Gingivitis - a disease of the gums caused by local symptoms and general changes in the body, occurring without breaking the periodontal connection.The incidence of gingivitis is large enough to suffer from this disease more often than children, pregnant women and young patients up to 30 years. gums Gingivitis refers to a group of periodontal disease, asgums included in periodontal tissue complex.
order not to be in the number of patients complaining of gingivitis in adults, one must be twice a year to visit a doctor periodontist, follow the rules and the regularity of the individual tooth brushing, and at the first signs of gingivitis (swelling, redness, bleeding) to seek dental care.
cause of gingivitis
causes of gingivitis are divided into general and local.Common causative factors include decreased immunity, gastrointestinal diseases, cardiovascular disorders, endocrine disorders (diabetes, thyroid disease, pregnancy, puberty) hypovitaminoses, allergic conditions.
Against the background of violations of a general nature is compounded by the impact of local factors: poor oral hygiene, the accumulation of pathogenic microorganisms, the presence of tartar, anomalies and deformations of the periodontal system, mechanical damage, radiation injuries and traumatic injuries of the gums (trauma, burns, insolvency dentures)bad habits (smoking), the use of medications (oral contraceptives), work on the production of heavy metals (mercury, lead).Products microorganisms accumulate on the surfaces of the teeth in insolvency oral hygiene, the site of accumulation of soft plaque plaque is formed, which is mineralized over time and turns into tartar.To eliminate these deposits is necessary to carry out professional cleaning ultrasonic devices for the removal of solid dental plaque, and the plaque removal of pigmented unit Air flow.Required grinding and polishing surfaces with special paste and brush.On the smooth surface of the tooth is much more difficult to attach to microorganisms, so the teeth will last longer maintain its purity.Displaying the deep-fluorination special gels containing active fluorine to reduce the permeability of the tooth enamel, have anticaries activity, reduce the number of pathogenic microorganisms on the surface of teeth.But of course, should not happen for about an individual tooth brushing at home.It is necessary to teach the patient the correct brushing.Proper cleaning of the teeth implies a sweeping movements committed to the edge of the gums from the teeth of manual brush on all segments of the teeth for 2-3 minutes.Teeth should be brushed 2 p. / Day, the first time the last breakfast, the second just before bedtime.Brush must be individualized for each family member, kept in a special glass bristle up.The toothbrush is recommended to be replaced every three months.Patients with signs of gingivitis should acquire a soft bristle brush.There are brushes with colored bristles that are discolored, signaling you to replace with a new brush.It is very convenient for those who forget to do it.Pasta is desirable to alternate and do not use bleach.People with periodontal disease is best to use pasta with herbs and drugs.Such paste is desirable to acquire drug stores of your city.Use of oral rinses and dental floss (floss) welcome.However, the dentist should explain and show the model how to use dental floss.It is important to avoid further injury to the gums when brushing interdental spaces.Movement does not need to be sharp, without pressure.
Symptoms and signs of gingivitis
As mentioned earlier, gingivitis appears more often in young adults.Found morphological and clinical signs of inflammation.Heavy dental plaque, gingival bleeding on probing, the absence of periodontal pockets, with hypertrophic gingivitis, there may be a false periodontal pocket.
changes in bone structure of the alveolar bone is not present, the general condition of the patient does not suffer, hygiene codes and manifestations of gingivitis are made according to each other.Symptoms of gingivitis gum is gum swelling, soreness, which most patients complain primarily bleeding when cleaning your teeth or use of solid food, redness, possible bad breath from the mouth.
Types and forms of gingivitis
under the form of gingivitis is divided into catarrhal, hypertrophic and ulcerative.Based on clinical symptoms: acute and chronic.Depending on the degree of gravity - easy, medium and hard.Phase flow - acute and chronic.By localization - papillary, marginal, diffuse.Etiology - traumatic, chemical, gingivitis teenage pregnancy gingivitis.In its prevalence - focal and generalized.
