal predisposing factors for gingivitis include:

• allergic reactions;
• diabetes;
• mental or nervous disorders;
• malocclusion or other jaw abnormalities;
• bacteria - staphylococcus, E. coli, streptococcus;
• taking medications (steroids, oral contraceptives, anticonvulsants);
• pregnancy;
• diseases of the thyroid gland;
• metabolic disease;
• immunodeficiencies (HIV, AIDS);
• diseases of the digestive tract - reflux, gastritis, ulcers.

Diagnostics

Inflammation of the gums is detected by examining the oral cavity. To identify an infected area of \u200b\u200bthe oral mucosa, the dentist conducts a specific analysis - the Schiller-Pisarev test.

The patient's gums are stained with iodine solution. With inflammation, soft tissues acquire a light brown or brown tint.

A swab of plaque for microbiological examination is taken for chronic or recurrent gingivitis. The analysis helps to identify the pathogen and select an antibiotic. With generalized forms, additional studies are prescribed:

• General blood analysis. Reveals the number of platelets, the erythrocyte sedimentation rate, assesses the general state of the body.
• Dental X-ray. It is prescribed for the detection of sepsis, the detection of growths, damage to the bones and roots of the teeth.
• Fluorography to exclude tuberculosis.
• Ultrasound examination of the abdominal organs. It is carried out if there is a suspicion of diseases of the digestive tract, thyroid gland.
• Immunogram. It is carried out to assess the state of the immune system.
• Blood for sugar, HIV. It is prescribed to confirm or exclude immunodeficiency states and diabetes mellitus.

Gingivitis treatment

Mild gum inflammation is treated with local remedies - gels, rinses, ointments.

Fibrous gingivitis is removed by excision of the protruding soft tissue.

After the operation, antibiotics, anti-inflammatory and antiseptic agents are prescribed. The set of mandatory measures includes:

• Prevention of gingivitis - teaching the patient to properly brush teeth, use a floss.
• Anti-inflammatory, antibacterial therapy. The patient is prescribed medications to relieve inflammation, treat a bacterial or viral infection.
• Dental treatment includes dental filling, dental calculus removal, replacement of dentures.
• Physiotherapy- massage of the gums, electrophoresis (for quick delivery of the medicine to the deep layers of tissues)

Drug therapy

Doctors prescribe antibiotics for gingivitis when a bacterial infection and ulcerative necrotic lesions are detected. Preference is given to such groups of drugs:

• fluoroquinolones - Ciprofloxacin;
• tetracyclines - Doxycycline;
• penicillins - Amoxicillin;
• lincosamides - Clindamycin.

To maintain immunity, immunostimulating tablets are prescribed ( Cycloferon, Wobenzym) and vitamins ( AlfaVit, Multi-tabs). With the development of stomatitis and for the treatment of generalized forms of gum inflammation, antifungal and antiviral agents are prescribed - Anti-angina, Hexalysis, Imudon.

For local treatment, use:

• Antiseptics - Miramistin, Furacilin.The drugs kill the pathogenic flora. They are prescribed for the prevention and treatment of suppuration.
• Antimicrobial, wound healing agents - Metrogyl Denta, Solcoseryl. Gels are used to treat acute or chronic gingivitis, juvenile periodontitis. They relieve inflammation, reduce bleeding, and heal wounds.
• Pain relievers - Novocaine, Lidocaine. Prescribed to relieve pain.
• Herbal preparations - sea buckthorn and tea tree oils. They have anti-inflammatory and antiseptic effects, promote wound healing.

Dental procedures

To reduce bleeding gums and eliminate the cause of gingivitis, the dentist performs the following procedures:

• Professional teeth cleaning- Removal of dental plaque and plaque, polishing the tooth surface, fluoridation and application with calcium.
• Stone removal- laser, ultrasound, mechanical means. The dentist cleans the surface of the tooth from hardened plaque.
• Restoration of enamel. Special solutions with calcium and fluoride are applied to the tooth surface.
• Caries treatment. The damaged dentin is drilled out, treated with an antiseptic, sealed and polished.
• Replacement of prostheses or implants.
• Surgery - removal of a damaged tooth, resection of a part of the gum with the installation of drainage. The procedure is performed for ulcerative necrotic lesions, fibrous and edematous forms of gingivitis.
• Physiotherapy - electrophoresis with vitamins, darsonvalization (treatment of gums with high-frequency current), ultraviolet irradiation of the gums. They are prescribed for chronic inflammation.

