Gingivitis. Treatment in adults, children, effective drugs, folk remedies, causes, complaints

Gingivitis - inflammatory process in the gumsthat does not disturb the mobility of the teeth and does not touch the periodontal tissues. The disease implies the initial stage of inflammation of the soft tissues of the oral cavity, which, in the absence of timely treatment, can develop into a more severe pathology - periodontitis. Gingivitis occurs in people of all ages, but is most common in adults.

Disease types

In dentistry, there are several classifications of the disease.

Depending on how the disease proceeds, there are:

• acute gingivitis - is characterized by pronounced symptoms and is easily treatable;
• chronic gingivitis - a protracted course of the disease with erased symptoms, characteristic periods of exacerbations and remissions.

Depending on the form in which the inflammation of the gums is expressed, the disease is divided into 4 types.

Catarrhal gingivitis	The most common form of the inflammatory process, which occurs both acutely and chronically. Has pronounced symptoms in the form of swelling, pain, redness.
Hypertrophic gingivitis	It becomes a consequence of a long course of the disease and always appears in a chronic form. It is characterized by the proliferation of soft tissues of the mucous membrane in the oral cavity.
Ulcerative gingivitis	It is a consequence of catarrhal gingivitis, which has not been treated for a long time. Pathology is characterized by the destruction of the tissues of the mucous membrane, which leads to the formation of bleeding ulcers.
Atrophic gingivitis	It occurs as a result of prolonged circulatory disorders in the gums. This leads to a decrease in the volume of the gum tissue and exposure of the necks of the teeth. There are no signs of inflammation.

A separate classification includes herpes and desquamative types of the disease. Herpetic gingivitis is an inflammation of the gums caused by a herpes infection against a background of decreased immunity. Pathology is characterized by the formation of ulcers, localized not only on the gums, but also throughout the oral mucosa.

Desquamative gingivitis is a type of disease in which the epithelial ball sloughs off, as a result of which red ulcerous spots appear on the gums.

Stages and degrees

Gingivitis (treatment in adults is associated with the use of anti-inflammatory drugs), according to the degree of prevalence, is divided into:

• local - when the lesion of the gums covers the area of ​​1 or 2 teeth or interdental spaces;
• generalized - the lesion is spread over all tissues of the upper or lower jaw.

  

The disease also has varying degrees of severity:

• mild degree - characterized by damage to the interdental papillae and minor manifestation of symptoms: redness and the development of swelling of the gums;
• medium degree - inflammation covers the marginal part of the gums and manifests itself in the form of redness and bleeding;
• severe degree - the inflammatory process is generalized with severe symptoms and pain.

Symptoms

The manifestation of the symptoms of the disease depends on the form of its course.

Acute catarrhal gingivitis	itching in the gums; bad breath; increased pain during mechanical action on the gum; bleeding while brushing your teeth.
Ulcerative gingivitis	the appearance of aching pain; swelling of the gum tissue; the formation of small ulcers on the surface of the mucous membrane; putrid odor from the mouth; an increase in subfebrile temperature.
Chronic catarrhal gingivitis	slight swelling and cyanosis of the soft tissues of the mucous membrane; lack of pain; the presence of bad breath.
Chronic hypertrophic gingivitis	enlargement of the interdental papillae; change in the relief of the gingival tissue; swelling; increased swelling and bleeding from the gums.
Herpetic gingivitis	the appearance of herpetic vesicles and ulcers; severe pain syndrome; redness of the gums.

Reasons for the appearance

Gingivitis (treatment in adults and children has some difference) is often associated with a decrease in immunity and develops under the influence of local and systemic factors.

Systemic reasons include:

• infectious diseases;
• avitaminosis;
• diseases of the digestive tract;
• diabetes;
• tuberculosis infection;
• puberty.

Local factors that affect the development of pathology include, first of all, a violation of oral hygiene. Irregular brushing of teeth provokes the accumulation of plaque, which becomes denser and causes the development of tartar.