Hypertrophic gingivitis is quite common.In the etiology of generalized forms of hypertrophic gingivitis play a large role infectious, chronic traumatic exposure, metabolic disorders (pregnancy, puberty, endocrinopathies);central nervous system, reception of contraceptive drugs;circulatory system diseases and others.
emergence of localized forms of gingivitis helps malocclusion (deep, cross, open bite), the anomaly dentition (anterior crowding, supernumerary teeth).The process is most pronounced in the interdental papilla and marginal ledge anterior teeth in the second and third teeth.Microscopic tissue swollen, congested, heavily infiltrated by lymphocytes, plasmocytes with a mixture of macrophages.Friendly responds blooded epithelium that leads to a change in its vertical differentiation (increasing the number of layers parameters hyperkeratosis, acanthosis).Inflammation triggers actively dividing fibroblasts followed kollagenozov that promotes fibrosis (thickening) of gum tissue.Exacerbation of chronic gingivitis accompanied by an increase exudative reactions.
By the nature of the clinical and morphological manifestations isolated fibrous and edematous form of hypertrophic gingivitis.When inflammation (edema) form of the gingival margin and papillae sharply hyperemic, edematous, cyanotic.The mucosa of the gums sometimes grows so much that closes the crown of the tooth, forming deep gum pockets.Pockets containing food residues, tartar, bacteria that leads to suppuration.Receiving solid food causes pain, bleeding.When the fibrous form of slowly progressive new formation of connective tissue leads to a thickening of the gums, they are bleeding, painful, bluish.Additional mechanical stimulus leads to a marked increase in the interdental papillae and gingival formation of polyps.
atrophic gingivitis - a chronic disease that causes the decline of the gums.Arises from the variations of blood circulation and trophic tissue (deep pripasovannye bridges, clasps, the pressure of hard dental plaque, and others.).The mucous membrane of the gums dull, pale pink, gingival papillae are shortened, and then disappear altogether.Gingival margin valikoobrazno thicken the gum reduces the size in volume.Cervical teeth bared, is shown hypersensitivity to thermal agents.The inflammatory process is activated alveolar bone and periodontal boundary, they atrophy leads to expose the tooth roots, they are shortened, and then disappear altogether.
Prichinv acute serous gingivitis can be temperature, infectious exposure, trauma, allergic and toxic-allegricheskie factors.Acute gingivitis can follow measles, SARS, influenza, metabolic disorders, and others. Also poor hygiene (dental plaque, tartar) cause local decreased immunity tissues of the mouth.
risk of acute gingivitis in children is much higher, since 6-7 years immunity is not yet fully formed, he finally formed in 14-15 years.Compliance with proper brushing of teeth in children is very significant at an early age.Localized 1-2 defeat of teeth due to the accumulation of microorganisms, cavities on the contact surface defects seals, seals mismatch clinical requirements.If gingivitis is not broken integrity of the periodontal attachment.
Mild gingivitis - the defeat of only the edge of the gums, while moderate and severe forms of infestation and marginal alveolar gums.On examination, there is diffuse redness, swelling of the gum tissue, in probing possible light bleeding.General state of health does not suffer.Interdental papillae are rounded, hanging over the tissue of the tooth, periodontal pockets deepened.In the pockets of trapped food debris are subjected to decay, which exacerbates the condition.In the mucous membrane of the lips, cheeks, tongue visible imprints of the teeth, which testifies to their edema.Increased salivation, there is bad breath.
include acute forms of periodontal release: necrotizing gingivitis, a specific viral, gingival abscess.Acute necrotizing gingivitis (ulcerative) is characterized by severe pain, gingival papillae, their necrosis.Overall condition is violated and seen a rise in temperature, an increase in morbidity and lymph nodes.With severe cases, the formation of ulcers in the alveolar bone, communicating with the jaw bone.If the process is not treated, it can lead to tissue loss or death.
Acute specific gingivitis occurs against a background of specific lesions of the body: tuberculosis, actinomycosis, syphilis, candidiasis.Acute viral gingivitis: the reason for its development is the herpes simplex, herpes zoster, and salivary gland disease.Gingival abscess - a fusion of gingival papilla formation of pustules, accompanied by severe pain.Acute gingivitis is treated locally, and the elimination of local and general factors may prevent the manifestation of this disease.
acute gingivitis is easy to diagnose on the basis of complaints and clinical manifestations diagnosed quickly.The young age of the patient, high hygiene index Green-Vermillion, gingival bleeding on probing, the presence of cervical caries, seals sharp edges, no change in the interdental septa, the general condition of the patient without deviations (except ulcerative gingivitis forms).
etiology, pathogenesis and symptoms of chronic gingivitis is different from acute gingivitis.Chronic gingivitis can be atrophic, catarrhal, hypertrophic.
