Gingivitis: symptoms and treatment in adults. Acute Gingivitis: Causes, Symptoms and Features of Treatment Acute Chronic Gingivitis

Inflammatory disease The adhesion for which the surface inflammation is characterized, which flows without a disruption of the integrity of the sedental compound. Acute gingivitis in children and adults require immediate treatment, because his symptoms are less noticeable in time, and he goes into chronic stagingAnd then - and in periodontitis.

Acute ulcerative gingivitis is accompanied by the appearance of ulcers and necrotic raids. The gum is covered with grayish-dirty raid, under which a bleeding wound is detected.

Causes of disease development

A sharp catarrhal gingivitis is deservedly considered one of the most common diseases of the dysen. The main reasons for its occurrence and development, first of all, are not good hygiene. oral cavity And improper teeth care. In addition, risk factors are:

• dysen injuries;
• tobacocco;
• unrealized caries;
• traumating wearing braces.

TO general reasons You can attribute:

• lack of vitamins;
• gTS diseases;
• weed immunity.

Symptoms of acute gingivita

Acute gingivitis whose symptoms are pronounced, characterized by rapid development and one-time inflammation. For professional advice, it is necessary to contact when the following is detected:

• redness, personnel, bleeding dysen;
• soreness of soft tissues around the teeth;
• painful sensations when receiving food and carrying out activities of human hygiene.

Acute ulcer-necrotic gingivitis is characterized by the following symptoms:

• the appearance of the reel odor due to the mouth;
• the presence of mysteries covered with necrotic bending;
• sharp pain and bleeding of dyosen when making food and cleaning teeth.

In addition, in a patient with a peptic-necrotic form of the disease, an increase in body temperature is observed, fast fatigue, increase and pain lymph nodes. The deterioration of the state leads to a failure of full nutrition and hygiene of the mouth, which are often observed at the highest stage in the development of the disease.

Treatment of acute gingivita

For the successful treatment of acute gingivitis, it is necessary to properly establish the causes of the disease, the form and severity of the loss of adhesion. For this, a careful examination is carried out, including laboratory, which also allows you to identify the pathogens of gingivitis.

Independent treatment at home will not bring the desired results and will eventually lead to a flow of a disease in a chronic form. Professional treatment is carried out comprehensively, its methods are selected individually, depending on the form, severity and causes of the disease. The efforts of doctors are aimed at eliminating the focus of inflammatory processes, preventing the spread of infection in the oral cavity and prevent the dissemination of changes in a pathological nature. Professional cleaning is carried out, as well as the rehabilitation of the oral cavity, antibiotics, antifungal drugs and antioxidants are used.

Prevention of acute gingivita

Prevention is a real panacea from diseases of the dyssen and teeth. Following the simple rules, you can save the oral cavity healthy, and the teeth are strong:

• systematic preventive visits to the dentist;
• high-quality mouth hygiene, use of dental thread;
• refusal of tobacco.

Treatment of acute gingivitis of any forms is one of the activities of the Department of Dentistry of the Calt Clinic. We have experienced professionals who know how to cope even with the most difficult tasks.

Gingivitis - inflammation of the mixture, in which there is no disruption of the integrity of the accuracy fabrics. Without adequate treatment, the gingivitis goes into periodontitis and threatens the loss of teeth.

The reasons

The pathogens of gingivitis are various microorganisms - bacteria, viruses and fungi. Most often, the Gingivalis, Streptococcus Oralis, Actinomycetes Comitans and Porphyromonas Gingivalis and Porphyromonas Gingivalis are revealed at gingivitis. Disease pathogens are often in the oral cavity healthy peoplebut high immunity helps the body prevent development inflammatory process. When a common or local immunity decreases, gingivitis begins.

Causes of Gingivitis:

• insufficient oral hygiene;
• lack of adequate treatment of teeth diseases;
• diabetes;
• defective nutrition (especially with a lack of vitamin C);
• decrease in immunity;
• bacterial, fungal and viral diseases of the respiratory tract;
• smoking;
• pregnancy;
• hidden breathing nose;
• non-quality dentures and braces.

Many doctors consider gingivitis not a separate disease, but rather the result of other diseases of the oral cavity and the body as a whole. For them, gingivitis is a signal to reduce immunity.

Anyone can get sick with gingivitis, because its pathogens are rather common bacteria. It is noted that children under the age of 6 more often sick gingivitis than teenagers and adults. The active teething of the teeth injure the fabrics, and the desire of children to try everything is wrong with the requirements of hygiene.

It is also noticed that men fall more often than women. This is explained by the peculiarities of endocrine and immune systems and less attention to the state of the teeth.

People wearing dentures and braces trauming cavity fabrics also fall into a risk group. Dentists recommend them with special care to purify the oral cavity after meals, monitor the state of prostheses and braces and more often to visit the dentist for prophylactic inspection.

A separate risk group includes people who are not able to receive high-quality medical care. Regular inspections of the dentist, the treatment and prevention of teeth diseases, deposit removal reduces the likelihood of gingivitis. Long caries left without professional treatment, leads to the spread of bacteria to other sections of the oral cavity, including on the guys.

Symptoms Gingivita

Dentists allocate several types of gingivitis, their symptoms are different, but in general it is possible to describe such a symptomatic picture:

• redness of the dysen and the mucous membrane of the mouth;
• messen Foci;
• bloodfaction of Gomen, especially during the cleaning of the teeth;
• soreness of dysen;
• sensitivity of teeth and gums to hot and cold food;
• nasty smell from mouth;
• swelling of gantry papillas;
• dention;
• abundant peel on the teeth;
• selection of ingestion of adhesion;
• burning sensation;
• yazvovka on the guys;
• necrosis of interdental papillars and gums tissues.

The severity of the symptoms of gingivitis depends on the general condition of the body, timeliness medical care and quality of oral hygiene. With an extensive infectious damage to the oral cavity, a slight increase in temperature, weakness, drowsiness may also be disruption of digestion. High temperature indicates that gingivitis is not primary disease, and emerged against the background of more serious infectious processes. Even sharp gingivitis itself does not cause a significant increase in body temperature.

Types of Gingivita

There are several types of gingivitis.

1. Chronic gingivitis appears due to the lack of necessary hygiene, a large number of deposits on the teeth and is expressed as follows:

• no pronounced pain sensations and obvious inflammation of the fabrics;
• the gum pockets change slightly in size;
• sightly bleeding during the cleaning of the teeth;
• the tissue of the deceine grows and partially covers the crowns of the teeth.

2. Acute gingivitis has more obvious symptoms and is divided into catarrhal, ulcerative, hypertrophic, atrophic and peptic necrotic types.

Catarial gingivitis is caused by an acute bacterial or fungal infection and is accompanied by such symptoms:

• pronounced gum painting;
• acute pain;
• derne's edema;
• itching in the oral cavity;
• a small increase in body temperature;
• total weakness.

The ulcerative gingivitis is accompanied by the formation of ulcers on the subsidiaries, besides:

• strong burning and itching in the oral cavity;
• bloodfaction of Gomen;
• pain, especially during feeding and performing hygienic procedures.