How to treat gum disease at home

To get rid of gingivitis, it is important to follow the rules of hygiene - brush your teeth 2 times a day, use threads after meals. Eliminate plaque with water pressure and at the same time massage the gums with irrigators.

To reduce the risk of injury to the oral mucosa, exclude solid foods, cold or hot foods, and hot spices from the diet.

To strengthen the gums, get rid of vitamin deficiency and normalize the microflora of the oral mucosa, add the following foods to the diet:

• fresh fruits, vegetables;
• boiled meat, poultry, fish;
• vegetable soups;
• black tea;
• rosehip broth;
• dairy products - cottage cheese, milk, yogurt, sour cream.

Correct teeth brushing technique

1. Dampen your toothbrush with water.
2. Apply a pea-sized toothpaste to the bristles.
3. Use a circular motion to remove plaque from the outer surfaces of the teeth.
4. Brush the inside and top of your teeth in the same way.
5. Rinse out any remaining paste from your mouth.
6. Brush your teeth for 2-3 minutes.

Folk remedies for gingivitis

Herbs are used as additional remedies. They are brewed in boiling water (in the ratio of 2 tablespoons of raw materials per 500 ml of water) and used to rinse the mouth 2 times a day. To relieve inflammation, reduce bleeding of the gums, help:

• oak bark;
• calamus root;
• oregano;
• sage;
• chamomile;
Gingivitis - Definition, Causes, Symptoms

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment, based on the individual characteristics of a particular patient.

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From this article you will learn:

• what causes gingivitis,
• what are the forms of this disease,
• gingivitis in adults - symptoms and treatment at the dentist and at home.

The article was written by a dentist with over 19 years of experience.

Gingivitis is inflammation of the margins of the gums adjacent to the teeth, including the interdental papillae (Figure 1-2). In this disease, patients most often complain of bleeding gums, pain when brushing teeth, as well as swelling, redness or cyanosis of the gums. Gingivitis with a predominance of such symptoms in dentists is usually called the term "catarrhal".

However, in a small percentage of cases, inflammation can also manifest itself as an overgrowth of the gums, or even ulceration and necrosis. The most important feature that distinguishes gingivitis from other inflammatory gum diseases is that the inflammation does not spread deeper than the gum mucosa. Accordingly, with gingivitis, there is no destruction of the bone tissue around the teeth, the mobility of the teeth, i.e. symptoms characteristic of.

If you have mobility of some teeth, as well as periodontal pockets, from which pus can be released during periods of exacerbation, such symptoms no longer indicate gingivitis, but the presence of periodontitis (a more severe form of gum disease). You can read more about this disease at the link above. We only note that in most cases, its development is a consequence of not timely and / or ineffective treatment of gingivitis.

The main forms of gingivitis –

• catarrhal gingivitis (Fig. 1-8),
• ulcerative necrotizing gingivitis (Fig. 12-15),
• hypertrophic gingivitis (fig. 16-18).

1. Catarrhal gingivitis: symptoms

Among all patients with gingivitis, this form accounts for more than 97% of cases. Those. this is the most common form of the disease. The term "catarrhal" means that the inflammation captures only the mucous membrane of the gums (ie proceeds superficially), without affecting the bone tissue around the teeth and the gingival attachment. In Figure 3-5 you can see exactly what catarrhal gingivitis looks like in the mouth.

Cause of occurrence –
This is an extremely poor oral hygiene, as a result of which soft microbial plaque accumulates in the area of \u200b\u200bthe necks of the teeth, as well as the formation of tartar. Plaque bacteria release toxins and pathogens, which trigger inflammation in the gum mucosa. At the same time, various chronic diseases or vitamin C hypovitaminosis are not the direct causes of the development of gingivitis, but can be a predisposing factor that enhances the effect of microbial plaque.

Catarrhal gingivitis: photo

Symptoms –

• swelling of the gingival margin and interdental papillae,
• redness or cyanosis of the gums,
• bleeding gums when brushing teeth,
• soreness when brushing your teeth
• itchy gums
• usually, accumulations of microbial plaque are visible at the necks of the teeth.

