Gingivitis (inflammation of the gums) - types and forms (catarrhal, hypertrophic, ulcerative, necrotic, acute and chronic), causes of the disease, symptoms (bad breath, pain, bleeding, etc.), diagnostic methods, photos. Interdental papillae and problems with

DISEASES OF THE ORAL MUCOSA

According to their manifestations, diseases of the mucous membranes of the oral cavity can mainly be divided into three groups: 1) inflammatory lesions - stomatitis; 2) lesions similar to a number of dermatoses, dermatostomatitis, or stomatosis; 3) diseases of a tumor nature. Recognizing all these diseases requires first of all knowledge normal anatomy and physiology of the oral mucosa, the ability to study it taking into account the state of the whole organism, directly connected in its existence with the external environment.

RESEARCH METHODS. GENERAL SYMPTOMATOLOGY

The structure of the oral mucosa. The oral mucosa consists of three layers: 1) epithelium (epithelium); 2) the mucous membrane itself (mucosa propria); 3) submucosa (submucosa).

Epithelial layer formed by stratified squamous epithelium. The epithelial layer contains cells of various shapes - from a cylindrical, cubic layer to a completely squamous epithelium surfaces. As in the skin, the epithelial cover can be divided depending on the characteristics and function of its individual rows into four layers: 1) horny (stratum corneum), 2) transparent (stratum lucidum), 3) granular (stratum granulosum), 4) germinative (srtatum germinativum).

The germinal layer makes up a significant part of the epithelium of the mucous membrane. Its lower row consists of cylindrical, densely colored cells, with their narrow side facing their own membrane. These cells are considered to be the germinal layer of the germinal layer. It is followed by several rows of flatter cells, which are also well painted and connected to each other by jumpers. Then there are layers of cells that are in various stages of keratinization: 1) granular layer - the initial degree of keratinization, 2) transparent layer - a more pronounced degree of keratinization, which is the transition to the last, clearly defined stratum corneum. The transparent layer of epithelium on the oral mucosa is mainly observed in those places where keratinization manifests itself with greater intensity.

Actually mucous membrane formed by dense connective tissue with a fibrillar structure. The connective tissue of the membrane itself contains small blood vessels such as capillaries and nerves. The membrane at the border with the epithelium forms papillary outgrowths. These papillae come in different sizes. Each papilla has its own feeding vessel.

Submucosa also of a connective tissue structure, but it is looser than the shell itself and contains fat and glands; it contains larger vascular and nerve branches.

The mucous membrane of the oral cavity is equipped nerve fibers- sensitive and motor. The innervation of the mouth involves the cranial and spinal nerves, and cervical region sympathetic nerve. Of the cranial nerves, the following are suitable for the walls of the oral cavity: trigeminal, facial, glossopharyngeal, hypoglossal, partly vagus.

To study the oral mucosa, we use a number of techniques, which, depending on the characteristics of the case, are used in various numbers and combinations. The main examination of the oral cavity is made up of the following points: 1) - survey, 2) examination, 3) palpation - palpation, 4) microscopic examination. In addition, a study of the general condition of the body and individual systems and organs is carried out, and often additional serological, hematological and other laboratory tests.

Onpoс. As always, in case of diseases of the mouth, general, indicative questions are first asked, and then questions of a particular nature. When questioning patients suffering from lesions of the mouth, the doctor often immediately detects a number of objective symptoms that are associated with a disorder in the act of speech (dyslalia). They appear as a result of damage to oral tissues by processes inflammatory in nature or the presence of congenital or acquired oral defects. Disorders are manifested in a change in the sonority of speech and the nature of the pronunciation of individual sounds - letters.

Inflammatory processes on the lips, which reduce the mobility or swelling of the latter due to pain, often distort the pronunciation of most of the labial sounds: “m”, “f”, “b”, “p”, “c” (dyslalia labialis).

Inflammatory processes in the tongue, especially peptic ulcers or other diseases leading to restriction of the mobility of this organ, make it difficult to pronounce almost all consonants, which leads to a lisping conversation (dyslalia labialis). With the defeat of the back of the tongue, the pronunciation of the sounds "g" and "k" is especially affected.

When the integrity of the hard palate is damaged (syphilis, congenital cleft defects, trauma) and when the soft palate is damaged, even slightly, speech takes on a nasal tone: all consonants are pronounced through the nose. The pronunciation of the so-called closed consonants is especially impaired: “p”, “b”, “t”, “d”, “s”. This speech disorder is called rhinolalia aperta in contrast to rhinolalia clausa (dull sound). The latter disorder is observed during infiltrating processes of the palatine velum.

The doctor pays attention to all these disorders at the beginning of the conversation with the patient, thus introducing elements of a functional study of the mouth into the survey.

Particular attention should be paid to complaints of difficulty and pain during eating, mainly when the soft palate is affected. Swelling of the palate and pain interfere with the normal act of active swallowing. If the integrity of the palatine vault is damaged, liquid food flows into the nose. Small abrasions on the hard palate often cause severe pain when eating solid food. Painful lesions tongue also causes difficulty in eating solid food; liquid food passes more easily. Complaints of painful eating may also occur if the vestibule of the oral cavity is affected. With stomatitis and ulcerative processes in the mouth, patients complain of bad breath (foetor ex ore).

It is important to establish a connection between mucosal lesions and some other diseases. In the presence of stomatitis and stomatosis, it is necessary to pay Special attention for general infectious diseases, diseases of the digestive system, metabolism.

In acute cases, it is important to determine the presence of any acute general infection, for example, influenza. Often, influenza infection can precede stomatitis. In some acute diseases, damage to the mucous membrane provides very valuable diagnostic signs, for example, Filatov's spots in measles. Often stomatitis complicates some general debilitating disease or follows a disease, especially often after the flu. Acute as well as chronic lesions of the mucous membrane can be associated with skin diseases, general poisoning(medicinal, occupational, etc.), diseases of the gastrointestinal tract (anid and anacid gastritis, membranous colitis, etc.), helminthic infestation, nutritional disorders (vitaminosis - scurvy, pellagra, etc.), blood diseases (anemia, leukemia and etc.). Specific infections - tuberculosis and syphilis - should be highlighted. Diseases of the glands internal secretion, such as dysfunction thyroid gland, should also be noted during the survey.

Examination of the oral mucosa. The most valuable method of examining the mouth is examination. Regardless of the intended diagnosis, all parts of the mouth should be examined. It is necessary to examine the mouth at very good lighting, preferably during the day. Not only the affected area is subject to examination, but the entire mucous membrane of the oral cavity and the affected areas of the mucous membrane of the pharynx, skin, perioral area and face.