Hypertrophic gingivitis is associated with hormonal changes in the body and often celebrates adolescents, pregnant women, people with endocrine diseases. Also, this kind of gingivitis can occur against the background of receiving hormonal contraceptives. Symptoms of hypertrophic gingivitis are:

• gumper hyperplasia with swelling of gantry papillats;
• bleeding gums;
• gNEA;
• unpleasant smell of mouth;
• abundant dental tax;
• blue color gums.

Atrophic gingivitis can be called the opposite of hypertrophic gingivitis. In atrophically, the guy decreases in volume, the gum pockets are deepened, the roots of the teeth are broken. This disease is fraught with loss of teeth.

Georny-necrotic gingivitis is characterized by necrosis of interdental papillars. Other symptoms are:

• inflammation of the mucous membrane of the oral cavity;
• unpleasant smell of mouth;
• bloodflow Disen.

The most common version of gingivitis is catarp. The chronic version also meets often, but here the clinical picture is smeared, and it remains without treatment.

The localization of inflammation differ localized and generalized gingivitis. With a localized version, a few gums are affected, with generalized - all the guys and even sometimes neighboring tissues.

Diagnostics Gingivita

Diagnosis of gingivitis is engaged in a dentist. The complexity of diagnosis depends on the degree of illness and its type. Thus, chronic gingivitis can identify only a doctor on inspection, and acute, especially catarrhal and ulcerative, it is easy to diagnose the patient itself for acute pain, abundant red decrease or the formation of ulcers on the mucous membrane.

The diagnosis of gingivitis begins with a visual inspection. Next is the instrumental inspection. It is important to determine the stage of the disease and its localization - in some cases it is enough. In severe cases, it is important to estimate general state The body and precisely identify the pathogen. The dentist prescribes a general blood test and a microbiological study of the discharge oral cavity.

With hypertrophic gingivitis, an endocrinologist consultation may be required. Gingivitis in this case can become a symptom of a more serious endocrine disease. For effective treatment Gingivitis requires correction of a hormonal background. If the disease began on the background of acceptance hormonal drugsThey should be canceled or replaced with others.

With catarile and ulcerative gingivitis, the immunologist may be required. Serious inflammation of Mösen shows that the body does not cope with infection. The immunologist must define the immune status of the patient, to find the cause of local and general immunodeficiency and suggest ways to enhance immunity.

Gingivitis in children must be treated together with pediatricians. The teething and growth of the teeth injure the guise and causes their inflammation. The kids actively know the world and pull the various items in the mouth to try their taste. Along with the toys and fingers in the mouth, microbes fall, which become the cause of gingivitis. Pediatrician will prompt optimal oral hygiene for children of different ages And select the most gentle treatments.

Treatment of Gingivita

The treatment of gingivitis is selected individually depending on the type of disease, its gravity and localization.

The most important point in the treatment of gingivitis becomes eliminating the inflammatory process, especially during the catarial type of disease. To do this, resort to antimicrobial and antifungal drugs. With localized inflammation, local means are used - rinsing, loosening, creams, gels. With generalized gingivitis complicated high temperatures, weakness and distribution of infection, the systemic reception of antibiotics is recommended.

For strong painwhich sometimes accompanied by acute catarrhal gingivitis, periodontal doctors recommend local painkillers - gels and ointments. It is also possible to receive painkillers in the form of tablets and capsules.

The second important stage of treatment is the removal of dental nucleation and tartar. The hardened fence cannot be removed by a conventional toothbrush, so the cleaning of the teeth is carried out by professional equipment in the dental office. Recommended ultrasonic cleaning To remove sediments, since mechanical will be extremely painful when inflammation. Ultrasound gently removes soft raids, dental stone, pollution and motchers of enamel. Ultrasound cleaning is often combined with the cleaning of the Air Flow system. The jets of water and air purify the interdental space, gum pockets, recesses and cracks on the teeth. These procedures are usually painless, but with acute gingivitis, the patient can feel pain and discomfort.

After removal of dental, the dental is proceeded with the treatment of teeth. Statistics show that gingivitis rarely flows without caries or pulpitis. These dental diseases are often hiding under a thick layer of deposits. If the teeth do not cure, the guys will be infused constantly. Children are recommended to carry out the sealing of FISSUR - this is the procedure for which the grooves on the chewing surface of the teeth are filled with a special composition. The surface of the tooth becomes smooth and does not let the infection inside. The sealing of FISSOR is recognized as a reliable prevention of diseases of the teeth in children, which has a beneficial effect and in a state of adhesion.

In the case of necrotic gingivitis often required surgical intervention. Memorial sections of the gums are not restored, so they require deletion. Surgical treatment is required and with purulent gingivitis. Gnot capsules open, cavities are washed antiseptic solution. The surgeon assistance is required for hypertrophic gingivitis. Distess need to reduce to normal sizes. The danger of the scorched adhesion lies in the fact that the dental enamel is not cleared under them properly, and the likelihood of the development of the prickly caries is great. Hypertrophic gingivitis spoils and appearance teeth, so need surgical treatment and for the sake of aesthetic effect.

Complications

Gingivitis can give complications if the disease is not treated on time. The main complications is:

• loss of tooth;
• the spread of infection on the deep layers of fabrics, including bones;
• dissemination of infection to other organs and systems.

Especially dangerous gingivitis for people with a serious immunodeficiency. The immune system It is not capable of localizing the infection, and it applies further. In this case, timely diagnosis and effective treatment is particularly important.

Permanent bleeding of adhesion can lead to blood infection, if the ulcers are not processed properly, the slices of food fall into the gum pockets, hygiene is not respected. Violation of blood flowability leads to enhancement of bleeding.

Prevention

Gingivitis is a serious illness, and it is easier to prevent it than to cure.

The prevention is based on qualitative and regular teeth hygiene. The teeth should be cleaned at least 2 times a day, and after each meal, you should rinse with warm water. Toothbrush should be changed regularly. Electric bricks Proved greater efficacy compared to ordinary. They are better removed to the dental tax, and also better massage, raising tissue density and improving their blood supply.

It should be cleaned not only the teeth themselves, but also guys, the language, the inner surfaces of the pitch. To clean the language advise to use a special scraper. In addition, it is important to clean and intersabolic space. To do this, use dental threads. Useful and active rinse. But the toothpick is better not to use. Sharp edges injured their dysna and scratch tooth enamel.

People prone to adhesion inflammation should rinse with special balsams with anti-inflammatory components. You can use ready pharmaceutical means Or prepare herbs champs. After acute food, it is necessary to rinse the mouth with a soda solution, it normalizes the acidity and prevents corrosive by tissues.

Once every six months should be attended by a dentist for professional teeth hygiene. Recommended ultrasound cleaning combined with the Air Flow system. The need for professional cleaning of teeth is proved numerous clinical studies. During hygiene, the doctor can identify diseases of the teeth and recommend treatment. Tightening with treatment is not recommended. Surface caries to cure easier than deep caries or pulpitis.