The appearance of bleeding is associated with an increase in the permeability of the walls of the capillaries, fragility of the capillaries, a decrease in the thickness of the epithelium of the mucous membrane of the gums. All this arises as a result of the influence of toxins and pathogens of microbial plaque on the mucous membrane of the gums. Most often, bleeding occurs at the time of exposure to mechanical factors (traumatizing weakened gums), for example, when brushing your teeth or chewing rough, tough food.

Soreness when brushing your teeth also occurs due to thinning of the epithelium of the gingival mucosa. Thinning of the epithelium against the background of gum inflammation is a natural process, and develops due to an increase in the rate of desquamation of epithelial cells (site).

Forms of catarrhal gingivitis –

There are 2 variants of the course of the catarrhal form of gingivitis. Firstly, it is acute catarrhal gingivitis (Fig. 3-4), which is characterized by a bright red color of the gums, acute development, and sometimes significant bleeding and pain when brushing teeth. In this form of the disease, due to pain when brushing teeth, patients sometimes refuse to hygiene at all, which leads to an even greater increase in the amount of microbial plaque, and as a result, further exacerbates the situation.

Secondly, the chronic form of the disease (Fig. 5-6), which is characterized by sluggish symptoms for a long period of time. In this case, catarrhal gingivitis, the symptoms of bleeding will be quite insignificant, and there will be no pain during cleaning. The marginal gingiva and gingival papillae will have a bluish color. However, an exacerbation of symptoms may periodically occur, which usually happens against the background of a drop in immunity during the period of colds.

Home treatment for gingivitis -

Treatment for catarrhal gingivitis will be quick and effective if 3 conditions are met. First of all, treatment should first of all be aimed at removing soft microbial plaque and hard dental calculus, as the causes of the development of inflammation. Secondly, anti-inflammatory therapy, which may include various rinses and special gels for the gums. The third point is the normalization of oral hygiene.

The course of anti-inflammatory therapy can be carried out without problems at home, but microbial plaque and tartar can be removed from the surface of the teeth only by visiting the dentist. The fact is that only "freshly formed" soft microbial plaque can be removed well with the help of an ordinary toothbrush and paste. And the problem is that, in the absence of regular hygiene, the soft microbial plaque in the oral cavity quickly enough undergoes mineralization with calcium and phosphorus salts contained in saliva.

After partial mineralization of the soft microbial plaque, which occurs on average within 10-16 hours, it hardens and becomes tightly attached to the tooth. This is how hard dental deposits are gradually formed (Fig. 7-8), which can no longer be removed by simply brushing your teeth with a brush and paste. If you start using antiseptic and anti-inflammatory drugs for the gums without removing the dental deposits that caused the inflammation of the gums, the effect of the treatment will be short-lived, and the inflammation itself will become chronic.

How hard dental plaque looks like -

Findings: Please note that dental deposits can be not only clearly visible supragingival (as in Fig. 7-8), but also subgingival, which are located slightly below the level of the gums. Usually, such deposits can be suspected in the presence of cyanosis and bleeding of the gums - with a visible absence of plaque or dental deposits in the area of \u200b\u200bthe necks of the teeth (Fig. 5). Subgingival calculus can only be identified and removed with dental instruments.

DETAILED TREATMENT SCHEME -

As we said above, the treatment of gingivitis consists of professional dental cleaning at the dentist, a course of anti-inflammatory therapy, and, no less important, teaching the patient proper oral hygiene (including the use of dental floss).

1) Removal of dental plaque -

There are several methods for removing dental plaque, but given that with gingivitis the gum is inflamed and usually bleeds, it is best to use it (Fig. 9). A special nozzle creates ultrasonic vibrations and breaks the attachment of dental plaque to the surface of the tooth enamel. The procedure usually takes 30 to 60 minutes (depending on the amount of plaque). The procedure is usually painless, but if desired, it can be performed under anesthesia (the video of the procedure can be viewed at the link above).

Gingivitis: photos before and after treatment

Important: Notice how the bluish gums turned pink after the gingivitis treatment in Figure 10-11. The return of healthy gum color is primarily associated with the removal of dental plaque. Without this, even the most powerful anti-inflammatory drugs will not be able to completely normalize the condition of the gums, because the toxins and pathogens of microbial plaque and dental plaque will continue to affect the gums.

