Chronic gingivit - the inflammation of desnevy nipples and edge of a gum proceeding with the periods of aggravations and remissions. Chronic gingivit it is shown by stagnant hyperaemia and puffiness mucous gums, bleeding, deformation (growth, an atrophy) of a gum, an unpleasant smell from a mouth. The diagnosis of a chronic gingivit is made parodontology on the basis of data of the anamnesis and survey of an oral cavity. Treatment of a chronic gingivit includes professional hygiene of an oral cavity, local processing by antiseptics, reception of anti-inflammatory, antiedematous means, immunoproofreaders, physical therapy, according to indications – removal of growths of a gum.
Chronic gingivit – is long the flowing, softly expressed inflammatory process in surface tissues of a gum. At a gingivita durability of zubodesnevy sheaves is not broken, but in case of a chronic current pathological changes can progress to periodontosis and be followed by loss of teeth. Chronic gingivit - the most widespread disease of a parodont in stomatology, including at persons of teenage and young age. After 60 years the frequency of occurrence of a chronic gingivit reaches 90-100%. Women are ill a chronic gingivit less than men.
Reasons of a chronic gingivit
The facultative microflora collecting in tooth deposits at insufficient care of an oral cavity acts as the leading factor of development of a chronic gingivit. At children the risk of an inflammation of gums is increased due to the lack of due hygiene, plentiful congestions of an old dental plaque at not created local immune protection.
Chronic gingivit can be connected with long irritation of tissues of gum the scale, a sharp edge of the destroyed tooth which is hanging down in edge of a seal, artificial crowns or orthodontic devices. Can lead a thermal burn of a gum, influence on it of acids, alkalis, ionizing radiation to a chronic gingivit; intoxication salts of heavy metals, medicines, smoking. Anomalies and deformations of zubochelyustny system (oral breath, the wrong bite, density of teeth, absence of antagonists) can become the reason of a chronic gingivit.
Decrease in nonspecific resilience of an organism against the background of endocrine shifts (diabetes, the pubertatny period, pregnancy, a climax, reception the COOK), pathologies of a gastrointestinal tract, hypovitaminoses, system, allergic, skin and infectious diseases (tuberculosis, syphilis, actinomycosis) contributes to emergence of a chronic gingivit. Deskvamativny gingivit develops at a disease of a system red volchanka, ordinary puzyrchatka, by red flat it is deprived or at pathological local immune reaction to some substances in tooth deposits. The hormonal imbalance at teenage age promotes development of a hypertrophic chronic gingivit.
Classification of a chronic gingivit
On an etiology chronic gingivit subdivide on infectious, traumatic, thermal, chemical, yatrogenny, gormonalno caused, allergic. On prevalence chronic gingivit can be localized (papillit - an inflammation of an interdental nipple and marginal gingivit - an inflammation of free edge of a gum) and generalized (diffusion).
Chronic gingivit can proceed benign (with defeat of desnevy nipples), medium-weight (with distribution on a regional gum) and heavy (with capture of all alveolar gum). On the nature of inflammatory process distinguish catarrhal, hypertrophic and atrophic chronic gingivit, and also special morphological types: plazmotsitarny (atipichesky allergic gingivostomatit), deskvamativny and granulematozny.
Symptoms of a chronic gingivit
Chronic catarrhal gingivit is characterized by a long current and insignificant complaints. Puffiness and stagnant hyperaemia (redness, cyanosis) of a mucous membrane of gums, their bleeding during the toothbrushing and reception of rough food is noted. Inflammatory changes can be shown restrictedly on desnevy nipples and on edge of a gum or extend to all alveolar part. Adjournment of a dental plaque and naddesnevy scale, an unpleasant smell from a mouth is observed.
Hypertrophic gingivit develops against the background of a chronic catarrhal inflammation; it is shown by growth of tissues of gum due to increase in volume of interdental nipples. Expressiveness of growths can be easy degree (the gum covers no more than 1/3 crowns of tooth), average weight (to a half of a crown) and heavy (more than 1/2 crowns of tooth are closed). At an edematous form of a chronic hypertrophic gingivit of a gum swelled up, reddened, a little painful, bleed at meal and toothbrushing; at a fibrous shape of a gum dense, light pink color, with existence of false parodontalny pockets.