For the prevention of gingivitis, a full-fledged nutrition is recommended. Vitamin C is especially important. Dtomatologists recommend to eat more fruits and vegetables. They contain many vitamins. In addition, they have a rather dense structure and well purify the surface of the teeth from the climb. Support the health of the teeth will also help food rich in calcium. Calcium is digested only with vitamin D, so it should be more often walking, take sunbathing or use synthetic vitamin D in drops. This is especially true for residents of the northern regions, where the sunny day is short, and the lack of vitamin D is in dire.

Smoking and alcohol reduce local immunity, spoil the dental enamel and cause inflammation of the dysen. Often, smokers have chronic, ulcerative and ulcerative-necrotic gingivitis. It should be abandoned by these bad habits for the sake of the health of the teeth and the whole organism as a whole.

Gingivitis: types and forms (catarrhal, ulcerative, hypertrophic, atrophic, acute and chronic), severity, symptoms and signs, diagnostic methods, complications (dental opinion) - video

Gingivitis: Treatment of hypertrophic, catarrhal, ulcer-necrotic and atrophic (preparations, methods, surgical operations) and the prevention of gingivitis (toothpastes), folk remedies and rinsing (dentist's opinion) - Video

Gingivitis in children - causes, symptoms, treatment. Gingivitis in pregnant women (hypertrophic, catarrhal): treatment, rinsing at home (dentist's opinion) - video

The site provides reference information solely to familiarize yourself. Diagnosis and treatment of diseases must be under the supervision of a specialist. All drugs have contraindications. Consultation of a specialist is obligatory!

Gingivitis - This is the inflammation of the gum mucous membranes, which can be infectious and noncommunicable, leak is acute or chronically.

With gingivite It is involved in the process of the gums without a circular bundle between attached gum and neck tooth. When involving such a compound, the gums with the tooth develops periodontitis, the outcome of which can be a loss of a tooth.

Types and forms of gingivitis (classification)

Bystuch, distinguish:

1. Acute gingivit - has a pronounced course, when proper treatment And the elimination of the causes of the development of the gum is completely restored, recovery comes. Possible transition to a chronic form. More than such a form of gingivitis suffer from children, teens and young people.

2. Chronic gingivitis - Symptoms of the disease are often erased, patients sometimes get used to them. In chronic flow, periods of exacerbations and remissions are noted. Over time, irreversible changes are formed in the gums, the formation of pockets between the tooth and the gums and the dental root is possible.

The prevalence of the process of gingivitis is:

1. Local or focal gingivitis - The gum is amazed in the region of one or several teeth and intersubolic spaces.

2. Generalized or common gingivities - The gums are amazed throughout the jaw, more often and upper and lower. Generalized Gingivitis is a reason to think about the presence of more serious diseases in the body, which caused problems with gums, such as diabetes, immunodeficiency, including AIDS, digestive disease.

Types of gingivitis depending on the shape of the inflammation of the gums:

1. Catarial Gingivit - This is the most frequent form of gum inflammation, can be acute and chronically. For catarrhal gingivitis, serous inflammation is characterized, edema is manifested, pain, painting and separation of mucus from inflamed gum mucosal.

2. Ulcerative gingivitis (ulcerative-necrotic gingivitis of Vensena)- This form of gingivitis is less common, is usually the outcome of catarrhal inflammation. Associated with the activities of bacteria that destroy the tissues of the mucous membrane to form an ulcery and pus.

3. Hypertrophic (hyperplastic) gingivitis- always has a chronic course. This form usually occurs as a consequence of a long inflammatory process in the gums. It is characterized by the growth of the tissue of the gum mucosa ( medical term - Proliferation).

The two forms of hypertrophic gingivitis are distinguished:

• Emirates - In the tissues of the mucous membranes, the gums expressed swelling, the blood circulation is enhanced, that is, a chronic inflammatory process is observed. This form is partially reversible, that is, with proper treatment, it is possible to reduce the reduction of gums.
• Fibrous form - in the mucous membrane, the connecting (scar) fabric grows, while there are no signs of inflammation, this is the outcome of the chronic process and, unfortunately, irreversible. This is a visible cosmetic defect and discomfort when taking hard food.

4. Atrophic gingivit - A rather rare disease, which, in contrast to hypertrophic gingivitis, leads to a decrease in the volume of gums. This occurs with a long circulatory disorder in the gums. Most often atrophic gingivitis arises against the background of periodontal (destruction of the bone of alveolar processes of the jaws).

Separately, it is possible to allocate such forms of gingivitis:

1. Gingivit pregnant - This is a rather frequent phenomenon with which a woman faces in an interesting position. This is usually hypertrophic gingivitis, its edema form. The development of such gingivitis is associated with hormonal changes in the body of the future mother.

2. Gingivit teenagers - oddly enough, it is kids teenagers and young people - these are the most frequent patients With a diagnosis of gingivitis (8 out of 10 visitors dental clinics with complaints about the problems with the gums). In most cases, this contingent detects a sharp catarrhal gingivitis, so to speak "an easy degree" of the disease, but in the presence of hormonal failures, the chronic hypertrophic form of the disease is possible.

3. Herpety gingivitis - Inflammation of the gums caused by a virus of a simple herpes. This is in most cases acute ulcerative-necrotic gingivitis against the background of chronic herpetic infection. Herpetic ulcers are usually located not only on the gums, but also on the mucous membranes of the entire oral cavity. Usually such a gingivitis indicates problems with immunity.

4. Deskvamative gingivit. With this form of gingivitis, there is a partial rejection of the surface epithelium of the gum mucosa. First, red spots appear, which form bubbles, after their autopsy appear painful ulcers. The feature of this gingivitis is that the reasons are unknown, it is always a generalized and chronic process with a wavy flow.

The causes of gingivita

The reasons for the development of gum inflammation are very much, and each of us faces them in everyday life. Two groups of reasons can be distinguished that lead to gingivitis. First, these are internal reasons, that is, those processes that are normal or pathologically occur in the body and act on the gum. Secondly, it external factorsTraumizing, annoying and inflaming gums.

The main cause of gingivitis are diseases of teeth, infection and incorrect cavity care. The remaining factors in most cases are a predispose soil for the inflammation of the gums, although they can act separate reasons.

External reasons for the development of gingivitis

1. Infection and violation Hygienes oral cavities- The pathogenic bacteria settle on the teeth, the gums mucous membranes and the oral cavity, are able to cause inflammation. Infections fall through food, the remains of which remain in the oral cavity, dirty hands, toys, nipples, kitchen accessories, when using dirty toothbrushes. Also, gingivitis can cause the so-called "children's infections", that is, a windshnaya pack, cortex, rubella, scaryttern and others.

2. Toothstone - a raid on the teeth, which is impregnated with calcium salts and hardens, has a color from yellow to brown. Such a flaw eventually forms almost every person, it is difficult to remove it at home. A dentist copes with this task. The tooth stone is often postponed in the gums, pushing the gum, traumating it. In addition, the dental flare is a good medium for the development of various bacteria in it. As a result - gingivitis is inevitable.

3. Caries - Always a source of chronic infection.

4. Hike to a dentist It may end with gingivitis. This is an irregular seal, the removal of the tooth, the injury of the mucous membrane during the treatment of teeth, prosthetics, use the cap to correct the bite and so on.