Lips and cheeks. The oral mucosa mainly differs from the skin in the presence of a thin epithelial layer, very slight keratinization of the surface layers, abundant blood supply due to the presence of a dense vascular network, and the absence hair follicles And sweat glands, a small number of sebaceous glands, which are mainly located in the area of the mucous membrane of the lips from the corners of the mouth to the free edge of the teeth. The skin, located at the junction with the mucous membrane in the area of the red border of the lips, is also similar in structure to the mucous membrane. These features of the latter, as well as the presence of bacteria and a moist, warm environment in the form of oral fluid, determine different manifestation lesions on the mucous membrane and skin of the same origin.

The examination begins from the vestibule of the mouth. Using a mirror, spatula or hook, first pull back the lip, then the cheek. On the inner surface of the lips, thin lines can be seen from under the mucous membrane. superficial veins and intertwined strands of loose connective tissue and the orbicularis oris muscle protrude. Upon closer examination, sparsely scattered small yellowish-white nodules can be seen. These are the sebaceous glands. In people suffering from seborrhea, the number of sebaceous glands in the oral cavity is often increased. On the lateral parts of the lips, especially the upper, small nodular protrusions are visible - mucous glands. On the mucous membrane of the cheek, sebaceous glands are sometimes found in significant numbers in the form of a scattering of yellowish-white or grayish tubercles, which are usually located along the bite line in the area of molars and premolars. Acinous glands are also found on the mucous membrane of the cheeks. There are fewer of them here than on the lip, but they are larger in size. A particularly large gland is located opposite the third upper molar (gianduia molaris). It should not be confused with a pathological formation. During inflammatory processes of the mucous membrane, the number of visible glands usually increases.

On the buccal mucosa at the level of the second upper molar, if the cheek is pulled back, one can see a small protrusion of the papilla type, at the top of which the stenon duct opens - the excretory duct parotid gland. To determine the patency of the stenon duct, the examination can be supplemented with probing. The direction of the stenon duct in the thickness of the cheek is determined by a line drawn from the earlobe to the red border of the upper lip. Probing is performed using a thin blunt probe, while the cheek should be pulled outward as much as possible. The probe, however, cannot be passed into the gland. Usually the probe gets stuck in the place where the stenope duct passes through m. buccinator. Without extreme necessity, probing is not recommended to avoid the introduction of infection and injury. Is it easier and safer to examine gland function through massage? massage the area of the parotid gland from the outside; the doctor observes the opening of the duct; saliva flows normally. When the gland becomes inflamed or the duct is blocked, saliva is not released, but pus appears.

In the transitional fold, mainly at the point of transition of the mucous membrane of the cheek to the gum, in the area of the upper molars, blood vessels, especially veins, are sometimes clearly visible. They should not be mistaken for pathological formations.

The normal mucous membrane of the lips and cheeks is mobile, especially on the lower lip; it is less mobile on the cheeks, where it is fixed by the fibers of the buccal muscle (m. buccinator). In the presence of inflammatory processes, deeply penetrating ulcers, the mucous membrane takes on an edematous, swollen appearance, sometimes tooth marks are visible on it, and its mobility is sharply limited.

In addition to inflammatory processes, swelling of the mucous membrane is observed in heart and kidney suffering, in some diseases associated with dysfunction of the endocrine glands (myxedema, acromegaly).

After examining the vestibule of the mouth (lips and cheeks), the oral cavity is examined (Fig. 175).

The mucous membrane of the hard palate in appearance it differs significantly from that on the cheeks. It is paler, denser, motionless and has a different relief. In the anterior part there are symmetrical, transverse elevations of the mucous membrane (plicae palatinae transversae), which smooth out with age. The relief of the mucous membrane of the palate is significantly distorted under the influence of wearing plastic prostheses. In the midline of the central incisors there is a pear-shaped prominence called the palatine papilla (papilla palatina). In some subjects it may be pronounced, but it should not be mistaken for a pathological formation. The area of the palatine papilla corresponds to the location of the incisive canal of the upper jaw (sapalis incivus). Sometimes in the middle of the hard palate there is a rather sharply protruding longitudinally located elevation (torus palatinus). This formation represents a thickening of the palatine suture (raphe palatini), and it also cannot be considered pathological. Numerous glands are embedded in the thickness of the mucous membrane covering the palate. They are located mainly in the mucous membrane of the posterior third of the hard palate, closer to the soft palate. The excretory ducts of these glands open in the form of pinholes - depressions on the mucous membrane of the palate (foveae palatinae, fossae eribrosae).

The glands located under the mucous membrane of the hard palate extend to the soft palate. The mucous membrane of the palate rarely looks like a uniformly colored cover. In smokers, it is almost always inflamed and colored deep red. With lesions of the liver and biliary tract, the color of the soft palate sometimes takes on a yellowish tint, and with heart defects - bluish.

Language. When examining the tongue, a very complex picture is revealed. Its surface has a villous appearance due to the presence of various papillae. Usually the back of the tongue is colored pink color with a matte finish. However, the tongue is often coated or coated, most often gray-brown in color. Any raid must be regarded as pathological phenomenon. Sometimes the tongue, even in its normal state, may appear coated with a white coating, which depends on the length of the filiform papillae (papillae filiformes) scattered along its upper surface - the back and root. This plaque may disappear with age, and sometimes change during the day (more pronounced in the morning, less pronounced by the middle of the day, after meals).

The tongue, as a rule, becomes coated in cases where, due to inflammatory processes and pain in the oral cavity or other reasons, its normal mobility is disrupted or speech, chewing, swallowing is difficult, or there is a disease of the stomach or intestines. In such cases, plaque appears not only on the back and root of the tongue, but also on the tip and side surfaces. Plaque can also cover the palate and gums. Plaque, or deposits, is usually formed due to increased desquamation of the epithelium and mixing of desquamation products with bacteria, leukocytes, food debris and oral mucus. The presence of plaque on only one side of the tongue depends, for the most part, on the limitation of the activity of this side of the tongue, which is observed with hemiplegia, trigeminal neuralgia, hysterical anesthesia, and unilateral localization of ulcers. I.P. Pavlov believes that the basis for the occurrence of plaque is the neuroreflex mechanism.

Around the angle formed by the large papillae, at the apex of which there is a blind opening (foramen coecum), the posterior part of the tongue begins, devoid of papillae. The follicular apparatus of the tongue is located here and, thanks to the presence large quantity crypt (bays), this part in appearance resembles an amygdala. Some people call it the “lingual tonsil.” The follicular apparatus often enlarges during inflammatory processes in the oral cavity and pharynx. An increase can be observed in the normal state of these departments, with changes in lymphatic system organism.

