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Gingivitis Inflammation of gingival tissues commonly associated with dental plaque & calculus Acute gingivitis Causes: Local Poor dental hygiene Food stagnation (soft sticky) Badly restored filling Prosthesis - Orthodontic appliance Mouth breathers Trauma/ Traumatic bite Infection .
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Gingivitis Inflammation of gingival tissues commonly associated with dental plaque & calculus Acute gingivitis Causes: Local • Poor dental hygiene • Food stagnation (soft sticky) • Badly restored filling • Prosthesis - Orthodontic appliance • Mouth breathers • Trauma/ Traumatic bite • Infection Dr S Chakradhar
General causes • Vitamin deficiency: Vit C , Vit B2, Vit A • Hormonal effect • Pregnancy • Puberty • Systemic diseases: DM, TB, severe anemia and leukemia, HIV • Drugs: nifedipine, phenytoin, OCP Dr S Chakradhar
Types • Acute necrotising ulcerative gingivitis • Herpetic gingivitis • Nonspecific gingivitis • Leukemic gingivitis Dr S Chakradhar
ANUG • Etiology • Borellia vincenti • Fusiform bacilli • Predisposing factors • Smoking • Poor oral hygiene • Alcohol • Immunocompromised condition Dr S Chakradhar
Clinical features • Pain • Ulcer • Bleeding • Salivation • Halitosis • Metallic taste • Fever, malaise and enlarge cervical LN Dr S Chakradhar
Management • Maintaining oral hygiene • Prevention of plaque & Calculus • Wash the lesion with 3% Hydrogen peroxide • Paint with 10% chromic acid gel • Advice antiseptic mouthwash eg 0.2% chlorhexidine • Analgesics as needed • Metronidazole 400mg PO TDS for 7 days Dr S Chakradhar
Acute herpetic gingivitis • Caused by Herpes simlex virus, Herpes labialis • Occurs usually in children of 3 to 6 yrs Clinical features • Small painful vesicles • Ulcer • May involve the lip, cheeks, tongue and palate • Halitosis • Fever, enlarged LN Dr S Chakradhar
Management • Maintaining oral hygiene • Prevention of plaque & Calculus • Self limiting disease (1 or 2 weeks) • Bed rest • Soft diet • Analgesics • Tetracycline mouth wash • 250mg in 30ml water 6hrly Dr S Chakradhar
Acute non specific gingivitis • Probably due to overgrowth of normal bacteria • Cl/F similar with pain and swelling of gums • Bleeds on probing and pus may also be seen • Treat by H2O2 wash • Advise proper oral hygiene Dr S Chakradhar
Chronic gingivitis Causes • Plaque and calculus around gingival margin • Mouth breathers and incompetent lip seal • Traumatic bite • Inadequate treatment of acute gingivitis Dr S Chakradhar
Clinical features • The classic triad of redness, swelling, and bleeding on gentle probing are diagnostic • Usually complain that 'gums bleed on brushing‘ • Color change: from pink to beefy red/purple • Gingival pockets Dr S Chakradhar
Treatment • Oral hygiene maintenance • Brushing • Mouthwash • Regular scaling • Gingivoplasty / Gingivectomy • Antibiotics: tetracycline Dr S Chakradhar