5. Dental implant rejection.

6. Physical stimuli: High and low temperatures, injury solid food or various objects, coarse cleaning of teeth, as well as radiation.

7. Chemical stimuli. Alcohol, the use of poor-quality toothpaste, rinsing agent and other "dental chemistry", love for candy, vinegar, spices, accidents of swallowing of various solutions lead to chemical burns. The burn damages the mucous membrane, prepares the ground to attach bacteria.

8. Smoking - Combined effect on the mucous membrane of the mouth. Cigarette smoke is a chemical and physical irritation factor. In addition, smoking reduces local and general immunity, accelerates the deposition of the dental stone, acts on nervous systemwhich contributes to the violation of salivation. Smoking is one of the reasons for the development of atrophic gingivitis.

Photo: Smokers teeth.

9. Breathing through the mouth and Snoring - at the same time, the mucous membranes of the mouth breathes, which contributes to the reproduction of bacteria.

10. Habits Nutrition also contribute to gum inflammation. This is a love for a sweet, sharp, sour and salty, the predominance of soft food, a lack of a raw vegetable food menu. It all annoys and injures the mucous membranes of the oral cavity.

Domestic reasons for the development of gingivitis

The cause of gingivita	Gingivita shape that can develop	How does gingivitis develop?
Teething	Acute catarrhal gingivitis	A growing tooth always injures the gum from the inside. Most often, kids suffer both with the growth of dairy teeth and when they change them permanent. Adults are encountered with this problem with the growth of the so-called "wisdom teeth" or 3 molars (eights).
Malocclusion and other jaw development anomalies	Chronic catarrhal gingivitis, Less often peptic and hypertrophic form.	Incorrectly located teeth during chewing periodically or constantly injured the gums and other mucous membranes of the oral cavity.
Immunity impairment: chronic nasopharynx diseases; immunodeficiency; HIV AIDS.	Chronic gingivitis, generalized forms.	A reduced general or local (in the oral cavity) immunity cannot fight various bacteria, viruses and mushrooms, as a result - any physical or mechanical irritation of gums leads to the development of gingivitis.
Lack of vitamins - Avitaminosis and hypovitaminosis	Catarial and ulcerative gingivitis, can leak acute and chronically.	The most classical manifestation of gingivitis is the qing - the lack of vitamin C, which is found in cold countries and in the deserts. The lack of vitamin C leads to a violation of the formation of collagen - building material connective tissuewhich is present absolutely in all organs and tissues. Also to gingivitis predisposes the deficit of vitamins A, E, group V.
Disruption of digestion and gliste invasion	Chronic gingivitis	In violation of work digestive system There are different states: impairment of acidity of digestive juices, including saliva; disadvantage nutrients and vitamins; decrease in immunity; allergic reactions. All these factors affect the gums itself and on local immunity, reduce the ability of mucous membranes to deal with various infections.
Hormonal violations: diabetes; diseases of the thyroid gland; imbalance of genital hormones.	Any shape chronic gingivita, generalized forms are often developing. Hormonal violations most often are the cause of the development of hypertrophic gingivitis.	Hormonal problems lead to disruption of metabolism. The exchange of collagen suffers - as a result of a faster transition of chronic gingivitis in a hypertrophic form. In addition, due to violation of protein metabolism, immunity suffers and resistance to many infections.

Reception some medicinal preparations – to a greater extent, these are hormones (hormonal contraceptives, steroids), as well as anticonvulsant drugs.

Incixation of the bodydue to drug use, poisoning salts of heavy metals, severe infectious pathologies, tuberculosis, liver diseases or kidney.

Etiology Gingivita

Gingivitis can cause various infections as those that normally eat in the oral cavity and pathogencies that come from outside. The most common cause of gingivitis are staphylococci, streptococci, intestinal wand, mushrooms genus candidate, herpessvus. Such infections such as tuberculosis and syphilis can also lead to gingivitis.

Symptoms

The first signs of Gingivita

The first sign of Gingivita – this is blooding the gums. The intensity of bleeding depends on the severity of the flow of the inflammatory process. Usually, the teeth are cleaning to bleeding, as well as the taking of solid food (for example, apple). But with severe processes, the blood may appear without much irritation of the gums, especially after sleep.

Basic symptoms

• Bleeding gums;
• soreness in the area of \u200b\u200bthe gum, which is enhanced during the meal, especially when receiving irritating food, for example, hot or cold, sweet, acute or salty;
• itching, swelling and redness of the gums on a limited area or throughout the mucosa of one or both jaws;
• unpleasant smell of mouth;
• the presence of ulcers, ulns, bubbles;
• an increase or decrease in gums in volume;
• increased body temperature and other symptoms of intoxication - weakness, poor appetite, up to refusal of food, bad state of health etc.

But the clinical picture of each of the types of gingivitis varies. In most cases, the dentist does not make it difficult to determine the correct diagnosis, simply assessing all the symptoms and inspected the gums. The treatment tactics and recovery process depends on the correctly defined form of gingivitis.

Symptoms of gingivitis depending on the type

View of Gingivita	Complaints of the patient	Changes when examining gums, photo
Acute catarrhal gingivitis	bleeding gums; itching, burning and soreness in the gum; rarely arise symptoms intoxication; the symptoms are pronounced, in most cases recovery quickly comes.	The gums bleed when pressed on it, edema, bright red, loose, and interdental nipples are increased in size. It is possible to identify single small yasers. On the teeth in most cases there is a toothflight and a dental stone.
Chronic catarrhal gingivitis	Bleeding; itching and soreness; sensation of pressure in the gum; metal taste in the mouth; unpleasant smell of mouth; the exacerbations are replaced by the taper periods, often during remission symptoms are present, but weakly expressed.	The gums bleeding, has a blue shade, its thickening is noted, the gums resemble a roller above or under the tooth (due to edema). Detection of dental stone, teeth do not stick.
Ulcer-necrotic gingivitis	Symptoms of intoxication (increase in body temperature, weakness, and so on), often

Content

According to statistics, about 70% of Russians suffer from the bleeding of the gums. This is the main symptom of the dental disease - gingivitis. The problem is more often found in children up to 7 years and pregnant women. Avoiding the disease helps balanced nutrition and properly selected cavity care products.

What is gingivitis

The gum mucosa contains a large number of nerve endings and blood vessels. When exposed to annoying factors, damage, injuries arises pain and bleeding.

The inflammation of the gum mucosa is called gingivitis.

The disease is characterized by swelling, the appearance of unpleasant smell of mouth. On the picture soft fabrics They look blushing, and around the tooth there is a white or gray flare. Provocate inflammation of the microbes. They allocate toxins and enzymes irritating the mucous membrane.

Than dangerous gum inflammation

The prolonged effect of microorganisms on soft tissues of the mouth leads to the chronization of the inflammatory process. Against the background of the protracted gingivitis, such complications are possible:

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

Classification of pathology

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

• Acute.Characterized by pronounced symptoms. After eliminating the cause of the inflammation of the gums is completely restored.
• Chronic. Clinical picture erased. In the gums are formed irreversible changes.