When examining the lateral surface of the tongue at the root, rather thick venous plexuses, which can sometimes mistakenly appear abnormally enlarged (Fig. 176).

In the lower part of the tongue, the mucous membrane becomes more mobile in the middle, passes into the frenulum of the tongue and into the covering of the floor of the oral cavity on the sides. Two sublingual folds (plicae sublinguales) extend from the frenulum on both sides, under which the sublingual glands are located. Closer to the middle, lateral from the intersection of the hyoid fold and the frenulum of the tongue, there is the so-called sublingual caruncle (caruncula sublingualis), in which there are the outlet openings of the sublingual and submandibular salivary glands. Inward from the sublingual fold, closer to the tip of the tongue, a thin, uneven, fringed process of the mucous membrane (plica fimbriata) is usually visible. In this fold there is an opening for the anterior lingual gland of Blandin-Nun (gl. Iingualis anterior), which is located at the tip of the tongue or at the site of transition of the mucous membrane from the bottom to bottom surface language. During inflammatory processes that spread to the floor of the mouth, the caruncle swells, rises, the mobility of the tongue is limited, and the tongue itself moves upward.

Symptoms of inflammation. When examining the mucous membranes of the oral cavity, you should pay attention to a number of symptoms and take into account the degree and nature of their deviation from normal looking. The following features should be fixed first.

Firstly, type of mucous membrane: a) color, b) shine, c) surface character.

Inflammatory processes cause a change in color a. At acute inflammation due to hyperemia, the mucous membrane takes on a bright pink color (gingivitis and stomatitis). The intensity of the color depends not only on the degree of congestion of the superficial vessels, but also on the tenderness of the mucous membrane. So, for example, on the lips, cheeks and soft palate, the color is brighter than on the tongue and gums. In chronic inflammation (congestive hyperemia), the mucous membrane takes on a dark red color, a bluish tint, and a purple color.

Changes in the normal luster of the mucous membrane depend on the defeat of the epithelial cover: keratinization or violation of integrity (inflammatory and blastomatous processes), or the appearance of fibrinous or other layers (aphthae).

Surface character may vary depending on changes in the level of the mucous membrane. According to the depth of destruction of the latter, one should distinguish: 1) abrasions (erosion) - a violation of the integrity of the surface layer of the epithelium (there is no scar during healing); 2) excoriation - violation of the integrity of the papillary layer (during healing, a scar is formed); 3) ulcers - a violation of the integrity of all layers of the mucous membrane (during healing, deep scars are formed). Violation of the integrity of the mucosa in abrasions and ulcers causes changes in the level of the mucosa - lowering it. Scars, on the contrary, for the most part give a limited increase in the level on the mucosal surface. However, atrophic scars are known (with lupus), causing a decrease in the level of the mucous membrane. A decrease is also observed in retracted scars after deep destruction of the mucous membrane.

Hypertrophic productive forms of inflammation of the mucous membrane also noticeably change it appearance.

Changes the surface relief of the mucous membranes and the presence of nodular and tuberculate rashes. A nodule, or papule, is a small (from a pinhead to a pea) elevation of the mucous membrane in a limited area. The color of the mucous membrane over the papule is usually changed, since the papule is based on the proliferation of cellular elements in the papillary and subpapillary layers, accompanied by dilation of the superficial vessels. Papular rashes on the mucous membrane are observed mainly during inflammatory processes [syphilis, lichen ruber planus]. Large papules (plaques) are observed with aphthous stomatitis, and sometimes with syphilis.

tubercle in appearance it resembles a papule, differing from it only anatomically. It covers all layers of the mucous membrane. Due to this, the tubercle, unlike the papule, leaves a mark in the form of an atrophic scar during reverse development. Typical manifestations of tubercular lesions on the mucous membrane are lupus and tubercular syphilide. The difference between the tubercular rashes in these two diseases is that with syphilis the tubercle is sharply limited, and with lupus, on the contrary, the tubercle does not have a clear outline. Sometimes, as, for example, happens with lupus, the presence of tubercular lesions of the mucous membrane is masked by secondary inflammatory phenomena. In this case, to identify the tubercles, it is necessary to squeeze out blood from the hyperemic tissue. This is achieved using diascopy: a glass slide is pressed onto the area of mucosa being examined until it turns pale, then the lupus tubercle, if present, is indicated as a small yellowish-brown formation.

A gross change in the surface level of the mucous membrane is caused by the presence of neoplasms (tumors).

Thus, studying the appearance of the mucosa can be valuable for diagnosis. Determination of color, gloss, and level must also be supplemented with data on the extent of the lesion and the location of its elements.

Banal stomatitis and gingivitis usually give diffuse lesions, some specific gingivitis, such as lupus, are mostly limited and strictly localized in the anterior area. upper teeth. Lupus erythematodes has a favorite localization on the oral mucosa - mainly the red border of the lips and the inner surface of the cheek in the area of the molars. Lichen planus is located mainly on the mucous membrane of the cheek according to the bite line.

Next, one should distinguish a confluent lesion from a focal one, when the elements are located separately. In the oral cavity, the focal arrangement of elements produces predominantly syphilis. In tuberculous and common inflammatory processes, a confluent arrangement of elements is observed. Almost always, when examining the oral cavity, the outer coverings should also be examined.

Below is an inspection diagram.

Inspection scheme

1. Statement of damage to the mucous membrane.

2. Nature of appearance and course.

3. The main elements of the lesion.

4. Grouping elements

5. Growth of elements.

6. Stages of development of elements.

For a spot

1. Size.

3. Coloring.

4. Durability.

5. Topography.

6. Current.

7. Availability of other elements.

For papule and tubercle

1. Size.

3. Coloring.

4 Stages of development.

5. Topography.

For ulcers

1. Size.

5. Depth.

6. Secret.

7. Density.

8. Soreness.

9. Surrounding tissue

10. Development.

11. Current.

12. Topography.

For scars

1. Size.

4. Depth.

5. Coloring.

Having finished morphological analysis lesions, the doctor supplements it, if necessary, with palpation examination and palpation. This cannot be neglected.

Examination of the outer integument is aimed mainly at establishing changes in the color and appearance of the skin, and the presence of swelling. Such an examination usually does not give solid indicative signs, since the appearance of the swelling often says little about its nature and origin. Swelling of the cheeks and chin can be caused by the presence of collateral edema, which is caused very often or by phlegmonous inflammation subcutaneous tissue, or tumor process. To establish the nature of the swelling, it is necessary to "perform a palpation examination.