3) Normalization of oral hygiene -

Keep in mind that just curing gingivitis is not enough. It will reappear very soon if you do not start brushing your teeth correctly and regularly. In the absence of regular oral hygiene, plaque and calculus will re-form very quickly and cause new inflammation. Good hygiene includes not only the use of a toothbrush and toothpaste, but flossing as well. In order not to clutter up this article - we do not give detailed recommendations on hygiene here, but you can take them into service in our articles:

It is also worth noting that for the period of treatment for gingivitis, you may need a special soft toothbrush, as well as a healing paste. A soft toothbrush for gingivitis (labeled "Soft", ie "soft") - is necessary only if brushing your teeth causes you pain and desire to give up hygiene altogether. But dentists recommend using such a brush only for the period of treatment of gingivitis - no more than 2 weeks, because soft bristles are less effective at removing microbial plaque.

Examples of soft bristled toothbrushes –

If you do not use a special mouthwash, for example, Lacalut Active, which contains aluminum lactate to quickly reduce bleeding gums, then you can use a special anti-inflammatory toothpaste to clean your teeth. Lakalut, Parodontax, President, Asepta, Forest Balsam ... there are a lot of such pastes, and to make it easier for you to choose, we have compiled a special rating of such products:

2. Necrotizing ulcerative gingivitis of Vincent -

Such gingivitis has the official name "necrotizing ulcerative gingivitis of Vincent". Sometimes the terms are used - Vincent's gingivitis or ulcerative gingivitis. This is the most severe form of gingivitis, which is accompanied, among other things, by symptoms of body intoxication. There are acute and chronic forms of this disease (Fig. 12-15).

Causes of occurrence–
a significant role in development is played by critically poor oral hygiene, when there is a significant increase in the mass of microbial plaque on the teeth (especially fusobacteria and spirochetes). Under these conditions, the local immunity of the oral mucosa ceases to cope with the large amount of toxins released by pathogenic bacteria. As a result, there are foci of necrosis of the mucous membrane and its ulceration.

The triggering factor that triggers the development of necrotizing ulcerative gingivitis against the background of poor oral hygiene can be a sharp decrease in immunity or an exacerbation of severe concomitant chronic diseases of the body. But these factors are only predisposing, the main reason is poor hygiene and the accumulation of microbial plaque and / or tartar.

Acute ulcerative necrotizing gingivitis: photo

Chronic ulcerative necrotizing gingivitis: photo

Necrotizing ulcerative gingivitis: symptoms and treatment in adults
upon visual examination, it can be found that the gums are covered with a whitish or yellowish coating, there are areas of ulceration of the gums, some of the gingival papillae are necrotic. In the acute course of the disease, patients complain of high fever, loss of appetite, headaches, putrid breath, bleeding and pain in the gums (Fig. 12-13). In the chronic course of Vincent's gingivitis, the symptoms are less pronounced (Fig. 14-15).

How to cure ulcerative necrotizing gingivitis - treatment is carried out exclusively at the dentist, and urgently. The basis of treatment is the removal of dental plaque, including the mandatory scraping of necrotic plaque. Plaque along with dental plaque is well removed using a conventional ultrasonic tip (scaler), followed by removal of plaque residues with a curette spoon. Further, antibiotics, antiseptic rinses, anti-inflammatory drugs are prescribed.

• Antibiotic therapy –
  the prescribed antibiotics must be effective against fusobacteria and spirochetes, therefore, a combined preparation of amoxicillin and clavulanic acid "Amoxiclav" in tab. (for adults - tablets of 500 mg of amoxicillin + 125 mg of clavulanic acid, which are applied 3 times a day - during the first day of the disease, and 2 times a day for the next 6 days).

  In parallel with Amoxiclav, you need to take the antibiotic Trichopol (Metronidazole) - 500 mg 3 times a day, only 7 days. In parallel with this, you should use antiseptic rinses with a 0.2-0.25% chlorhexidine solution, as well as a gum gel - better, but if there is soreness of the gums, then Cholisal.