By meaning of chronic gingivitis include hypertrophic form. It is characterized by an abnormal growth of the mucous membrane and is divided into two subspecies:

• Even. In the gums, blood circulation is enhanced, they increase in size. The process is considered partially reversible. With proper treatment, it is possible to suspend the growth of tissues.
• Fibrous.Part of the mucous membrane is replaced by a connective tissue. Pathological changes are irreversible.

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

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

In the form of inflammation, these types of gingivitis are distinguished:

• Catarial.It is found in 95% of cases. Only the gum mucosa is damaged, bone It remains untouched.
• Atrophic. Rare shape of the disease. Leads to a decrease in the volume (atrophy) gums. Frequent cause There is an insufficient blood supply for soft tissues.
• Ulcerative necrotic gingivitis.The consequence of the unrealized catarrhal form. On the inner surface of the jaw, the foci of necrosis and small ulcers are formed.

Separately classify such subspecies of the disease:

• Juvenile- Teen inflammation in adolescents 12-18 years old. Appears against the background of puberty, in the absence of full oral hygiene.
• Transubertate. It appears in children of 7-12 years with a reduced immunite, lack of vitamins.
• Herpetic. The inflammatory process causes herpes virus.
• Gingivit pregnant - associated with the hormonal restructuring of the body.
• Deskvamativaya - Partial rejection of the mucous membrane. At the gums appear jets that burst and form ulcers. The etiology of the disease is unknown.

Signs of Gingivita

The chronic catarrhal disease is characterized by redness and bleeding gums during the cleaning of the teeth or after the use of solid food.

Hypertrophic gingivitis causes swelling of soft tissues.

At the same time, the gum remains dense, but a false sedate pocket is formed. Acute gingivitis proceeds with pronounced clinical picture. In addition to bleeding, such symptoms are possible:

• hyperemia mucosal mouth;
• malware smell of mouth;
• flaw in language and sky;
• increasing body temperature;
• weakness;
• loss of appetite;
• metal flavor;
• the presence of ulcerations, ulnts in the mouth.

In adults

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

• With a light form of change, imperceptible: hyperemia is absent, the gums are a bit bleed.
• If Gingivitis middle severityRed gums swell, painful sensations appear after cleaning the teeth, the reaction to cold or hot food. It smells unpleasant from the mouth.
• The heavy form is characterized by the strengthening of all symptoms. In the pathological process, other areas of the oral cavity are involved: bubbles or ulcers are visible on the inside of the cheeks and lips, the sky is covered with a green-gray raid. The gums hurt and bleed when touched.

In children

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

Symptoms in adolescents are similar to the manifestations of the disease in adults.

In children under 3 years old, there are additionally present such signs:

• an increase in body temperature (up to 37-37.5 ° C);
• plasticity;
• failure to eat;
• bad Son.;
• the appearance of pink saliva;
• silver smell of mouth.

Why gums are inflamed

Adolescents are more common gingivities of bacterial nature. Low immunity, viral infections, lack of vitamins contribute to the development of the disease.

The inflammation of the gums is possible against the background of puberty, allergies, when wearing orthodontic structures for aligning teeth.

Adult causes are external and internal. The first group includes:

• disruption of oral hygiene;
• launched caries;
• dention;
• rejection of implants;
• improper nutrition;
• smoking;
• alcohol abuse;
• disturbing of nasal respiration, snoring.

The internal predisposing factors of gingivitis include:

• allergic reactions;
• diabetes;
• mental or nervous disorders;
• incorrect bite or other jaw abnormalities;
• bacteria - staphylococcus, intestinal wand, streptococcus;
• reception of medicines (steroids, oral contraceptives, anticonvulsant drugs);
• pregnancy;
• diseases thyroid gland;
• metabolic disease;
• immunodeficiency (HIV, AIDS);
• diseases digestive tract - Reflux, gastritis, ulcer.

Diagnostics

The gum inflammation is detected when examining the oral cavity. To identify an infected site of the mucous membrane, the dentist conducts a specific analysis - Schiller-Pisarev sample.

The slicer of the patient is painted with a solution with iodine. When inflammation, soft tissues acquire a light brown or brown shade.

Masp of dental plaque for microbiological research is taken with chronic or recurrent gingivitis. The analysis helps to establish the pathogen and choose an antibiotic. In generalized forms, additional studies are appointed:

• General blood analysis. Receives the amount of platelets, the rate of sedimentation of red blood cells, gives an assessment with the general condition of the body.
• Dental x-ray. It is assigned to detect sepsis, the detection of growths, damage to the bones and the roots of the teeth.
• Fluorography to exclude tuberculosis.
• Ultrasound procedure Abdominal organs. It is carried out with suspected diseases of the digestive tract, the thyroid gland.
• Immunogram. It is carried out to assess the state of the immune system.
• Blood on sugar, HIV. Assigned to confirm or eliminate immunodeficiency conditions and diabetes mellitus.

Treatment of Gingivita

Inflammation of the gums light shape Treat with local means - gels, solutions for rinsing, ointments.

Fibrous gingivitis eliminate the excision of protruding soft tissues.

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

• Prevention Gingivita - training patient properly cleaning teeth, use thread.
• Anti-inflammatory, antibacterial therapy. Patients prescribe medicinal drugs for inflammation, treatment of bacterial or viral infection.
• Dental treatment Includes dental sealing, dental removal, replacement of prostheses.
• Physiotherapy- gum massage, electrophoresis (for quick delivering medication in deep layers of fabrics)

Medical therapy

Antibiotics with gingivitis doctors are prescribed when identifying bacterial infection and ulcer-necrotic damage. Give preference to such groups of drugs:

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

To maintain immunity, immunostimulating tablets are prescribed ( Cycloferon, Vobenzym.) and vitamins ( Alphabet, multi-tabs). With the development of stomatitis and for the treatment of generalized forms of inflammation of the gums are prescribed antifungal and antiviral tools – Anti-Angry, Hexalysis, Imudon.

For local treatment Use:

• Antiseptics - Miramistin, Furacilin.Preparations kill the pathogenic flora. Prescribed for the prevention and treatment of suppuration.
• Antimicrobial, wound healing agents - Denta metrged, Salcossuril. Gels are used to treat acute or chronic gingivitis, youthful periodontitis. They remove inflammation, reduce the bleeding, heal wounds.
• Anesthetic drugs - Novocaine, Lidocaine. Assigned to relieve pain.
• Vegetable preparations - Oil sea buckthorn and tea tree. They have anti-inflammatory and antiseptic effect, contribute to healing wounds.

Dental procedures

To reduce the bleeding of the gums and eliminate the cause of the gingivitis, the dentist conducts such procedures:

• Professional cleaning of teeth- removal of dental sediments and plaque, polishing the surface of the tooth, fluoridation and appliqués with calcium.
• Stone removal- Laser, ultrasound, mechanical way. The dentist cleans the surface of the tooth from the hardened laid.
• Enamel restoration. Special solutions with calcium and fluorine are applied to the surface of the tooth.
• Treatment of caries. Damaged dentin is drilled, processed by antiseptic, seal and grind.
• Replacing prostheses or implants.
• Surgery - Removal of damaged tooth, resection of a part of the gums with drainage installation. The procedure is carried out with ulcerative-necrotic damage, fibrous and emulsion form of gingivitis.
• Physiotherapy - electrophoresis with vitamins, darsonvalization (gum treatment with high-frequency current), ultraviolet irradiation of gums. Assigned in chronic form of inflammation.