Other external factors include:

• mechanical damage to the mucous membrane of the gums (burns with hot food, pricking by particles of solid products);
• damage to the gums by caustic chemicals;
• the development of caries;
• poor-quality sanitation.

The risk group for the development of the disease is:

• women taking oral contraceptives;
• people taking cyclosporine-based drugs

It should be noted that gingivitis rarely develops as a separate independent disease. Often, pathology acts as a concomitant symptomatology of more serious disorders in the body.

Diagnostics

Diagnosis of gingivitis includes the use of therapeutic and instrumental research methods. The initial diagnosis is carried out on the basis of the patient's complaints, after a visual examination of the state of the oral mucosa. The dentist will assess the shape, color and size of the interdental papillae, the degree of deformation of the gingival margin, and the mobility of the teeth.

If, after a visual examination, differential diagnosis is required, the doctor will offer to pass one of the following instrumental examinations:

1. Probing the integrity of the periodontal joint - a well-known diagnostic method in dentistry using a special instrument - a probe. This method is used in case of severe swelling of tissues in the area of ​​the tooth neck, when a false impression is created about the formation of a gingival pocket. Immersion of the instrument into the gingival groove to a depth of less than 1 mm indicates the integrity of the gingival joint.
2. Schiller-Pisarev test - a method using an iodine-containing solution, which stains the gums and monitors the development of the reaction to the sample. In the case of pathology, the mucous membrane turns brown.
3. Determination of the Green-Vermilion hygienic index - a method in which the amount of plaque on the teeth is determined without the application of aids. During the dental examination, the degree of contamination of 6 teeth is assessed and the general hygiene index is derived using special points. With gingivitis, the value of this index increases.

In some cases, for the differential diagnosis of gingivitis with periodontitis, X-ray examination or orthopantomography is used.

When to see a doctor

If the first symptoms of gingivitis are detected, it is necessary to seek help from a dentist. Long-term absence of treatment of the disease can lead to the development of a more serious pathology of the oral cavity - periodontitis.

The primary manifestation of gingivitis is associated with the following symptoms:

• redness of the gum tissue;
• the presence of itching and discomfort while chewing food;
• the appearance of blood on the brush while brushing your teeth;
• swelling of the gums;
• bad breath.

In the case when a more serious disease has become the cause of the development of gingivitis, consultation of narrow specialists is required:

• endocrinologist (with diabetes mellitus);
• hematologist (for blood diseases);
• gastroenterologist (for chronic diseases of the gastrointestinal tract).

Prophylaxis

To avoid the development of gingivitis or reduce the risk of its occurrence, you should adhere to simple rules regarding oral hygiene and condition the body as a whole:

• daily clean teeth from food debris and sticky plaque;
• visit the dentist regularly for oral cavity sanitation;
• lead a healthy lifestyle;
• do not abuse smoking;
• make professional teeth cleaning.

Treatment methods

Gingivitis (treatment in adults depends on the form of the course of the disease) responds well to treatment if diagnosed early. To eliminate the pathology, mainly medications are used, the action of which is aimed at eliminating the inflammatory process in the gums.

Physiotherapy is used as an additional treatment. For the treatment of advanced stages of hypertrophic gingivitis, gingivectomy or cryodestruction is used. In most cases, patients also need to clean their teeth to remove deposits.

Medications

For the treatment of gingivitis, several groups of drugs are used: anti-inflammatory, antiseptic, analgesic, antibacterial.

At the initial stage of acute catarrhal gingivitis, drugs are used in the form of anti-inflammatory gels, ointments and powders for the preparation of solutions:

• Periodontal disease - a product in the form of a mouthwash. The drug prevents the formation of plaque, eliminates bleeding and relieves inflammation in the gums. Use the remedy 2-4 times a day after brushing your teeth or eating. For this, 10 ml of the substance must be taken into the mouth and rinsed for 1 minute. Do not eat food within 30 minutes after use. Price - from 160 rubles.
• Metrogyl Denta - antimicrobial and anti-inflammatory dental gel. For gingivitis, apply a thin layer of the gel to the affected areas of the gums 2 times a day. The duration of treatment is from 7 to 10 days. Cost in pharmacies - from 250 rubles.
• Malavit - anti-inflammatory and analgesic agent based on herbal ingredients. To prepare a solution for irrigation of the oral cavity, dilute 10 drops of the drug in 200 ml of warm water. Rinse the gums 1-2 times a day. Cost - from 300 rubles.