Important : the use of antibiotics and antiseptics at home (without removing deposits and necrotic plaque) leads to the transition of acute necrotizing gingivitis into a chronic form - with a gradual increasing necrosis of the gums, exposing the roots of the teeth, as well as constant intoxication of the body. Therefore, an urgent visit to the dentist is required. After the inflammation subsides, agents are prescribed that accelerate the epithelialization of the mucous membrane, for example.

3. Hypertrophic gingivitis -

Hypertrophic gingivitis is a chronic type of gum disease. With it, an increase in the volume of the gums is noted, which can occur either due to persistent chronic edema of the gums (which practically does not respond to anti-inflammatory therapy), or due to its fibrous growth. The hypertrophic form of gingivitis most often occurs only on the anterior surface of the dentition.

Causes of occurrence–
most often occurs with endocrine disorders, toxicosis of pregnant women (gingivitis of pregnant women), with hormonal changes in adolescents (juvenile gingivitis), as well as with malocclusion and in the presence of local traumatic factors - overhanging edges of fillings and crowns. In some cases, gingival hypertrophy is a consequence of long-term chronic catarrhal gingivitis.

Hypertrophic gingivitis - symptoms and treatment will depend on the form of the disease, i.e. from what exactly caused the increase in the gums (edema or its fibrous growth). In accordance with this, edematous and fibrous forms of hypertrophic gingivitis are distinguished.

• Edematous form (fig. 16-17) -
  gingival papillae with this form are enlarged not due to tissue proliferation, but due to their edema. Accordingly, they will not be dense, but loose. It is this form of gingivitis that most often develops in pregnant women and adolescents against the background of hormonal changes. At the beginning of treatment, it is necessary to remove dental plaque and anti-inflammatory therapy.

  If the effect of these measures is insignificant, then sclerotherapy is used, when, against the background of anesthesia, a sclerosing solution is injected into the edematous gingival papillae. Usually solutions of 40% glucose, 25% magnesium sulfate, 10% calcium chloride are used. Each papilla is injected with 0.1-0.2 ml of solution. The course is 3 or 4 injections into each gingival papilla. The intervals between the series of injections are usually 1-2 days. In the absence or insufficiency of the effect of such therapy, prednisolone is injected into the gingival papillae.

• Fibrous form(fig. 18,19) -
  the gingival papillae in this form are dense, and not loose as in the edematous form. This is due to the fact that the increase in gum volume was not due to edema, but due to the proliferation of fibrous connective tissue. Treatment begins with the elimination of traumatic factors (overhanging edges of fillings, crowns, as well as in the presence of a traumatic bite - carrying out selective grinding of teeth). In parallel, the removal of dental plaque is carried out.

  The main method of treatment for fibrous forms is surgical excision of the gum tissue (Fig. 19-21). After excision, a course of anti-inflammatory therapy is prescribed, for example, medical dressings with heparin ointment, hydrocortisone and other drugs. It should be noted that in the absence of treatment, a long-lasting edematous form of hypertrophic gingivitis can easily turn into fibrous.

Gingivitis: Home Treatment

Once again, we draw your attention to a very important point - the treatment of gingivitis in adults at home is possible only in terms of a course of anti-inflammatory therapy. At home, you can successfully use antiseptic rinses and applications to treat catarrhal gingivitis, but you still have to visit your dentist to remove plaque.

A small example: a person's gums are bleeding and he decides to use the means he heard about in the advertisement. These can be various gels, gargles, or anti-inflammatory toothpastes. And indeed, while a person uses such means, bleeding decreases, or for a while it disappears completely. But as soon as the use of funds stops, the gums begin to bleed again, plus their swelling and redness returns.

The reason for this is quite commonplace - the person tried to treat symptoms (such as bleeding, soreness, swelling) - without removing the cause of these symptoms (microbial plaque, as well as hard supra- and subgingival dental deposits). The advertisements for various dental products do not talk about the causes of bleeding or the need to remove dental plaque. Moreover, for obvious reasons ... We hope that our article on the topic: Gingivitis symptoms and treatment in adults, photos - turned out to be useful to you!

Sources of:

1. Add. professional,
2. Based on personal experience as a periodontist,
3. National Library of Medicine (USA),
4. American Academy of Periodontology (USA),
5. "Non-surgical periodontal treatment" (Roncati M.).