Chronic catarrhal gingivitis occurs with some frequency, manifesting itself as a slight redness and swelling of the gums.It features a long and lingering over.Presenting complaints by patients, are not expressed.The process is limited and diffuse, with the defeat of the interdental papillae and marginal gingiva.
Chronic hypertrophic gingivitis - this increase in gingival papillae, which may cover the entire outer surface of the tooth to form a false periodontal pocket.There is pain in the use of food, bleeding.When protracted course of any of the forms of gingivitis may develop atrophic gingivitis, in which gums are reduced in size, injured while taking solid food becomes thin.
atrophic gingivitis extends to the interdental papillae, they look like a cut, marginal gingiva also flattened.Atrophic gingivitis - a repository of infection, it can trigger the development of acute diseases of internal organs.
Chronic gingivitis is divided into easy, hormonal, medical, idiopathic, specific gingivitis.
Chronic gingivitis is caused by a simple solid dental deposits in adults and children, which are concentrated in the waste products of microorganisms.Hormonal gingivitis occurs most often in teenagers on a background of puberty and in women during pregnancy or while taking oral contraceptives.Perhaps the development of chronic gingivitis during treatment with steroids.
specific gingivitis cause Candida albicans, Actinomyces israelii and Treponema pallidum - pathogens of candidiasis, syphilis and actinomycosis.The degree of tissue damage depends on the degree of gingivitis.Chronic gingivitis is a precursor to periodontal disease.Acute forms are treatable, but not chronic, possibly only maintaining them at the same level, without the occurrence of exacerbations.
On examination, the mouth can be seen reddening of the gums with a bluish tint.Papilla increased in size and thickened.During exacerbation of chronic gingivitis, the gums become bright red, swells, bleeds when touched.On the surface there is a corresponding amount of dental plaque, periodontal connection is broken, the pockets are not determined.There are many tests to determine the symptoms of gingivitis to its first signs.These include the measurement of gingival fluid, RN gingival fluid sample Kulazhenko (the formation of a hematoma on the gums), gingival bleeding index, gingival thermometry, microbiological testing, X-ray examination, photoplethysmography, reoparodontografiya, polarography and many others.
Gingivitis in children
Children suffer gingivitis often.The causes of this disease in children can be external and internal.External causes of gingivitis in children is teething, during which there is a natural trauma to the oral mucosa.During infancy, preschool and early school children have a habit of all the "try on a tooth," take things in their mouths, which can damage the mucous membrane and to be a source of infection.
also cause gingivitis in children can be a seal, inadequate clinical requirements, the sharp edge of collapsing temporary tooth.External features include a variety of infectious diseases, the presence of cavities.The disease is associated with diabetes, tuberculosis and nephropathy.Wearing orthodontic apparatus, which is an additional retention point for the delay in the microbes poor brushing.
internal causes of gingivitis in children are: improper eruption of the tooth, which injure the gums, insufficient intake of vitamins and minerals in the body of the child, an unbalanced diet, reduced immunity.Gingivitis may be an additional symptom of the disease, but can act as an independent pathology.In inflammatory signs of gingivitis in children is divided into catarrhal, hypertrophic, necrotizing and mixed.Each of them has acute and chronic forms and.
Pretty easy inspection of the mouth of the child is determined by acute gingivitis gums.The child often refuses to take food, he whiny and irritable, not sleeping.The manifestations are well expressed in the mouth: gums red, swollen, bleeding is determined, the amount of plaque increased.The clinical picture of chronic form of gingivitis is blurred.The most common form of gingivitis in children is hypertrophic gingivitis.It is also called juvenile or puberty gingivitis.The main complaints of pain in children, bleeding when eating, aesthetic disadvantage.These changes disappear after puberty.Perhaps removing growths surgically.
At an early age children the second most common form is the catarrhal gingivitis.It is manifested by inflammation of the gums, bleeding and bad breath.The consequence of catarrhal gingivitis ulcerative gingivitis is due to lower defense system.The general health of the child is violated (the temperature increase in submandibular or neck lymph nodes), the children refuse food intake, tearfulness, sluggish.In the mouth picture ulcerative gingivitis: pain, bleeding, and the presence of dental plaque.