Antiseptics are prescribed for the development of ulcerative gingivitis to treat soft tissue ulcers.

The most popular are:

• Miramistin - a solution for topical application, which has a broad spectrum of action and has a bactericidal effect. With gingivitis, it is recommended to use 10-15 ml of the drug for rinsing the mouth 3-4 times a day. The average price in pharmacies is from 300 rubles.
• Furacilin - antimicrobial solution for rinsing the mouth. Use the drug as a mouthwash 3-4 times a day. Cost - from 40 rubles.
• Chlorhexidine - an antiseptic agent in the form of a 0.05% solution. In the treatment of gingivitis, the drug is used 2-3 times a day as a mouthwash. The duration of treatment is 10-12 days. Antiseptic price - from 30 rubles.

Painkillers are used for acute inflammatory processes, which are accompanied by severe pain syndrome. Anesthetics can be both local and general.

Local anesthetic drugs include:

• Holisal - dental gel with anti-inflammatory effect. Begins to act after 2 minutes. after application to the affected area and relieves pain for 5-8 hours. The drug must be rubbed with a thin layer into the soft tissue of the mucous membrane 2-3 times a day before meals. Average price - from 336 rubles.
• Kamistad - a combined preparation in the form of a gel with the addition of lidocaine and chamomile extract. The tool promotes a quick and long-term reduction of pain during inflammatory processes in the gums. A strip up to 1 cm long is applied to the affected area and the gel is gently rubbed in. The frequency of use is up to 3 times a day. The cost of the drug is from 240 rubles.

Systemic analgesics include:

• Nimesil - granules for suspension preparation. The drug belongs to the class of non-steroidal anti-inflammatory drugs. To achieve a pronounced effect, take 1 sachet 2 times a day for 7-12 days. Average price - from 680 rubles. per package (9 sachets).
• Diclofenac - a drug in the form of tablets, which has analgesic effects and relieves inflammation. The daily dose is 100-150 mg per day, divided into 2 doses. The duration of treatment is determined individually. Cost - from 40 rubles.

Antibiotic therapy is used in the absence of the desired effect in the treatment of other groups of drugs.

The most popular antibiotics used in dental practice are:

• Lincomycin - an antibiotic of the lincosamide group, which has a bactericidal effect. The daily dose of the drug is 1500 mg, divided into 3 doses. Duration of treatment is 5 to 7 days. Price - 60-100 rubles.
• Siflox - a broad spectrum antibacterial agent containing ciprofloxacin. Take 500 mg 2 times a day for 7-10 days. Average cost - from 90 rubles.
• Amoxicillin - antibiotic of the group of semi-synthetic penicillins with a broad spectrum of action. A single dose of the drug for people over 40 kg is 250-500 mg. The intensity and duration of admission are determined individually. Cost - from 50 to 100 rubles.

In severe ulcerative gingivitis, after removal of necrotic masses on ulcers, patients are prescribed keratoplastic agents that normalize the metabolic processes of the oral mucosa.

These drugs include:

• Retinol - vitamin A, necessary to accelerate the healing process of damaged areas. An oily solution is used in the form of applications, applied to the mucous membrane 3-4 times a day. The duration of the application is 10-15 minutes. The course of treatment is up to 10 days.
• Aekol - a complex preparation with the addition of retinol, vitamins A and K. the agent is also used in the form of applications 3-4 times a day. The duration of treatment is 7-10 days.

Traditional methods

Folk remedies for the treatment of gingivitis are effective when they act as concomitant therapy with medications. Folk recipes include special decoctions used to rinse the mouth and apply to the affected areas.