TO palpation examination mouth lesions have to be resorted to quite often. Palpation should be performed when examining neoplasms of the mouth, some ulcers, and in all cases of lesions of an unexplained nature.

When feeling the tumor, in addition to its consistency, one should determine the depth of the location, the mobility of the tumor itself and the mucous membrane above it, and the connection with the surrounding tissues and organs. When feeling the ulcer, the doctor should be interested in its density, edges and the nature of the infiltration around the ulcer. These data often provide valuable auxiliary information in the differential diagnosis between cancer, tuberculosis, syphilis and nonspecific ulcer on the tongue, cheek, lip.

A cancerous ulcer is characterized by the presence of a very dense cartilage in consistency, a rim around the ulceration. Feeling cancerous ulcer painless. On the contrary, palpation of a tuberculous ulcer often causes pain. The edges of a tuberculous ulcer are slightly compacted and do not give the sensation of a cartilaginous ring when palpated, which is so characteristic of cancer. Sometimes a hard chancre or syphilitic ulcer on the lip or tongue, cheek, due to the presence of a dense painless infiltrate, can be difficult to distinguish by touch from a cancerous ulcer.

Nonspecific ulcers of the oral mucosa, when palpated, for the most part differ significantly from those described above due to their superficial location. Here, however, one should keep in mind chronic ulcers of traumatic origin, especially those located on the lateral surface of the tongue, at its root. These ulcers, due to trauma constantly caused by a carious tooth or poorly fitted prosthesis, are surrounded by a rather dense infiltrate. And yet they remain more superficial and less dense than with cancer.

Often, in order to examine dental patients, it is necessary to use palpation of the external tissues of the face and neck. This study is carried out in search of inflammatory infiltrates, neoplasms, and when examining the lymphatic system. It is recommended to feel the soft tissues of the face with the head well fixed.

Visible diffuse swelling of the soft tissues of the face, which is observed during inflammatory processes in the jaws, mostly occurs due to collateral edema. Palpation examination usually reveals in the doughy mass of edematous tissue the presence (or absence) of a compacted area, infiltrated tissue or a fluctuating area of abscess.

The lymph nodes. Especially often it is necessary to examine the lymph nodes. As is known, the study of nodes has great importance for clinical assessment of inflammatory and blastomatous processes. Lymph from the soft and hard tissues of the mouth is drained through the following system of nodes. The first stage is the submandibular, chin, lingual and facial lymph nodes; second - superficial and upper deep cervical nodes; third - lower deep cervical nodes. From the lower deep cervical nodes, lymph enters the truncus lymphaticus jugularis.

Certain areas of the mouth and dental system associated with the first stage lymph nodes in the following way. All teeth, with the exception of the lower incisors, give lymph directly to the group of submandibular nodes, the lower incisors - to the chin and then to the submandibular nodes. The floor of the mouth, cheeks (directly and through the superficial facial nodes), as well as the lips are connected to the submandibular lymph nodes, with the exception of the middle part lower lip, giving lymph first to the mental nodes. The back part of the gums of the lower jaw gives lymph to the submandibular nodes and deep cervical nodes, and the front part - to the mental nodes; the gums of the upper jaw - only in the deep buccal, the tongue - in the lingual and directly in the upper deep cervical. The palate is connected directly to the deep facial lymph nodes (Fig. 177, 178).

Palpation of the chin and submandibular lymph nodes is carried out as follows. The doctor stands to the side and slightly behind the patient. The patient relaxes the neck muscles by slightly tilting his head forward. Using the tips of the three-middle fingers of both hands, the doctor penetrates from the right and left into the submandibular region, pressing the soft tissues. Thumbs, while resting on the lower jaw, fixing the head. The submandibular nodes are located inward from the edge of the lower jaw in the following order. Anterior to the submandibular salivary gland- two groups of lymph nodes: 1) in front of the external maxillary artery and 2) behind the artery; behind the salivary gland is the third group of submandibular lymph nodes. The mental nodes are located along the midline of the chin between the geniohyoid muscles (Fig. 177).

To palpate the facial lymph nodes, it is more convenient to use a two-handed examination: one hand fixes and lifts the cheek from the inside, the other palpates the glands from the outside. Sometimes it is useful to use a two-handed examination when palpating the submandibular and mental lymph nodes, for example, in very obese subjects with inflammatory infiltration of soft tissues, etc. The facial lymph nodes are located mainly on the buccal muscle in the space between the masseter and orbicularis oris muscles. Cervical nodes run along the internal jugular vein.

When palpating the lymph nodes, it is important to determine their size, consistency, mobility and pain. Normally, the lymph nodes are not palpable at all or are vaguely palpable. Acute inflammatory processes in the mouth cause an increase in the corresponding nodes; the lymph nodes become painful when touched. In these cases, acute perilymphadenitis may also appear; the nodes are palpated in a continuous package. In banal chronic inflammatory processes, the nodes are usually enlarged, mobile and slightly painful. The glands are especially dense in cancer and syphilis; they can also be palpated in separate packets. With cancer in further stages of its existence, limited mobility of nodes may be observed due to metastases. Chronic perilymphadenitis is considered characteristic of tuberculous lesions of the lymph nodes.

If the interdental papilla hurts, you should determine the type of disease that caused the inflammation process.

Gingivitis

This is inflammation of the gums without compromising the integrity of the dentogingival junction. Highlight the following types gingivitis:

– swelling and redness of the gums. A person feels pain and itching in the affected area, especially after eating food.
- appearance of ulcers. Manifested by pain and...
– the papillae increase in size and become red. They can partially cover the tooth and, in the absence of treatment, begin.
– the papillae decrease in size, thereby exposing the dental ligaments.

If you consult a dentist in a timely manner, gingivitis goes away within 7-10 days. In the absence of acute pain and discharge of pus from the gums.

May be of the following type:

– the lesion occurs in the area of the root system;
marginal periodontitis - affects the gums, most often in the interdental space.

The disease can progress without visible symptoms and lead to complete tooth loss and infection of nearby tissues. The disease may also have acute symptoms and appear in the form of small formations on the papillae with pus inside.

Fibromatosis

is a tumor-like lesion of periodontal tissue, which is manifested by hypertrophy of the gingival margin, papillae or the entire alveolar gum.

Most often develops in people young. Often detected in children during temporary or permanent teeth. Signs are observed mainly in women.

Treatment for gum fibromatosis involves surgical excision of the overgrown gums.

