Gingivitis is a disease that occurs in the presence of metal prostheses in the oral cavity that alter electrochemical processes and lead to the development of symptoms such as a metallic taste in the mouth, a perversion of taste, burning of the tongue, decreased salivation, a violation of the general condition of the body (headaches, irritability, weakness, fatigue, anxiety). Diagnostics includes the study of clinical symptoms and dental examination data, measurement of potentiometric indicators. Treatment of galvanosis is complex: removal of the causal factor (prosthesis, inlays), immunocorrection, treatment of local inflammatory and general somatic diseases.
Meaning
Gingivitis is an acute or chronic inflammation of the gums, which occurs quite often. The cause is a violation of oral care, young people and children during teething are more susceptible to pathology.
Causes
The main cause is sticky plaque. It accumulates along the edges of the gums and in hard-to-reach places for brushing teeth, after 72 hours, the plaque thickens and a tartar forms, which cannot be removed with regular brushing.
During puberty and during menstruation, the likelihood of gingivitis increases. Women who take oral contraceptives for a long time also fall into the risk group. The use of immunosuppressants, in particular cyclosporine, and antihypertensive agents containing nifedipine, as a side effect provoke the development of hypertrophic form. These drugs cause hyperplasia of the gum tissue, which makes it difficult to care for teeth and daily plaque removal. The accumulation of plaque and the multiplication of microorganisms contribute to the development of this disease.
The endogenous causes are the growth of teeth. Since a growing tooth injures the gum, catarrhal form is often diagnosed in children during teething. Vitamin C deficiency, diseases of the gastrointestinal tract, a decrease in general and local immunity are essential in the pathogenesis of disease. So, in people without pathologies, a short-term inability to observe oral hygiene does not lead to the development of gingivitis.
Exposure to external physical factors such as injuries, burns, radiation exposure and the effect of aggressive chemicals on the gum are the most common causes of gingivitis. Bacterial agents cause gingivitis mostly in children and adults with immune system disorders.
Recently, iatrogenic factors have played a significant role in the occurrence of gingivitis, when patients with a weak psyche, under the pressure of the information flow about the importance of oral care, discover symptoms of gingivitis. Improper behavior of the doctor can also provoke the appearance of a psychogenic nature. Disease is more susceptible to smokers, patients with tartar and people who consume excessively hot or cold food.
In children before puberty, immune protection is only being formed, so the presence of foci of chronic infection, dental caries leads to the development of gingivitis. The incidence of gingivitis in children with tuberculosis infection, rheumatism, liver and gallbladder diseases is higher. In diabetes mellitus, the chemical composition of saliva changes, its antibacterial properties decrease. Among people suffering from any form of diabetes mellitus, gingivitis occurs in 70% of cases.
Disease rarely develops as an independent disease. Much more often it is a symptom of other diseases of the oral cavity or a consequence of diseases of internal organs.
Symptoms of gingivitis
In most cases, pathology occurs without a violation of the dentoalveolar junction. If the entire gum of the jaw or both jaws is inflamed, then gingivitis has become widespread. But localized gingivitis is more often diagnosed when a small segment of the gum is affected. With limited gingivitis, there are also lesions of nearby teeth. If disease affects only the gingival papillae, then papillitis is diagnosed, with lesions of the entire gingival margin, they talk about the marginal course of gingivitis.
In acute gingivitis, there are classic manifestations of the inflammatory process – swelling, hyperemia, local increase in tissue temperature, soreness and hypersalivation. There is bleeding of the gums, spot hemorrhages, sometimes with gingivitis there may be ulceration of the gums.
Chronic gingivitis occurs due to prolonged exposure to adverse factors. And most often his clinical picture is blurred. The main manifestation is gum hyperplasia, sometimes the entire crown of the tooth is covered with gingival tissue, which normally should not be.