How to treat gum inflammation at home

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

To reduce the risk of injury to the mucous meal, eliminate solid food, cold or hot dishes, sharp spices from the diet.

To strengthen the gums, get rid of avitaminosis and normalize the microflora of the mucous membrane Make such products in the diet:

• fresh fruits, vegetables;
• boiled meat, bird, fish;
• vegetable soups;
• black tea;
• rubber branch;
• dairy products - cottage cheese, milk, yogurt, sour cream.

Proper teeth cleaning technique

1. Moch toothbrush water.
2. Apply in the bristle toothpaste (pea size).
3. Circular movements Remove the flare from the outer surface of the teeth.
4. Similarly, clean the inner and upper side of the teeth.
5. Rinse your mouth from pasta residues.
6. Clean the teeth for 2-3 minutes.

Folk remedies from gingivitis

As additional funds Herbs are used. They are brewed in boiling water (in the ratio of 2 tbsp. Raws on 500 ml of water) and are used to rinse the oral cavity 2 times a day. Remove inflammation, reduce the bleeding of the gums help:

• oak bark;
• the root of AIR;
• oregano;
• sage;
• chamomile;
Gingivitis - Definition, Causes, Symptoms

Attention! The information presented in the article is familiarized. Article materials do not call for independent treatment. Only a qualified doctor may diagnose and give recommendations on treatment, based on the individual characteristics of a particular patient.

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• What is gingivitis
• What provokes Gingivit
• Symptoms Gingivita
• Diagnostics Gingivita
• Treatment of Gingivita
• What doctors should contact if you have gingivitis

What is gingivitis

Gingivitis- Inflammation of the gums caused by the adverse effects of local and common factors, often by their combination flowing without a disruption of the integrity of the sedentine attachment.

Gingivitis meets in persons predominantly young (up to 25-30 years). When examining schoolchildren (Moscow), the gingivitis was diagnosed with 69% 10 years old, in 77% 12 years old, in 87% 15 years old.

In the adult population most often (90%) occurs chronic catarrhal gingivitis. Acute catarrhal gingivitis develops in childhood due to sharp bacterial and viral infections and is one of the clinical manifestations of these diseases.

What provokes Gingivit

To local etiological factorsthe development of gingivitis includes a low level of oral hygiene, resulting in a dental plaque; anomalies attaching bridles of lips and language; Defects of sealing, prosthetics and orthodontic treatment; Anomalies of the position and the crowding of teeth; Disturbance of bite and others. These factors contribute to the occurrence of localized gingivitis (inflammation of the limits of 1-4 teeth) or may aggravate generalized forms.

General factors are of great importance in the mechanism of development of gingivitis: the pathology of the digestive tract (gastritis, ulcerative disease), hormonal disorders (pregnancy, period of puberty, diabetes, thyroid disease), blood disease, stress, drug treatment, professional intoxication (lead, bismuth, aluminum, mercury, fluorine, bromine, iodine, etc.). These reasons cause usually generalized manifestations of gingivitis.

The listed etiological factors lead to a decrease in the defendant mechanisms of the gums.

Against the background of the reduction of protective mechanisms, the gums is activated by the action of the microflora of the dental plaque and the dental plaque, which in last years A leading role in the etiology of gingivitis is discharged.

In etiopathogenesis hypertrophic gingivitachanges of hormonal background (period of puberty, pregnancy, endocrine pathology) are essential medicines (contraceptives, hormones, diphenin, etc.), blood disease (leukemic reticulosis), radiation and chemotherapy. The role in the etiology of localized hypertrophic gingivitis of local factors is established: bite anomalies (deep, open, cross), the position of the teeth (recurrence, superkone teeth), the difficulties of teething, hanging the edges of the seal, injured orthopedic and orthodontic structures.

Symptoms Gingivita

Regardless of the clinicorphological form, characteristic differential identified signs are distinguished:

• the disease is detected mainly in children and young people;
• the presence of non-mineralized ompeted deposits (microbial falling, mild falling, food residues) and dental stone;
• direct relationship between index index index and inflammation index;
• the frequent combination of gingivitis with focal demineralization - caries in the stain stage in the subrian area;
• the presence of certain clinicorphological manifestations of inflammation in the gum and its deformation: with catarrile gingivitis due to edema (acute and aggravation of chronic) and inflammatory infiltration; with ulcerative - due to alteration and necrosis; under proliferative - as a result of proliferation;
• bedding with a light sounding of the grooming groove;
• lack of a gum pocket;
• lack of clear changes in interdental partitions;
• the absence on the radiograph of signs of destruction;
• the general condition of the patients is not violated.

In acute or exacerbation of chronic catarrhal and ulcerative gingivitis, depending on the severity and the prevalence of the process, a different intoxication is observed.

The severity of gingivitis is determined by the combination of general changes in the body and the degree of gums involvement in the pathological process.

Catarial gingivitis meets primarily in the form of chronic gingivitis or exacerbation. Acute catarrhal gingivitis is usually a symptom of acute respiratory infection.

The clinical manifestations of the catarrhal gingivite are due to morphological changes in the epithelium and the connective tissue to be subject to it. In the epithelium, sections of desquamations, edema, signs of paracratose and acanthosis are determined, the level of acidic glycosaminoglycans and glycogen is increased. In the prudence of the epithelium layer, the amount of protein is reduced and the RNA content is sharply reduced, in the connective tissue - chronic inflammation: Edema, hyperemia, stas, accumulation of lymphocytes and plasma cells.

There is a pronounced cell infiltration of gums. Initially, infiltrates in stroma have focal nature, located mainly perivascular, consist mainly of lymphocytes and macrophages. As inflammation progressing, the composition of the infiltration changes, plasma and obese cells begin to prevail. The newly formed vessels and fibroblasts appear, collagen formation is observed.

During the exacerbation of chronic gingivitis, leukocyte infiltration is enhanced. There are phenomena of phlebects and reduction of the capillary bed. The phenomena of edema are more often found in the epithelial attachment and subepithelical, are absent in deep stroma departments.

Reflection of pronounced vascular structures are dystrophic changes Epithelium (vacuole, balloon dystrophy), the phenomena of the adtoma.

The results of the histaenzimatic examination of the gums indicate significant metabolic disorders in the form of an increase in the permeability of the capillary type vessels, reducing the activity of aerobic oxidation and glycolysis processes in the cells of the epithelium and stroma.

Thus, a picture of chronic nonspecific inflammation and exacerbation phenomena is observed during catarile gingivitis. In the structure of the main substance - biochemical shifts, indicating a decrease in the activity of oxidizing agent enzymes.

Epithelial attachment is not violated.

The clinical picture of the catarrhal gingivitis largely depends on its severity associated with the degree of gums involvement in the pathological process.