Gum inflammation is a fairly common disease that occurs in both adults and children. Today many people complain about increased sensitivity and bleeding gums. When your gums become inflamed and bleed, your mood plummets. And there is a reason. Not only does a smile with inflamed gums look, to put it mildly, unattractive. So, there are also painful sensations and bad breath. AND toothache may happen. Why should there be a good mood here? And when you think that inflammation of the gums can lead to loss of teeth, the melancholy overwhelms you.

Gum inflammation

If you feel that there is swelling of the gums, pain, blood, painful sensations when eating hard, hot or cold food, and sometimes suppuration at the base of the teeth or their loosening - a sign of one of inflammatory diseases oral cavity.

Gingivitis - First stage inflammation the surface of the mucous membrane of the gingival papillae between the teeth or the edge of the gums near the tooth. It manifests itself in the form of increased sensitivity, pain, redness, swelling and bleeding of the gums, sometimes the pain radiates to the temple or ear.

The cause may be damage to the mucous membrane when eating, brushing teeth, or traumatic installation of fillings, dentures, crowns or braces. May appear in those with malocclusion or short bridle lips.

Gingivitis is a fairly common disease, the treatment of which must be taken seriously. If left untreated, gingivitis can progress to the more serious disease periodontitis.

Gingivitis can occur as an accompaniment of the underlying disease, which should be treated first.

Also found gingivitis during pregnancy, which may be accompanied by swelling of the gums, bleeding, the appearance of pus and odor from the mouth. Painful sores may appear and the temperature may rise.

Gingivitis in children occurs if the rules of oral hygiene are not followed or the mucous membranes in the oral cavity are injured, as a result of which microbes enter it, causing inflammation. The reason may also be lack of vitamins and minerals in the body and during teething. Children's gingivitis is treated in the same way as in adults, but in more gentle ways.

Periodontitis

Periodontitis is usually considered advanced gingivitis. It is accompanied by tooth mobility, periodontal pockets appear with leaking pus, the bone around the teeth atrophies, periodontitis penetrates into the bone, and the roots are exposed. If you don't timely treatment Over time, the teeth will fall out.

With these diseases, gum inflammation occurs in the area of either single or all teeth.

Periodontal disease

Periodontitis occurs as a result little or uneven load on teeth. Accompanied by slight bleeding, usually without pain, and a small amount of tartar. It develops slowly, but if left untreated, leads to periodontitis. Most often found in older people.

Bleeding gums independent disease is not. Most often observed when brushing teeth as one of the symptoms of gingivitis or periodontitis.

If the gums become swollen due to periodontitis, which is caused by an infection in the tooth canals, it is useless to treat gum inflammation. Necessary fill root canals.

If your gums are injured as a result of incorrect, traumatic installation of fillings, crowns, dentures or braces, you should first consult a dentist to eliminate the cause. Without this, gum treatment will not be effective.

Causes of gum inflammation

Usually distinguish internal and external reasons the occurrence of gum inflammation. External causes as a result of exposure include:

poor oral hygiene or its complete absence, or improper care behind her;
presence of tartar;
improper installation of fillings, dental crowns, prosthetic braces;
malocclusion;
smoking.

Internal reasons are:

diseases of internal systems and organs (gastrointestinal tract, cardiac, hematological, diabetes etc.);
immunodeficiency;
lack of vitamins in the body;
medications taken;
genetic problems;
sometimes pregnancy.

That is, most often gum inflammation associated with dental infection or other pathology human body. It may lead to serious complications and disorders in the body.

Treatment options at home

Gum inflammation can be treated using different methods. In any case, in order not to harm your health and prevent the development of more serious diseases, before starting treatment, you must consult a dentist to determine the diagnosis.

In serious cases, the doctor will prescribe treatment, in combination with which additional home remedies will provide a good effect.

In simpler cases, it is enough to use at home products that provide anti-inflammatory, antiseptic, decongestant and analgesic effects.

Speaking about ways to treat gums at home, there are medicinal products pharmacy (medication) and folk.

Pharmacy products

Pharmaceutical products include rinses, sprays, applications, toothpastes and gels. All pharmaceutical drugs are supplied with instructions for use, which must be followed and followed in order to obtain the desired result.

Modern pharmacology has created on the basis of healing natural remedies and medicinal plants natural safe and effective drugs.

For bleeding and inflammation of the gums, various pharmaceutical products, which relieve inflammation, relieve pain, eliminate bleeding, itching and burning, relieve swelling and disinfect the mucous membrane from microorganisms and bacteria.

Antiseptic rinses include:

Listerine (2 times a day for 30 seconds) is one of the most effective rinses.
Stomatofit (3-4 times a day for 10-15 days).
Furacilin (2-3 times a day).
Chlorhexidine (spray 0.2% for periodontal disease and 0.05% for childhood gingivitis- after each meal until recovery).
Miramistin (3-4 times a day).
Chlorophyllipt (3 times a day with a diluted solution).
Rotokan (until the inflammation is eliminated).
Hydrogen peroxide (solution of 1 tablespoon in 100 ml of water 2 times a day).
Malavit (10 drops / glass of water for rinsing 1 week daily).
“Forest balm” (after each meal until symptoms disappear).

The effect of treatment with rinses can be enhanced by using compresses and applications in parallel. medicinal pastes, gels and ointments.

Therapeutic gels and ointments form a protective film on the mucous membrane. They are applied to the gums several times a day, after rinsing. The most effective means:

Special toothpastes have also proven effective in the treatment and prevention of bleeding and inflammation of the gums. They contain extracts medicinal herbs and anti-inflammatory ingredients. For gum inflammation, it is recommended to use toothpastes:

Folk remedies for treatment

In order to get a truly positive therapeutic effect and the disease does not progress, before deciding how to treat gum inflammation at home, it is recommended to consult a specialist not only to make a diagnosis, but also, if necessary, to do a cleaning, remove tartar and get basic prescriptions .

Typically, application folk remedies has centuries of experience. Medicinal plants as in pure form, and in combination with other plants, are increasingly used for the prevention and treatment of diseases of various etymologies. An important advantage of medicinal plants is their low toxicity and the absence of side effects in most cases.

Typically you will need to prepare infusion, decoction or alcohol tincture based on medicinal plants for rinsing the mouth, preparing compresses or therapeutic applications.

Healing herbs have antibacterial (calendula, chamomile), anti-inflammatory and analgesic (sage, yarrow), astringent and strengthening (oak bark, St. John's wort) properties.

