Gingivite

Definition

The gingivite is a ignition of the gum , associated or not with phenomena degenerative, necrotic or proliferative.
It is caused by the bacterial plate.
The gingivite is a Maladie parodontale, i.e. a disease concerning the Parodonte, the fabrics surrounding the Dent.
A healthy gum must be “in orange skin”, pale pink, and does not bleed with the contact. At the time of the gingivite, the gum becomes red (any variation of color signs a pathological situation), smooth, inflated. It bleeds easily, either at the time of the Brossage, or sometimes even spontaneously. One can observe pockets parodontales, i.e. a space which is formed between the top of the gum and the level where it sticks to the bone.

Classification

The gingivite can be localized or generalized, marginal, papillary, diffuse.

Gingivite " simple" chronicle

It is the usual gingivite, Inflammation of the gum due to the Dental plaque.
Signs: redness; edema (risen papillae); brilliant gum, glazed (piqueté disappears); frequent bleeding. There can be formation of pockets.
They are not painful.

Hypertrophic or hyperplasic Gingivite

An important increase in volume is observed (sometimes one does not see even any more the teeth). The gum is very fibrous; texture and the color remain normal (because one does not see the ignited part).
The etiology is the proliferation of the fibroblasts. It is sometimes of idiopathic origin, but generally it is supported by certain drugs: some Anti-epileptic S, the cyclosporine, the nifédépine. (and some Beat-blocking S)

Localized hypertrophic Gingivite: épulis

It is about a framboized tumor. The color is pronounced, glazed texture; the depth of the furrow increases much (up to 7-8 mm instead of 2-3 usual); bleed very easily.
Also called gingivite gravidic, it is favoured in particular by some Hormone S female (frequent in the expectant mother).

Ulcéro-necrotic Gingivite

In this very particular case, one deals with tissue destruction by Nécrose, without formation of pocket. One observes craters following the destruction of the gum. The GUN is very painful.
It is generally started by a very important Stress, or a serious Maladie. One needs a Immunodépression to start a GUN.

Causes

Factor etiologic

The factor etiologic (the causal factor, responsible for the disease) of the gingivite is always the dental plaque , primarily made up of bacteria.
The Bacterium S being foreign bodies, constitute an aggression, and cause a defense reaction on behalf of the gum. This reaction results in the visible Inflammation: surge of blood to bring the cells of Immunizing defense .
The Dental plaque is formed permanently, and must be eliminated by the Brossage, twice a day.

Supporting factors

the presence of tartar .

The Tartre is mineral-bearing plate. It thus mainly consists of bacteria. It causes a double irritation of the gum: on the one hand a biological irritation because of the bacteria; in addition a physical irritation because it is rough. Once the tart formed, one cannot any more eliminate it by simple a Brossage. It is necessary to go to the Dentiste to make a Détartrage.

Of the badly positioned and/or badly adapted crowns; overflowing restorations.

If the crown S posed by the dentist do not reconstitute exactly the physiological shape of the tooth, they retain the bacterial plate more easily and support its accumulation. The form and the aspect of the restorations are especially important on the level of the collet (the zone of the tooth on the level of the gum) and of the Contact point (the zone between two teeth).

Of the badly aligned teeth (returning the more difficult Brushing).
Certain hormones.

The gingivite is supported by the presence in the blood of some Hormone S, in particular at the woman, during the Grossesse. One will be able in this case to see creating épuli S, hyperplasy very localized of the gum. This phenomenon is not serious.

Certain drugs.

Certain drugs support a Hypertrophie gum (of the anti-epileptics, immuno-suppressors).

systemic Diseases: diabetes, Leukemia, immunizing disease (AIDS).

Evolution

The gingivite is highly likely to evolve/move in Parodontite if it is not traitée.
The parodontite is an ignition of the alveolar Os. This one will try to flee bacterial irritation, and one observes a reduction in the osseous level, generally associated with a mobility of the teeth concerned. The parodontite is responsible for irreversible damage.
A Abcès parodontal will be able to also occur.

Treatments

Of the regular baths of mouth as of the massages on the level of the zone concerned (using a pomade under ordinance) makes it possible to eliminate the hematomas recovering the teeth.
the day laborer use of a hydropulsor of very large is also efficacitée.

Treatment etiologic

The treatment etiologic or preventive medication is, by far, best things. It acts:

Of a brushing regular and effective of the teeth. The plate must be eliminated most perfectly possible with each brushing (twice a day).
Of a also regular descaling . The frequency is variable according to the individuals, according to the speed of formation of the dental plaque. A frequency of once per annum is the usual average (at the same time as the check).

Curative treatment

A curative treatment is undertaken only whenever the treatment etiologic appears insufficient, which is seldom the case when one is still at the stage of gingivite. A surgical treatment is generally necessary when one is at the stage of parodontite.

Depth of too important pocket. In this case the surgery can become necessary.
hypertrophic, generalized or located Gingivite (épulis). In this case one practices a Gingivectomie, surgery simple, with good performances.

See too

Disease parodontale

External bonds

Gingivite and parodontite
Treatment of the gums

Simple: Gingivitis Zh-min-nan: Khí-hoāⁿ-iām

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