Catarrhal form is characterized by a pronounced inflammatory reaction, there is redness and swelling of the gums. The inflamed surface becomes sensitive to temperature changes. Some patients with catarrhal gingivitis note itching and soreness during meals.
With ulcerative-necrotic form, ulcerated areas and areas of necrosis appear on the mucous membrane of the gums. The gums are sharply painful. Due to the reproduction of putrefactive microflora, halitosis appears – fetid breathing. The general condition of the patient suffers: the temperature rises, sometimes to febrile values, regional lymph nodes increase. Due to soreness, eating is disrupted, sometimes with gingivitis there is a persistent refusal to eat (anorexia), general weakness and symptoms of exhaustion increase.
Hypertrophic gingivitis is clinically manifested by an increase in gingival papillae, which eventually cover most of the tooth. At the initial stages, hypertrophic form practically does not manifest itself, unpleasant sensations are also absent. Tissue hyperplasia is usually noticed during a preventive dental examination. But over time, in the absence of therapy, gum soreness increases during meals and during touching. Brushing teeth for patients with hypertrophic gingivitis becomes a difficult and painful procedure, as a result, they refuse to take care of the oral cavity, and therefore multiple caries joins.
In addition to the phenomena of gingivitis and caries, there is an unpleasant smell from the mouth, accumulation of plaque and tartar. Eating becomes dramatically painful. A particularly acute reaction is observed when taking acidic, hot and spicy food. With atrophic gingivitis, gum atrophy occurs. The gum level gradually decreases, the neck of the tooth is exposed, and then its root. Subjectively, it is manifested only by soreness during taking cold or hot food.
During menopause, women often develop gingivitis of a desquamative nature. The formation of keratin-containing epithelial cells decreases, which is manifested by an increase in mucosal permeability. The gums are easily damaged, bleed and painful even with a slight touch. Sometimes the phenomena of gingivitis are preceded by the formation of bubbles.
Gingivitis is not an independent disease. Basically, this is one of the clinical manifestations of periodontitis and periodontal disease, so it is important to identify the signs of gingivitis in a timely manner and conduct therapy.
Diagnosis and treatment
Gingivitis is diagnosed during visual and instrumental examinations. No additional diagnostics are required. However, to identify the underlying cause, a thorough interview of the patient and examination by other periodontists is necessary. Prior to the detection and correction of the disease that is the cause of gingivitis, local treatment is resorted to.
With gingivitis, it is necessary to clean the teeth from plaque and tartar and recommend that patients carefully observe oral hygiene. Persons who are predisposed to the occurrence of gingivitis need to visit the dentist more often for professional oral hygiene.
The use of drugs that improve local immunity is shown. After eating, mouthwash with antiseptic solutions and herbal decoctions is mandatory. Rinsing with non-aggressive compounds, such as chamomile decoction, can be carried out without restrictions, but it should be borne in mind that with gingivitis, soda solutions and alcoholic solutions of medicinal herbs should be used with caution. If disease has a pronounced pain syndrome, then taking analgesics is justified.
Hypertrophic gingivitis often occurs due to improper filling and installation of crowns. Replacement of restorations leads to a complete cure. Pathology that occurs during pregnancy, taking medications, resolves itself after childbirth or withdrawal of medications. If tissue hyperplasia is persistent, then gingivectomy with the removal of growths is indicated.
The prognosis is favorable, but in the absence of treatment, the process can go into a deep form – periodontal disease develops, in which tooth loss is possible.
Literature
- Gingivitis / James T. Ubertalli // Справочник MSD. — 2017.
- Chronic Gingivitis: The Prevalence of Periodontopathogens and Therapy Efficiency / M. Igic, L. Kesic, V. Lekovic, M. Apostolovic, D. Mihailovic, L. Kostadinovic, J. Milasin // Eur J Clin Microbiol Infect Dis. — 2012; 31(8): 1911-1915.link
- Atlas of diseases of the oral mucosa / E.V. Borovsky, N.F. Danilevsky. — M.: Medicine, 1981.