For simple inflammation, rinsing with a decoction or infusion may be sufficient. But herbal infusions They do not last long, it is advisable to cook them daily. Most effective and safe sage, burnet, yarrow, chamomile, calamus, oak bark, sorrel, St. John's wort, linden blossom, calendula, eucalyptus and many others.

Below are some of the most simple recipes treating gums with home remedies.

First aid for gum disease

In case of severe pain, to treat gums at home before visiting a doctor, it is recommended to rinse your mouth with the following solutions:

potassium permanganate;
baking soda;
chlorhexidine;
furatsilina.

Or use ointments that will reduce bleeding gums, have an antiseptic effect and reduce pain.

The main thing is to under no circumstances resort to radical methods of self-medication, as this may cause more serious consequences. In order to stop the spread of inflammation, it is best to apply various infusions with antimicrobial activity. Pharmacies sell these without a prescription. highly effective means, like "Stomatidin", "Mevalex" and "Givalex". They should be used according to the instructions included in the package.

The beauty of the teeth depends on the condition of the gums. When the gingival tissues filling the interdental spaces become inflamed, many uncomfortable and alarming signs appear, leading to the development of serious pathological processes in the oral cavity.

A person should immediately seek help from a specialist, since the ongoing disease can have an aggressive effect on the integrity of the dentition.

Dentists also strongly recommend regularly using preventive measures, helping to reduce the risk of inflammation of the sensitive and vulnerable part of the soft tissue.

General overview

Interdental papillae are areas of gum tissue located between the teeth. They provide protection to the root system of each unit and prevent the accumulation of food particles, which over time decompose and infect the oral cavity with pathogenic bacteria.

The interdental papilla (papillae) is a dense connective tissue, which is covered by oral epithelium.

In appearance, the interdental papillae resemble pyramids that fill the spaces between the incisors. Healthy interdental tissues have a light peach color. They fit tightly to the surface of the units, leaving no gaps. Their shape and size are proportional to the teeth.

When inflamed, the papillae may recede from the teeth, forming a black triangle. The pathological process contributes to the development of edema, painful sensations and bleeding.

The papilla, like all gum tissue, is unable to regenerate and grow back. If its integrity is compromised due to rough hygienic cleansing or exposure of tooth roots (recession), then this pathological course cannot be reversed.

Reasons for deviations from the norm

More often, negative changes in the structure of interdental soft tissues occur due to poor hygienic care. Illness of the papillae negatively affects the condition of the dental units.

For this reason, contacting a specialist when signs of the disease appear in the form of tissue edema and redness is mandatory. The doctor will diagnose and prescribe the correct treatment.

Pathology can occur for several reasons. Let's look at the general factors:

bad habits (smoking, alcoholism);
lack of useful trace elements in the body;
hormonal disbalance;
infectious diseases;
diseases of the digestive system;
pathology of the cardiovascular apparatus;
decrease in protective functions in the body;
long-term drug therapy with drugs of certain groups.

Local factors can also have a detrimental effect on soft structures oral cavity. The list compiled by experts is as follows:

thermal or chemical burn;
mechanical injury;
hardened plaque;
poor oral hygiene;
teething phase;
unsuccessful restoration of the integrity of the dentition with the help of prostheses.

Remember! Negative Impact the condition of soft tissues can be affected not only by the above factors, but also by the sharp edges of the crown or filling material.

In this case, the pathogenic factor can cause disturbances only at the site of injury to the gum tissue.

Symptoms

A progressive pathological process can be recognized by the presence of edema and redness of soft structures.

If treatment is not started on time, negative changes in the tissues will cover more areas and provoke bleeding gums, unpleasant sensations of irritation.

In advanced cases, there may be structural changes papilla. The increased volume of tissue covers the tooth almost half of its entire crown part. This entails pain during eating, as well as discomfort and difficulty chewing it.

The main manifestations of the pathology are as follows:

cluster purulent exudate in the gaps between teeth;
bad breath;
gum hyperplasia;
the occurrence of pain during chewing food;
darkening of damaged mucosa;
dental hyperesthesia (increased sensitivity to various irritants);
diffuse changes in the structure of soft tissues.

Remember! Untimely treatment can lead to the development various pathologies in the oral cavity, which entail significant destruction of soft and hard structures.

Gingivitis and periodontitis

The progressive course of the pathology can lead to an inflammatory process that develops against the background of intensive proliferation of bacteria in the oral cavity.

The pathological condition often leads to tooth decay due to changes in the density of surrounding tissues. With this clinical picture, doctors diagnose gingivitis (gum disease).

As a rule, this disease, divided into types, is a precursor to periodontitis.

Catarrhal gingivitis

According to statistics, this form diseases are more common than others. It can be recognized by the following manifestations of the body:

bleeding gums;
excessive accumulation of fluid in the gum tissue;
inflammation of the mucous membrane, causing it to redden;
unpleasant feeling of irritation;
appearance unpleasant odor and the taste of rot;
growing pain syndrome during eating;
deformation of the outlines of the gums;
general weakness.

The stage of development of the disease can be mild, moderate or severe. The complexity of the case depends on the location of the affected area in the oral cavity and the intensity of the symptoms.

Ulcerative gingivitis

In some cases, inflammation of the gingival papilla can provoke the development of ulcerative gingivitis. This disease is considered a complex form of the pathological process in the interdental spaces..

Erosive, ulcerative and necrotic manifestations appear on the gums, which can affect both the surface of the mucous membrane and the deeper layers.

The symptoms of the disease are as follows:

dirty gray plaque on the periodontal tissues;
bleeding gums;
increased body temperature;
unnatural lightening of the skin of the face;
lack of appetite.

You should not self-medicate for ulcerative gingivitis, since incorrectly selected therapy can provoke the occurrence of purulent inflammation which will lead to serious health problems.

Hypertrophic gingivitis

This disease is characterized by chronic inflammation of the gum tissue and is accompanied by an intense increase in their volume.

The gingival papillae grow and cover the crowns of the teeth by a third from the outside and from the side of the tongue. According to the density of the gum, it remains hard, and under it, on the surface of the units, tartar is formed.

Symptoms:

keratinization and thickening of soft structures;
darkening of the mucosa;
increasing the density of gum tissue;
pain even when lightly touching the affected area;
difficulties in eating.

More often the disease develops against the background hormonal imbalances or problems in the body's metabolic processes.

Periodontitis

Clinical picture of this disease expressed in the presence of inflammation near the apex of the tooth root. At the second stage of the disease, the inflammatory process affects the edge of the gum.

The progression of the pathology leads to the resorption of bone tissue. The formed cavity is filled with granulation tissue. As a result, for the pus to escape out, a fistula is formed or a cyst is formed.