To relieve the inflammatory process and disinfect the gum mucosa, the following folk remedies are used:

1. Infusion of calendula, chamomile and yarrow. Take 1 tbsp. l. dried flowers of each of the plants, mix in a separate bowl. 2 tbsp. l. pour 400 ml of boiling water over the resulting dry mixture and insist for 1 hour. Rinse the mouth with the resulting infusion for 1 min. The frequency of use is 2-3 times a day.
2. Sage broth. Take 1 tsp. l. dry leaves of the plant and pour 1 cup boiling water. Put the resulting mixture on fire and boil for 5-7 minutes. Cool the broth and strain. Rinse your mouth three times a day.
3. A solution of soda and salt. Dissolve 1 tsp in 1 glass of warm water. l. soda and salt. Rinse your mouth 3-5 times a day for 2-3 days.
4. Broth from oak bark. 1 tbsp. l. Pour 200 ml of hot water over chopped oak bark and boil over low heat for 10 minutes. Strain the resulting broth, add 50 ml of warm water. Rinse your mouth 3 times a day.
5. Peppermint infusion. Take 1 tbsp. l. peppermint and pour 200 ml of boiling water. Insist the solution for 30 minutes. Use as a mouthwash for sore gums 3 times a day.
6. In addition to rinsing solutions, you can make oily mixtures for applying applications at home:

• St. John's wort oil for a compress. 1 tbsp. l. Pour 100 ml of vegetable oil with crushed St. John's wort and bring the solution to a boil. The resulting funds are applied to cotton swabs and laid on the affected areas of the mucous membrane.
• Rose oil. To prepare the applique, mix 4 drops of rose oil with 2 tbsp. l. any vegetable oil. Apply the resulting mixture to a cotton pad and apply to the inflamed gum area.

Other methods

Gingivitis (treatment in adults consists of several stages) is not always possible to eliminate with the use of drug therapy. In dental practice, an important place is given to physiotherapeutic methods that have a beneficial effect on the state of the periodontium.

The most effective of them are:

1. Phonophoresis of medicinal substances - the use of ultrasound in combination with drugs that penetrate the mucous membrane during exposure to ultrasonic vibrations. For the treatment of gingivitis, a contact medium is used - glycerin, petroleum jelly and drug mixtures. The course consists of 12 procedures, which are carried out every other day.
2. Drug hydrotherapy - irrigation of the mucous membrane with water with the addition of carbon dioxide and decoctions of medicinal herbs. The procedure stimulates microcirculation in the soft tissues of the oral cavity. Physiotherapy is used for acute and chronic gingivitis.
3. Darsonvalization - a method of exposure to the affected areas of the gums with a gingival electrode, used to improve blood supply and relieve swelling. It is used for the chronic form of the disease.
4. Electrophoresis with drugs - the introduction of drugs and vitamins into the mucous membrane of the gums using diadynamic alternating current. For the procedure, vitamin C, calcium salts and calcium gluconate are used. Electrophoresis is used to relieve inflammation and swelling of the gums in the chronic course of gingivitis. The course consists of 10-15 procedures.
5. Hydroelectortophoresis - a method of treatment in which the delivery of medicinal substances into the periodontal tissue is carried out using a unidirectional pulsating current. Treatment of pathology is carried out using NVPS, antibacterial and homeopathic remedies.
6. Fluctuorization - anti-inflammatory and absorbable contact technique using special oral electrodes. It is used exclusively for the chronic stage of the disease. The course consists of 10 procedures lasting 10-15 minutes.

Possible complications

Gingivitis in adults, if left untreated, can lead to the development of more serious diseases of the oral cavity:

• periodontitis;
• periodontal disease;
• purulent abscess of the gums.

In turn, the advanced stages of periodontitis cause complete or partial loss of teeth.

Gingivitis is the development of any inflammatory process of the soft tissues of the gums. In adults, the disease occurs in both acute and chronic forms and has many types. Treatment of pathology consists of the use of medications and physiotherapy methods. The development of complications is possible in the absence of timely medical care.

Article design: Vladimir the Great

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