At a chronic gingivit against the background of poisoning with salts of heavy metals there is a border of dark color on desnevy edge, the increased salivation and metal smack in a mouth. Feature of a plazmotsitarny form of a chronic gingivit is formation of microabscesses, a possibility of distribution of an inflammation on the sky and bystry development of stomatitis.
At a deskvamativny gingivit there are edematous eritematozny spots, serous and hemorrhagic bubbles, the centers of easily exfoliating epithelium with an exposure of the bleeding and painful subject fabric. Recurrence of a current with the sharp sudden beginning, gradual fading of symptoms and long (1-2 years) the remission period is characteristic. In case of a granulematozny gingivit appear one - or multifocal spots of red or red-white color up to 2 cm in size in the field of interdental nipples, sometimes with occupation of other sites of a gum.
The long chronic current of a gingivit is followed by its transition to atrophic gingivit, characterized by dystrophic changes of desnevy nipples and desnevy edge, thinning and reduction of volume of a gum, stripping of necks of teeth, increase in their sensitivity to temperature and flavoring irritants, strong morbidity of gums.
Diagnostics of a chronic gingivit
The diagnosis of a chronic gingivit can be established by the stomatologist or parodontology according to the anamnesis, visual and tool survey of an oral cavity. At dental survey dental health, a mucous membrane of desnevy nipples and desnevy edge, a type of a bite, existence of tooth deposits, a condition of dentures and so forth is estimated.
Sounding of a desnevy groove reveals a positive symptom of bleeding, preservation of integrity of zubodesnevy connection, lack of a desnevy pocket, an immovability of teeth. The condition of a bone tissue is determined by data of a X-ray analysis of tooth. Consultations of other experts in general are necessary for establishment of the reason of a chronic gingivit and assessment of a condition of an organism: endocrinologist, gastroenterologist, infectiologist, dermatologist, allergist, rheumatologist.
Treatment of a chronic gingivit
Complex treatment of a chronic gingivit provides elimination of an etiologichesky factor, impact on the pathological center and the patient's organism in general. Elimination of the local factors irritating and injuring a gum includes removal of tooth deposits, treatment of caries, removal of the destroyed teeth, correction of anomalies of a bite, defects of sealing and prosthetics, correction and replacement of orthopedic and orthodontic designs, plasticity of bridles of lips and language, etc.
Within complex therapy of a chronic gingivit professional hygiene of an oral cavity, processing of a mucous membrane by antiseptics (solution of peroxide of hydrogen, a hlorgeksidin, miramistiny), rinsings by broths of herbs (a camomile, bark of an oak, an eucalyptus) after food or toothbrushing, parodontologichesky applications on gums is carried out. In some cases timely and careful removal of local irritants promotes complete elimination of the inflammatory phenomena.
At a chronic gingivit use of antiedematous and anti-inflammatory medicines, if necessary - antibiotics, immunoproofreaders is possible. In treatment of a chronic gingivit the medicinal electrophoresis, laser therapy give positive effect massage of gums, Ural federal district. At heavy degree of a chronic hypertrophic gingivit make a diatermokoagulyation or cryodestruction of growths, according to indications – a gingivektomiya.
Forecast and prevention of a chronic gingivit
At timely and rational treatment of a chronic catarrhal gingivit there occurs recovery; without elimination of its reasons a recurrence is possible. Full treatment of an atrophic gingivit is unattainable, it is possible to suspend process of an atrophy only. The outcome of a symptomatic gingivit depends on weight of the main disease. For lack of treatment chronic gingivit passes into periodontitis and periodontosis with risk of loss of teeth.
Prevention of a chronic gingivit consists in observance of rules of hygiene of an oral cavity, regular visit of the stomatologist (1-2 times a year), sanitation of the centers of a chronic infection and treatment of all-somatic pathology.