The cyst-shaped element can be temporary - suddenly disappear, and after a while appear again.

The reason for the development of periodontitis lies in untimely treatment pulpitis or poor-quality filling of tooth root canals.

Inflammation during pregnancy

During gestation hormonal background women endure major changes. At this stage protective functions organism are reduced, the risk of developing various diseases in the oral cavity.

If treatment is not started in time, the pathology will begin to spread at high speed, which will lead to deterioration in overall health and negative effects on the fetus.

Incorrect therapy or its absence can provoke miscarriage or disrupt the process intrauterine development baby.

The influence of orthopedic structures

A poorly installed prosthesis or crown can become a provocateur for the development of pathology. Insufficient fit of the structure leads to injuries to soft tissues and mucous membranes. Inflammation develops in the affected areas.

In the absence of proper treatment, periodontal pockets form in the spaces between the teeth, which become an ideal environment for the accumulation of pathogenic microorganisms . Such clinical picture difficult to treat.

Teething

Gingival papillae often become inflamed during the eruption of wisdom teeth. If the condition is not aggravated by various factors, the patient experiences only swelling and minor pain.

Pain can be reduced by using analgesics, however, dentists recommend resorting to professional help, due to high risk development of purulent-necrotic process.

Specialist consultation

To assess the patient’s condition and understand what problem in the oral cavity he had to face, a specialist performs a visual examination.

Having recognized the pathology and the severity of its course, the doctor carries out a complete sanitation of the oral cavity. Hard deposits on teeth are removed using ultrasonic waves.

To make the surface of the teeth smoother, the specialist resorts to polishing procedures, which will help reduce the likelihood of plaque formation, including food debris and pathogenic bacteria.

Methods and tactics of treatment

Determining therapeutic measures is solely the task of a specialist. Complex therapeutic measures, aimed at suppressing pathology, depends on the disease, its course and degree of development.

Anti-inflammatory therapy

In dental practice, application therapy and antiseptics effectively relieve inflammation. When diagnosed with gingivitis, doctors often prescribe Chlorhexidine rinses.. Cholisal-gel has also proven itself to be excellent.

In the case of periodontitis, treatment must be comprehensive. A mini-surgery is performed, followed by antibacterial therapy with drugs from the antibiotic group.

Treatment methods for pregnant women are practically no different from health measures applied to ordinary patients. The only one distinctive feature- selection of approved drugs that ensure the safety of mother and child.

Antibiotic therapy

At severe course gingivitis or disease caused by bacterial agents, without antibacterial drugs not enough.

Most often, doctors prescribe the following medications:

Augmentin;
Klindamitsyn;
Vilprafen;
Macropen.

The choice of the most suitable remedy for a particular clinical case remains with the treating dentist. The dosage and frequency of doses is also determined by the physician.

Preventive measures for the development of dysbiosis include prescribing prebiotics and vitamins.

Surgical intervention

The most common method in surgical dentistry- this is coagulation, used not only for treatment, but also for plastic surgery of gingival tissues and mucous membranes. Thanks to innovative technologies excisions are carried out using electrodes.

Essentially, the operation consists of cauterizing the affected areas. The instruments for the operation are heated using electricity. Diathermocoagulation of gum tissue is carried out with a high-frequency alternating current wave.

If the operation is successful, the wound area should turn white. First of all, alternating current affects the vascular network and accelerates the rate of blood clotting.

Minor damage to the vessels allows them to quickly close, which prevents further bleeding.

This operation makes it possible in a matter of minutes disinfect the wound on the gingival papilla, eliminate signs of the inflammatory process and heal the affected tissue.

Treatment for injury

If the development of the inflammatory process on the gum is provoked by an injury caused by the overhanging edge of a frozen filling material, the first health care consists of cutting off interfering elements or completely replacing the filling.

If a prosthesis or crown is installed incorrectly, doctors will eliminate inflammatory symptoms drug therapy.

Typically, the treatment program is almost identical to the methods for eliminating gingivitis. Depending on the result, the doctor considers the need to remove prosthetic structures until the soft tissue is completely restored.

Rules for choosing care products

The inflammatory process on the gingival papillae can be quickly eliminated if you approach the problem comprehensively. In addition to drug therapy, it is important to scrupulously observe the rules of hygiene.

An important point in proper care of all tissues of the oral cavity is selection of toothpaste and brush. When purchasing a cleaning product and care device, you need to pay attention to the following:

the composition of toothpaste plays an important role, so it is better if it includes components of medicinal herbs that effectively relieve inflammation of any nature;
Ingredients based on antibacterial substances, such as trilosan, will not be superfluous in the paste;
daily care of teeth and gums requires not only a therapeutic effect, but also the adoption of preventive measures, therefore the paste must have not only a therapeutic, but also a preventive effect;
To reduce the likelihood of injury to the mucous membranes and gums, the brush should have medium-hard bristles.

The toothbrush is changed every 5-6 weeks. Compliance with this important rule will give you the opportunity to protect yourself from possible complications and speed up healing and recovery processes.

Prevention measures

Preventive measures aimed at the health of teeth and gums are as follows:

eating large amounts of seafood, greens, dairy (such foods are rich in calcium, which strengthens inert tissue);
conducting healthy image life (giving up bad habits is mandatory);
adherence to healthy eating rules;
careful and competent care oral cavity(brushing teeth morning and evening, flossing after every meal).

The acute stage of inflammation of the gingival papillae requires careful treatment planning, so it is important not to start the disease, but to resort to preventive measures in a timely manner.

They will help reduce the likelihood of developing pathology and the appearance of unwanted uncomfortable symptoms.

The video presents Additional Information on the topic of the article.

The inflammatory process affecting the gingival papillae and gum margin, interspersed with exacerbations/remissions, is called chronic gingivitis. The disease is manifested by congestive swelling of the gum surface, increased bleeding and deformation of the gums. The pathology is also characterized by an unpleasant odor of breath.

Diagnosis is made based on visual inspection and medical records. Treatment of chronic inflammation consists of: professional cleaning teeth, sanitation of the oral cavity with antiseptic solutions, etc.

Causes of the disease

Gingivitis that has become chronic is usually the result of poorly performed or incomplete treatment acute form pathology. That is why chronic gingivitis develops for the same reasons as its acute form.

These include:

Classification of the disease

Depending on the causes of the disease, the following types of chronic gingivitis are distinguished:

infectious;
thermal;
chemical;
traumatic;
caused by hormonal imbalances;
allergic.

