Chronic gingivitis - causes, symptoms, diagnosis and treatment
Chronic gingivitis - Inflammation of the gingival papilla and gingival margin, occurring with periods of exacerbation and remission. Chronic gingivitis is manifest congestive hyperemia and edema of the mucous membrane of the gums, bleeding, deformation (swelling, atrophy) gums, bad breath. The diagnosis of chronic gingivitis put periodontist on the basis of history and examination of the oral cavity. Treatment of chronic gingivitis include professional oral hygiene, local treatment with antiseptics, taking anti-inflammatory, decongestants, immunomodulators, physical therapy, if indicated - removal of growths gums.
Chronic gingivitis
gingivitis periodontal ligament strength is not broken, but in the case of chronic course lesions can progress to periodontal disease and tooth loss accompanied. Chronic gingivitis - the most common disease in periodontal dentistry, including among adolescents and young adults. After 60 years, the incidence of chronic gingivitis reaches 90-100%. Women suffer from chronic gingivitis less often than men.
plaque with unformed local immune protection.
Chronic gingivitis may be associated with long-term irritation of gum tissue tartar, a sharp edge of the destroyed tooth dangling edge fillings, artificial crowns or orthodontic appliances. It can cause chronic gingivitis gums thermal burn, exposure to it acids, alkalis, ionizing radiation; intoxication with salts of heavy metals, drugs, smoking. The cause of chronic gingivitis may be anomalies and deformation of dental system (mouth breathing, malocclusion, crowding of teeth, lack of antagonists).
By the occurrence of chronic gingivitis predisposes the reduction of non-specific resistance of the organism against the background of endocrine changes (diabetes, puberty, pregnancy, menopause, use of COCs), disease of the digestive system, hypovitaminosis, systemic, allergic, skin and infectious diseases (tuberculosis, syphilis, actinomycosis). Desquamative gingivitis develops at disease systemic lupus erythematosus, pemphigus vulgaris, lichen planus, or at the local pathological immune response to certain substances in dental plaque. Hormonal imbalances in adolescence contributes to the development of hypertrophic chronic gingivitis.
Classification of chronic gingivitis
According to the etiology of chronic gingivitis is divided into infectious, traumatic, thermal, chemical, iatrogenic, caused by hormonal, allergic.
As the prevalence of chronic gingivitis can be localized (papillitis - inflammation of the interdental papilla and marginal gingivitis - inflammation of the free gingival margin) and generalized (diffuse).
Chronic gingivitis can occur in mild form (with the defeat of gingival papillae), moderate (with the spread of marginal gingiva) and heavy (with the capture of the entire alveolar gingiva).
By the nature of inflammation distinguish catarrhal, hypertrophic and atrophic chronic gingivitis, as well as the specific morphological types: plazmotsitarny (atypical allergic gingivostomatitis), desquamative and granulomatous.
catarrhal gingivitis is characterized by a prolonged course and minor complaints. Marked edema and congestive hyperemia (redness, cyanosis) of the mucous membrane of the gums, bleeding when brushing their teeth and taking roughage. Inflammatory changes may appear limited at the gingival papilla and gingival margin, or spread on the entire alveolar part. There is a deposit of plaque and supragingival plaque and bad breath.
Hypertrophic gingivitis develops on the background of chronic catarrh; It manifested the growth of gum tissue due to increased interdental papillae. Intensity of growths can be mild (gums covering not more than 1/3 of the tooth crown), moderate (up to half of the crown) and heavy (closed more than 1/2 of the tooth crown). When chronic edematous form of hypertrophic gingivitis gums swollen, reddened, slightly painful, bleed when eating and brushing your teeth; when the fibrous form of gums dense, pale pink in color, with the presence of false periodontal pockets.
In chronic gingivitis on a background of poisoning heavy metal salts border appears dark on the gingival margin, increased salivation and metallic taste in the mouth.
A feature plazmotsitarnoy forms of chronic gingivitis is the formation microabscesses, the possibility of spreading inflammation on the palate, and the rapid development of stomatitis.
If desquamative gingivitis are swollen, erythematous spots, serous-hemorrhagic blisters, lesions peelable epithelium exposing the painful bleeding and underlying tissue. Characterized by cyclical trends with a sharp sudden onset, gradual fading of the symptoms and long (1-2 years) period of remission.
In the case of granulomatous gingivitis appear single or multifocal patches of red or red-and-white of up to 2 cm in the interdental papillae, sometimes with the capture of other gum areas.
Prolonged chronic gingivitis accompanied his transition in atrophic gingivitis, characterized by degenerative changes in the gingival papilla and gingival margin, thinning and reduction in gingival volume, exposed necks of teeth, increase their sensitivity to temperature and taste stimuli, great soreness of the gums.
dentist or periodontist with a history of visual and instrumental inspection of the oral cavity.
If the dental examination assessed the condition of the teeth, the mucous membrane of the gingival papilla and gingival margin, type of occlusion, the presence of dental plaque, the state of dentures, etc.
Probing the gingival sulcus reveals positive symptom of bleeding, periodontal preserve the integrity of the connection, the lack of gingival pocket, teeth immobility. Bone condition is determined according to the X-ray of the tooth.
To determine the cause of chronic gingivitis and evaluation of body condition in general are required consultation with other specialists: endocrinologist, gastroenterologist, infectious disease specialist, dermatologist, allergist, rheumatologist.
removal of dental plaque, caries treatment, removal of decayed teeth, correcting malocclusions, filling defects and prosthetics, correction and replacement of orthopedic and orthodontic appliances, plastic bridles lips and tongue, and others.
As part of the complex therapy of chronic gingivitis conducted professional oral hygiene, mucosa processing antiseptics (p-rum hydrogen peroxide, chlorhexidine, miramistinom), rinse decoction of herbs (chamomile, oak bark, eucalyptus) after eating or brushing teeth, periodontal applications on the gums ( metrogil-dent). In some cases, the timely and thorough removal of local irritants contribute to the complete elimination of inflammation.
In chronic gingivitis may use decongestants and anti-inflammatory drugs, if necessary - antibiotics, immunomodulators. The positive effect in the treatment of chronic gingivitis give massages gums, UFOs, iontophoresis, laser therapy.
In severe chronic hypertrophic gingivitis produce diathermocoagulation cryotherapy or growths, on indications - Gingivectomy.
Prediction and prevention of chronic gingivitis
With timely and rational treatment of chronic catarrhal gingivitis recovery occurs; without addressing its causes relapses. Complete cure atrophic gingivitis is unattainable, is only possible to suspend the process of atrophy. Exodus symptomatic gingivitis depends on the severity of the underlying disease. In the absence of treatment of chronic gingivitis becomes periodontitis and periodontal disease with the risk of tooth loss.
Prevention of chronic gingivitis is in compliance with the rules of oral hygiene, regular dental visits (1-2 times a year), readjustment of foci of chronic infection, and treatment of somatic pathology.