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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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

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Types
 Acute necrotising ulcerative gingivitis
 Herpetic gingivitis
 Nonspecific gingivitis
 Leukemic gingivitis

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ANUG
 Etiology
 Borelliavincenti
 Fusiform bacilli

 Predisposing factors
 Smoking
 Poor oral hygiene
 Alcohol
 Immunocompromised condition

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Clinical features
 Pain
 Ulcer
 Bleeding
 Salivation
 Halitosis
 Metallic taste
 Fever, malaise and enlarge cervical LN

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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
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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

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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

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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

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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 10
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

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Treatment
 Oral hygiene maintenance
 Brushing
 Mouthwash
 Regular scaling
 Gingivoplasty / Gingivectomy
 Antibiotics: tetracycline

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