Depending on the location of the inflammation, gingivitis can be:

Localized. If inflammation of the interdental papillae is diagnosed, then we are talking about papillitis. With inflammation affecting the gum margin, we can talk about marginal chronic gingivitis.
Generalized form. Here the inflammation spreads to the entire surface of the gum.

There is also a gradation depending on the severity of the disease:

mild form (only the gingival papillae become inflamed);
moderate (inflammation also affects the marginal part of the gums);
severe form (the entire alveolar gum is involved in inflammation).

Symptoms of chronic inflammation

Chronic gingivitis, like acute gingivitis, has characteristic symptoms:

Varieties of chronic gingivitis

Depending on the nature of the inflammation, the following subtypes of chronic gingivitis are distinguished:

catarrhal;
hypertrophic;
atrophic.

Chronic catarrhal gingivitis

The disease in this case is a reaction to the negative influence of microorganisms present in bacterial plaque on the surface of the teeth. Catarrhal form Chronic gingivitis develops as a result of poor oral hygiene. In the absence of adequate treatment, the pathology can transform into generalized periodontal disease.

Symptoms

The pathology clinic is quite typical:

bleeding;
itching in the gums that occurs as a result of mechanical stimulation of the gum surface.

Typical symptoms appear only during periods of exacerbation. But most often the disease is practically asymptomatic, developing rather slowly.

Advice! Chronic catarrhal gingivitis is diagnosed mainly in childhood and in young people 25-30 years old. Wherein general health the person remains without any changes.

Diagnosis of pathology

Diagnosis is made based on visual examination. The doctor notes the presence of tartar and signs chronic inflammation gums - hyperemia and swelling. The formation of periodontal pockets is not typical for the disease. And the teeth remain in their original places without moving.

Treatment of the disease

Treatment of chronic pathology involves the following steps:

Advice! The basis of treatment for chronic catarrhal gingivitis is high-quality oral hygiene.

In severe cases of the disease, antibiotics are prescribed.
The use of physiotherapeutic procedures gives excellent results.

Chronic hypertrophic gingivitis

This form of pathology is characterized by long-term inflammation, accompanied by overgrowth of gum tissue. No resolution of the periodontal junction is observed.

Main symptoms of the disease

The key sign of pathology is an increase in gum volume. But besides this, there are other striking symptoms:

severe painful sensations accompanying touching the inflamed surface;
bleeding that accompanies even light touches of the damaged gum;
pain when eating (this especially applies to hot, spicy and salty foods);
An increase in the volume of gum tissue causes difficulty in eating food, interfering with its quality chewing.

Depending on the clinical pathology, two subtypes of the hypertrophic form are distinguished:

granulating gingivitis;
fibrous pathology format.

For granulating hypertrophic gingivitis The following manifestations are typical:

increase in gum size;
intense dark red color;
significant swelling;
pain on palpation;
presence of proliferates;
bleeding that occurs with any touch;
formation of periodontal pockets.

Advice! Granular gingivitis most often affects large areas of the gum.

With the fibrotic course of hypertrophic gingivitis, the following conditions are observed:

increased gum density;
no pain, the surface often retains its usual color;
no bleeding;
the gum volume increases slightly;
deformation is observed only in places where the pathological process is occurring.

Gum overgrowth is determined by three degrees:

In the first degree, the edge of the gum becomes slightly thicker.
For the second degree, enlargement of the papillae is typical.
In the third degree, significant growth of the gum margin and gingival papillae is diagnosed. Visually, the gums take on the appearance of a dense cushion almost completely covering the teeth.

Treatment of hypertrophic gingivitis

Before choosing a treatment regimen, it is necessary to remove tartar and polish the surface of the teeth. The procedures are performed in the dentist's office. And only after this can treatment be selected based on the type of hypertrophic gingivitis:

In case of severe swelling, applications to the affected surface are prescribed. Potassium iodide, maraslavin, 3% copper sulfate can be used here. In severe cases, injections of hydrogen peroxide or glucose are prescribed, which are injected into the apex of the gingival papillae.
At fibrous form injection of lidase, previously dissolved in novocaine, into the interdental papillae is prescribed. In severe cases, it is prescribed surgery(excision of a hypertrophied gingival area), after which the use of heparin or hydrocortisone ointment is prescribed.
If gingivitis is caused by an allergic reaction, then treatment is carried out with ointments containing glucocorticoids.

Additionally, physiotherapy is prescribed (at the discretion of the attending physician):

electrophoresis (with heparin);
diathermocoagulation;
laser therapy;
performing a massage.

For this form of pathology, except chronic course, characterized by a decrease in gum volume. The reason for this is the drying out of the gingival papillae and gum margins. It differs in the localization of inflammation and can be:

in the form of a limited area of gum atrophy (diagnosed more often);
diffuse form (spread over the entire surface).

Chronic atrophic gingivitis is a clear sign of incipient periodontal disease. Periodontal inflammation is quite difficult to treat and has a recurrent course.

Treatment of the disease

Treatment of pathology is carried out exclusively under the supervision of a doctor. Self-medication can lead to serious complications. Treatment involves A complex approach, since it is necessary to eliminate not only the symptoms, but also the root cause of the pathology.

Therapy for atrophic gingivitis can be performed in two ways:

conservative treatment;
surgical intervention.

Conservative treatment involves the following scheme:

it is necessary to carry out high-quality dental sanitation oral cavity (heal carious teeth, remove tartar and microbial plaque);
all sharp edges of the teeth should be polished (this will reduce the risk of injury to the inflamed gum);
after completion of dental procedures, gum treatment with hydrogen peroxide is prescribed (up to two times a day);
the use of applications with healing preparations (sea buckthorn or rosehip oil);
taking vitamin complexes;
mouth sanitation (rinsing) with herbal decoctions with good tanning properties - oak bark or calamus;
Physiotherapy may also be prescribed.

Advice! Treatment of atrophic gingivitis with antibiotics is possible only as prescribed by a doctor.

If improvement cannot be achieved, it is recommended to carry out surgical intervention. Treatment consists of ginginoplasty, which involves replacing missing areas of gum with healthy tissue taken from adjacent areas.

Diagnosis of chronic gingivitis

The diagnosis is made based on a visual examination:

General treatment of chronic gingivitis

In general, treatment of pathology is as follows:

carrying out sanitation of the oral cavity with antiseptic solutions (applications are also carried out);
mandatory removal of tartar, after which antiseptic treatment must be carried out;
careful oral hygiene;
in severe cases of the disease, anti-inflammatory and antimicrobial agents may be prescribed.

Physiotherapy provides excellent results in the treatment of chronic gingivitis. An excellent prevention of the disease is regular visits to the dentist's office.