Chronic gingivitis: symptoms and treatment

Chronic gingivitis — is considered one of the most common lesions of gums and consists in the flow of inflammation in them. For the disease there are no restrictions as to the age category and gender. The source of such a disease can be a wide range of predisposing factors — from the lifestyle of a person and ending with the course of ailments that affect the organs of the digestive system.



The chronic form of gingivitis has a specific symptomatology, which is pronounced in the period of exacerbation. The main symptoms include redness or hypertrophy of the gums, bleeding during oral hygiene and an unpleasant odor from the mouth.

The correct diagnosis is established by the periodontist on the basis of information obtained during the initial diagnosis and examination of the oral cavity of the patient. Treatment of gum disease includes taking medications and physiotherapy. However, in some cases, a dental operation is indicated.

The International Classification of Diseases ICD-10 identifies a separate significance for this pathology — K 05.1.

Etiology

The underlying factor in the development of the inflammatory process in the gums is the accumulation of pathological microflora, which accumulates in the dental deposits. This is most often the case with insufficient care of the oral cavity.

Nevertheless, clinicians identify other causes of the disease, which are presented:


  • insufficient intake of vitamins;
  • an incorrect bite in an adult or child
  • tartar formation
  • Incomplete removal of dental plaque;
  • pathologies of the digestive system or any other chronic diseases
  • Regular mechanical damage to the gums, for example, with a hard toothbrush
  • close arrangement of dental units
  • lack of antagonists;
  • improperly installed seals or braces that injure the skin
  • poor-quality dental prosthetics
  • long-term addiction to bad habits, in particular to smoking cigarettes
  • constant breathing through the mouth;
  • the prolonged effect of ionizing radiation on the gums
  • poisoning of the body with drugs or heavy metal salts
  • eating excessively hot meals or drinks
  • complete absence or inadequate treatment of acute gingivitis
  • hormonal disorders, namely, the course of diabetes, adolescent puberty, the period of gestation of the child or the menopause
  • infectious, allergic or systemic diseases affecting the skin
  • transferred earlier vulgar pemphigus, systemic lupus erythematosus or red lichen

All of the above factors lead to the fact that against the background of inflammation there is a gradual growth of the gingival tissue, which in the advanced cases leads to complete closure of the tooth.

The main risk group is people over the age of sixty — in this category, this disease is diagnosed in 90% of cases. It is remarkable that female representatives suffer from this disease several times less often than men.

Classification

Chronic gingivitis can occur in various forms that will differ in their symptoms and tactics of therapy. Thus, the inflammatory process in the gums happens:


  • atrophic — characterized by the fact that it reduces the size of the gum, and signs of inflammation may be completely absent. This kind of gingivitis is considered the initial form of periodontitis;


  1. catarrhal chronic gingivitis — is considered the easiest form of the course of a similar ailment. This is due to the fact that only the upper layer of periodontium is involved in pathology. It often develops in infants against the background of eruption of milk teeth;
  2. desquamative — often an allergic response of the body to long-term use of medications or irritating products, as well as the use of hygiene products
  3. hypertrophic chronic gingivitis — has a pronounced and unpleasant symptomatology. Absence of treatment leads to the fact that the inflamed gum completely covers the tooth;
  4. ulcerative-necrotic — in the vast majority of cases refers to acute gingivitis, but it rarely develops in chronic conditions. This type of disease involves surgical excision of the affected areas of the gum.

Depending on the degree of involvement of the gingival parts, chronic gingivitis happens:


  • mild degree — only the interdental gingiva, i.e., the papilla, is affected
  • average severity
  • severe — all parts of the gum are involved in the pathological process, namely the papilla, marginal and alveolar zone.

The prevalence of the inflammatory process in the gums is different:


  1. chronic generalized gingivitis — the disease spreads to the mucous layer of the alveolar process of all teeth of both the upper and lower jaws
  2. chronic focal gingivitis — the inflammation covers a certain group of teeth.

Symptoms

The clinical picture will depend on the form and stage of the disease.

It should be noted that chronic generalized catarrhal gingivitis can for a long time be completely asymptomatic. Nevertheless, among the signs it is worth highlighting:





  • swelling of the gingival mucosa
  • redness or cyanosis;
  • bleeding when brushing teeth or while eating coarse food
  • bad breath from the mouth
  • accumulation of plaque;
  • formation of tartar;
  • pulsating pain in the gums
  • the appearance of a white plaque on the tongue
  • minor malaise
  • increased sensitivity of teeth.