For gingivitis, a mild degree is characterized by the defeat of gantry papillats; Middle severity - gums and marginal (edge) gums; For heavy - defeat the entire gum.

With chronic catarrhae gingivitis Patients do not appeal to the doctor, as there are usually no pain in the gums, but periodically appear a feeling of discomfort in the gums, an unpleasant smell of mouth, the bleeding of the gums when cleaning teeth and food. Interdental gantry nipples can acquire a blue color, and the edge of the gum - rolic-shaped form with unchanged attached gum. With exacerbation, patients complain of strengthening the bleeding of the gums when cleaning the teeth and the admission of solid write, a feeling of burning, cutting in the gums; The general condition is not violated. During the inspection, the hyperemia and edema of the gums are found, smoothed out the contour of the gum edge.

With exacerbation of chronic generalized catarrhal gingivitis, it is sometimes observed by a pronounced intoxication (malaise, weakness, heartbeat, subfebrile temperature). This is usually due to the exacerbation of the general disease, which is often the cause of exacerbation of the gum disease.

Chronic hypertrophic gingivitis is a chronic inflammatory process of gums with a predominance of proliferation processes. According to the clinicorphological features, edema and fibrous form; More often occurs a female form. Hypertrophic gingivitis is usually preceded by catarrhal inflammation, which can be combined with catarrhal gingivitis and does not have acute flow. Favorite localization - the region of the front teeth of the top and lower jaw.

Morphologically Elemental Form Hypertrophic Gingivitis, In addition to the edema of the epithelium and the main substance of the connective tissue and increasing the level of acidic glycozonoglycans, is characterized by the expansion and proliferation of capillaries, which creates an increase in the mass of the gums. There is an abundant and diverse cell infiltration (leukocytes, plasma and obese cells, lymphocytes).

With the swelling form of hypertrophic gingivitis patients, in addition to complaints of the bleeding of the gums in food, cleaning the teeth, make complaints on aesthetic defect associated with an increase in the volume of gums. Hypertrophic gingivitis, in which the gums hypertrophy does not exceed the tooth crown length, are called light; with a more pronounced deformation of the gums - up to the crown of the tooth - moderate; If the gum covers y or the entire tooth crown is a heavy hypertrophic gingivitis.

Objectively edema hypertrophic gingivitisit is characterized by an increase in the gums, the glossyinous surface of it, the bleeding in the sounding of the sedate groove, sometimes when tonging, the formation of false seashest pockets. Epithelial attachment is not violated. Journal and fit dental deposits may be found.

Fibrous form of hypertrophic gingivitismorphologically manifests itself by the oroging epithelium by the type of paracratose, thickening it and proliferation into the depths of the connective tissue. In the stroma - proliferation of fibroblasts and collagen structures, sealing of vessel walls, rare foci of inflammatory infiltration. Epithelial attachment is not violated. Initially, this form of gingivitis of patients usually does not bother. As the process (medium and severe), the patients notice the expansion of gums, cosmetic defects. Objectively detects the deformation of the gums, which has a pale corrosion color, dense, with a buggy surface. There is no bleeding, false seashest pockets, competent and fit dental deposits are determined.

Ulcerative Gingivitrepresents destructive shape The inflammation of the gums, in the etiopathogenesis of which a significant role is played by the change in the body's reactivity and, consequently, a decrease in the gum resistance to the autoinfection of the oral cavity (especially gram-negative bacteria, fuzospircuets).

This state may precede a sharp respiratory disease, stressful situations, supercooling. Ulcerative gingivitis most often arises from young people during or after common diseases (Influenza, ORZ, Angina), in case of malnutrition (especially the deficiency of vitamins), toxic substances, salts of heavy metals, due to irradiation. Stress may be of great importance in the development of this pathology, since it causes the blockade of the mononuclear macrophage system and stimulates glucocorticoid products. The provoking factors may be bad oral hygiene, the presence of multiple carious cavities and dental deposits, difficult to break through third molars (wisdom teeth).

Morphologically acute ulzenneconic gingivitisit is characterized by the ulceration of the epithelium of the gums, swelling and the destruction of collagen fibers, sharply pronounced leoko, lympho and plasmocyte infiltration.

The ulcerative gingivitis usually begins sharply: the pain and bleeding of the gums, hindered food, general ailment, rotten smell of mouth, increase body temperature. When examining the gum has a grayish color, gums are necrotized, an abundance of a soft dental plaque. Gums of the upper and lower jaws are affected, the disease is rarely localized on one jaw.

The severity of ulcerative gingivitis is determined not only by the degree of dams damage, but also the severity of general intoxication: an increase in body temperature, a change in peripheral blood: leukocytosis, an increased ESP, shift to the left; Regional lymph nodes may increase and become painful.

In the diagnosis of ulcerative gingivitis, it is necessary to eliminate blood diseases (leukemia, agranulocytosis), which are also characteristic of the gums of gums.

Ulcerative gingivitis of easy degree, like a catarrhal, is a reversible process. With a ulcerative gingivitis of medium and severe, the defects of the connecting epithelium and postnotic defects of the gums are irreversible: there are disturbances of the gum contour (the vertices of the tap papies are cut off) and the exposure of the necks of the teeth.

Diagnostics Gingivita

For differential diagnosis It should be taken into account, whose representatives of some nations and southern peoples have pigmentation on the gantry edge, which should not be taken for pathology.

The instrumental examination reveals the bleeding of the gums, a soft flare and the presence of an appropriate tartar. With the help of a periodontal probe, a sedental furrow is investigated: as a rule, the integrity of the sedental compound is not broken, there is no seashent pocket; Symptom of bleeding positive.

Additional examination methods include a positive silence-Pisarev test. The value of the hygiene index in most cases is greater than the norm, RMa is greater than 0. When the gingivitis progression, the volume (increases) and the qualitative composition of the gum liquid change. Compared with intact periodont with chronic catarrhae gingivitis, the number of gingle liquid is 4.6 times more. The percentage ratio of neutrophils, lymphocytes and monocytes remains unchanged, but the absolute number of these cells increases, as well as the number of leukocytes. The treatment time of the hematoma is reduced with a vacuum sample of Kulazhenko. The oxygen voltage in the gum (polarographic method) during chronic catarrhal gingivitis is reduced. The change in the form of a reopodontographic curve indicates either the pronounced dilatation of the vascular wall, which is better in prognostic plan, or about the resistance of the wall vessels of periodontal. X-ray of periodontal tissue changes are not detected.

Clinical tests are very important, allowing to identify signs of gingivitus before presenting a patient complaints to carry out the prevention of the clinical manifestation of gingivitis. Such tests refers primarily bleeding during the sounding of a sedental furrow. It should be noted that the morphological signs of inflammation are determined in the clinically intact gum.

Treatment of Gingivita

• Treatment of catarrhal gingivita

Treatment is starting with assessing the quality of the occasion of the oral cavity, removal of dental sediment and eliminate the action of traumatic factors. If necessary (the presence of traumatic bite), treatment is carried out with orthodontist and orthopedics. An important step is to remove dental deposits, which is carried out by special tools (hooks, excavators) and on special equipment (pneumatic and ultrasonic skalers of domestic and foreign production), as well as a combined method using various chemicals, followed by grinding, polishing of dental surfaces and fluorine preparations (varnishes, resins).