Hypertrophic or hyperplastic chronic gingivitis has such symptoms:


  1. proliferation of gingival tissue
  2. the change in the volume of the interdental papillae larger
  3. Swelling and redness of the gingival;
  4. mild pain syndrome
  5. blood allocation during hygiene procedures or at a meal — it is worth noting that chronic simple marginal gingivitis does not have such a sign;
  6. gum density
  7. formation of false periodontal pockets.

The symptomatology of the desquamative variety of the disease is presented:


  • the appearance of erythematous spots characterized by swelling
  • the formation of vesicles filled with serous-hemorrhagic fluid
  • exposure of the underlying tissues and bleeding
  • the appearance of pain when pressing on the gums.

For the atrophic version of inflammation, the following symptoms are inherent:


  1. hypersensitivity to cold or hot food and drink
  2. wrinkling of the gums
  3. Gradual denudation of the neck of the tooth.

The clinical picture for ulcerative-necrotic type of the disease is presented:


  • soreness and itching of the gums;
  • changes in the volume of regional lymph nodes
  • the formation of sores on the interdental papillae
  • increase in body temperature;
  • increased salivation.

If chronic gingivitis has been caused by poisoning with salts of heavy metals, the following symptoms will be expressed:


  1. appearance of a dark shade on the gingival margin
  2. abundant saliva secretion
  3. the constant presence of metallic taste;
  4. the formation of microabscesses;
  5. spread of the inflammatory process to the sky
  6. signs of stomatitis.

For the slow flow of gingivitis is characterized by a sudden exacerbation, a gradual fading of symptoms and a prolonged period of remission, which can last up to two years.

Diagnostics

If you have the above symptoms, you need to seek help from a dentist or a periodontist. Such specialists will be able to correctly diagnose and determine the tactics of how to treat chronic gingivitis.

Primary diagnosis involves the implementation of such activities:


  • the clinician’s examination of the patient’s medical history and life history — to determine the possible etiologic factor
  • Visual and instrumental examination of the oral cavity — the condition of the mucosa and teeth is assessed. In addition, the doctor pays attention to the type of bite, the presence and condition of dentures, braces or seals, as well as the presence of calculus or caries
  • a detailed interview of the patient or his parents — to determine the first time of appearance and severity of symptoms. This is very important, because catarrhal gingivitis in children and adults can be very asymptomatic for a very long time.

Instrumental diagnostic methods are limited to implementation:


  1. X-ray of the tooth — will indicate the severity of the course of the pathological process
  2. Sensing the gingival groove — will show the presence of bleeding, the absence of false gingival pockets and the immobility of the tooth.

In order to accurately establish the cause of what caused chronic gingivitis to the patient, consultations of such specialists are necessary: ​​


  • Endocrinologist and rheumatologist
  • gastroenterologist and infectious disease specialist
  • dermatologist and allergist.

Treatment

Elimination of such ailment requires a whole complex of therapeutic measures, namely:


  1. sanitation of the oral cavity;
  2. Removing tartar, sediment or caries
  3. Extraction of teeth that have been fractured
  4. elimination of bite anomalies
  5. neutralization of defects obtained during sealing or prosthetics
  6. replacement of prostheses
  7. plastic operation of the frenum of the lips or tongue

Also, chronic gingivitis treatment includes:


  • Professional oral hygiene
  • treating the inner shell of the mouth with antiseptic substances
  • mouth rinsing with chamomile, eucalyptus and oak bark — this should be done after each meal and hygiene procedures
  • Periodontal gum applications.

Thanks to all the above conservative methods, successful treatment of chronic catarrhal gingivitis is carried out, and in other cases resort to:


  1. taking antibacterial substances and immunomodulators
  2. gum massage
  3. drug electrophoresis
  4. laser therapy and ultraviolet radiation
  5. diathermocoagulation or cryodestruction of gingival prolapses
  6. Gingivectomy is an operation aimed at excision of the affected gum area.

Prevention and Forecast

To avoid the development of a disease such as chronic gingivitis, it is recommended:


  • completely abandon the addictions;
  • eat only warm food and drinks;
  • timely treatment of non-stomatological diseases that can lead to inflammation in the gums
  • Visit the dentist several times a year for preventive examination or removal of dental calculi and caries

The most favorable prognosis is catarrhal chronic gingivitis, but without revealing the cause of the disease, the likelihood of its recurrence is high. Completely cure atrophic gingivitis is impossible, complex therapy can only slow down the process of atrophy.

The outcome of chronic gingivitis, which was formed against a background of another ailment, completely depends on the source and the stage of inflammation.




It is worth noting that the lack of treatment of such a disease is fraught with the development of periodontitis, periodontitis or complete loss of teeth.