Give recommendations on the rules for cleaning the teeth, selecting toothpaste, using floss. If necessary, conduct control of the teeth (to determine the effectiveness of hygienic measures, coloring agents are used before and after cleaning the teeth).

In the presence of a pronounced inflammatory process, appliques of anti-inflammatory and antimicrobial means (0.06% chlorhexidine solution, 0.02% solution of furacin, chamomile infusion, calendula, sage, Rotokan, etc.). The most promising is the identification of microflora and determination of its sensitivity before appointing antibacterial drugs. Effectively proved the gel of meterogildin, diplenples, medical cryogels with dioxidine, chlorhexidine, etc. It is possible to use antiseptics (0.02% solution of furacin) and non-steroidal anti-inflammatory agents (ointment: 3% acetylsalicyl, 5% butadion). To improve epithelization processes, keratoplastic agents are used: fat-soluble vitamins A, E; Sea buckthorn oil and rosehip; Kratolin, Salkoseril, Actovegin.

Physical treatment methods are effective:

• hydromassage and hydrogaasque massage gums improve the hygienic state of the oral cavity, remove a mild dental flare and stimulate the microcirculation of periodontal tissues; course of treatment 5-10 sessions;
• the local exposure to the uflums of the short spectrum (KUF 280-1 180 mm) on the gum surface has a pronounced bactericidal effect; treatment course - 5 procedures;
• the radiation of the red and infrared gelineon laser (flux density of 100-200 mW / cm2) has an anti-inflammatory effect, normalizes local blood flow; course of treatment up to 10 procedures;
• electrophoresis CA2 +, Vitamins B, C;
• phonophoresis with dioxidine, dibunol, heparin has an anti-inflammatory effect, normalizes microcirculation.

A prerequisite for the appointment of physiotherapy are professional oral hygiene and eliminating local traumatic factors. Simultaneously with physiotherapy, if necessary, orthopedic and orthodontic treatment can be carried out.

General treatment is prescribed after examining the patient. It can be conditionally divided into a specific (directed for the treatment of a particular disease and clinical manifestation in the oral cavity) and non-specific (improving overall well-being, an increase in the reactivity of the body, improving homeostasis processes).

Vitaminotherapy- An important part of the integrated treatment of periodontal diseases. Vitamins are involved in the regulation of vital functions, the normalization of metabolism, preventing the development of degenerative processes and stimulation of regeneration. For example, vitamins C and P strengthen the vascular wall, reduce the exudation, contribute to the regeneration of periodontal tissues, vitamin E reduces oxygen consumption by tissues, participates in tissue respiration, regeneration, prevents the development of degenerative processes. With pronounced inflammation, desensitizing therapy is carried out using antihistamine (Pipolfen, Supratin, Dimedrol). In periodontology they are most effective in initial stages pathological process. Most often used vitamins A, C, R, E, group B and complexes of vitamins ("Relit", "Undevit", "Decamivit", "Aevit", "Pangeksavit", "complivit", "Titravit", "Vitrum", "Spectrum", "Supradin"), combined preparations containing vitamins and trace elements.

As a rule, the diagram of treatment is sufficient to effectively treat chronic catarrhal gingivitis. In the presence of aggressive factors (general-quality pathology, secondary immunodeficiency states etc.) more specialized, in-depth examination and comprehensive treatment With the involvement of specialists of the corresponding profile.

• Treatment of hypertrophic gingivita

In chronic hypertrophic gingivitis, the treatment is carried out taking into account the etiological factors and the clinical form of the disease. Consultations of the doctorspecialists of the relevant profile (gynecologist, endocrinologist, hematologist, etc.) are also needed.

With swelling, treatment is starting with the removal of naude deposits, appliques of anti-inflammatory and amicrobial means, destination physical factorsthat have an anti-ethnic effect (anodgalvanization, electrophoresis, darsonvalization by a short spark and others).

With the ineffectiveness of the treatment, the sclerosing therapy is shown by injection into the gantry nipples of hypertensive solutions: 10% calcium chloride solution, 40% glucose solution, 10% calcium gluconate solution, 90% ethanithic solution. Sclerosing agents are administered under the anesthesia thin needle from the top of the papilla to its base. It is simultaneously administered by 0.1-0.3 ml of the drug in 3-4 gums. The interval between the injections of 1-2 days, the course of treatment consists of 4-8 injections.

Steroid hormones are used as an anti-ethnic agent in the form of injection 0.1-0.2 ml of hydrocortisone emulsion and ointments for daily rubbing into gum papillars or in the gums of gums.

Effective injection of heparin. It is injected into the base of the gum-thoughts of 0.25 ml (5000 units); For a course of 10 injections.

For fibrous form Hypertrophic gingivitis shows NEVEMBICHIN: 10 mg of the preparation is dissolved in 10 ml of isotonic solution of sodium chloride and administered to 12-0.2 ml into nipples weekly; For a course of 3-5 injections.

Effective point diathermocoagulation of hypertrophic gums. The operation is produced under anesthesia. The electrode (root needle) is introduced into the clinic clinic to a depth of 3-5 mm (power 6-7 divisions of the coagulator scale, time 2-3 s). In each papiece coagulate 3-4 points. One session is coagulation of 4-5 papillars.

More often, in the fibrous form of hypertrophic gingivitis, they resort to surgical excision of hypertrophied gums - gingivectomy.

It should be remembered that in some cases the tactics change somewhat.

Nazube deposits remove pregnant women, they spend anti-inflammatory therapy. If, after delivery, the state state is not normalized, prescribed sclerosing therapy and surgical methods.

In the Gidantin Gingivitis, it is necessary to coordinate the question of the temporary abolition of the drug and the replacement of its other.

With leukemates, dentists spend only symptomatic therapy. Sclerosing agents, physiotherapeutic and surgical treatment methods in this case are not used.

• Treatment of Yazznunionectic Gingivita

For the treatment of a yazwnonecrotic gingivitis, it is necessary to anesthetize the areas of afflicting method (0.5-2% novocaine, lidocaine solution) or other types of anesthesia. Then the necrotic tissue is removed using sharp excavators and hooks. Manipulations should be carried out very carefully not to damage the fabrics. Simultaneously remove navel deposits, grind and polish sharp edges of teeth injured mucous membrane. Antimicrobial preparations are locally used: 0.06% solution of chlorhexidine, meterogildent, metrogyl, sangvitrine, biological drug composite (bik) diplenplots in the form of applications.

At home, it is recommended to make mouth baths with solutions of antiseptics (furacilin, metrged, chlorhexidine), phytopreparations (chamomile decractions, sage; green tea); Alkaline rinsing and appliques of meter hydrogen, Mazi metrogil. LM Chains recommends appointing metronidazole 0.5 g 2 times a day, DIDEDROL 0.05 g in the morning and in the evening, acetylsalicylic acid 0.5 g 3 times a day. Abundant drinking, gentle and full-fledged diet, vitamin therapy.