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Catarrhal gingivitis


Catarrhal gingivitis

Catarrhal gingivitis

Catarrhal gingivitis is one of the forms of gingivitis, which occurs as a result of the pathogenic effect of pathogenic microorganisms and their metabolic products, that is, hard and soft dental deposits. The disease is exudative in nature (accompanied by the release of fluid from the gum pocket).

The catarral form of acute gingivitis is characterized by rapidity and superficial manifestation of symptoms (inflammation does not go beyond the mucous covering of the gums).

Common signs of inflammation are present in the symptoms of this disease:

  • Marked swelling
  • Hyperemia of vessels (arterial and venous) in the subepithelial connective tissue
  • Inflammatory infiltrate in tissues contains white blood cells
  • Tissue structures remain without significant changes.

The exacerbation of the chronic form of catarrhal gingivitis is already considered the initial link on the path to the appearance of periodontitis. In the study revealed a complex of background structural tissue changes.

Changes in the structure of the affected tissues are associated with the occurrence of trophic disorders with repeated, consistent exacerbations of inflammatory disease.

In the period of exacerbation, the connective stroma gradually thickens and is sclerosed. Sclerosis is also subjected to vessels at the site of the pathological process.

The nature of the inflammatory fluid in the tissues during exacerbation is more dense. It contains more neutrophils and eosinophils, and there are fewer lymphocytes of macrophages.

At the peak of the inflammatory process, leukocytes are found in the epithelial covering of the gums. There are few of them and this fact does not lead to significant changes. But with a microscopic examination, it becomes clear that leukocytes come to the surface of the mucous membrane of the gums. This is precisely the reason for the appearance of white plaque on the mucous membrane of the alveolar process in catarrhal gingivitis.

Causes of catarrhal gingivitis

The primary cause of the development of chronic catarrhal gingivitis is poor dental and oral hygiene. In conjunction with the fact that there is no adequate and timely treatment, the disease quickly moves from a localized (limited) to a generalized form (spreads over the entire surface of the gums of the upper and lower jaw).

Soft plaque is deposited in the place of adhesion of the gums to the crown of the tooth. This is a favorable area for the nutrition and reproduction of bacteria, since a small depression retains food debris and is poorly cleaned with a toothbrush.

There are several reasons for the accumulation of plaque in this area:

  • Insufficient dental and oral hygiene
  • Changes in the composition and / or amount of saliva secreted
  • Bite pathology (crowding of teeth, orthognathia, prognathia)
  • Reducing the body's immunity
  • Wearing orthopedic or orthodontic

All of the above situations have one result: the balance between the active influence of the pathogenic flora on the periodontal soft tissues is disturbed, an advantage occurs in the direction of microorganisms. As a result, an inflammatory reaction of the gums occurs in the form of gingivitis.

The mechanism of development of catarrhal gingivitis

The development of this form of gum disease occurs in several stages:

  1. Above the gumline and in the periodontal pocket (a small space between the marginal part of the gum and the crown of the tooth) a soft deposit accumulates.
  2. Bacteria penetrate the gum tissue and cause the development of the inflammatory process.
  3. The periodontal pocket expands and deepens, as the gingival margin swells and the tooth ligaments are weakened.
  4. The nutrition of the gum tissues is disturbed, the blood supply to the capillaries becomes less intensive. Local immunity is significantly weakened, which creates favorable conditions for the further development of pathogenic flora.

Thus, there is a vicious circle, which can be broken only by the passage of appropriate treatment in the office of the periodontist.

Symptoms of catarrhal gingivitis

The symptoms of catarrhal gingivitis are quite pronounced, therefore, it is easy to carry out a correct diagnosis.

Patients with this type of gum disease often complain about:

  • Unpleasant itching in the inflamed area
  • Bleeding of periodontal tissues when brushing teeth and from eating solid foods, as well as unreasonable bleeding in the morning
  • The presence of a large number of tartar on all teeth
  • Bad breath

Inflammation often occurs in young people and children. The development of the pathological process is slow, with poorly pronounced symptoms. The general condition of the body does not undergo pathological changes.

When examining the oral cavity can be seen:

  • The presence of a large number of mineralized and non-mineralized dental plaque
  • Inflammation of the gums, which has already passed into the chronic stage and is expressed by redness, swelling and bleeding during mechanical action on soft tissues
  • No abnormal tooth mobility

X-ray examination is not informative, since the bone tissue in catarrhal gingivitis is not destroyed.

Acute stage of the disease

At the initial stage, the disease has all the signs of a primary inflammatory process.

The gums are bright red, the surface of the mucous membrane is swollen, glitters, and when touched to the gums blood immediately protrudes.

Acute catarrhal gingivitis has three degrees of severity:

  1. Mild degree, which is characterized by the spread of the inflammatory process only on the entire surface of the gingival papillae.
  2. When moving to a moderate degree, the lesion of soft tissues spreads to the entire marginal gingiva.
  3. A severe degree is easily differentiated by the spread of inflammation to the entire surface of the mucous membrane that covers the jaws, without going to the sky, the floor of the mouth and cheek.

Features of the acute stage

The exacerbation of the chronic stage of catarrhal gingivitis in the autumn or spring period is a rather frequent phenomenon, since all types of chronic diseases tend to aggravate precisely at this time.

Complaints during exacerbation of pain in the gums, the taste of blood in the mouth and an increase in the degree of bleeding of periodontal tissues.

An objective examination helps to identify the following symptoms:

  • Congestive hyperemia of the mucous membrane of the gums
  • With light probing, bleeding can begin.
  • Soft tissues have cyanotic (bluish) tint
  • Gum thickening has a roller shape
  • On all the teeth of the upper and lower jaw - a layer of soft plaque, supragingival and subgingival mineral deposits

In the event that the patient neglects seeking help at the dental office during an exacerbation, the symptoms gradually become less pronounced, the disease again goes into a remission stage.

It is possible that some people suffering from chronic catarrhal gingivitis have a false idea that the disease completely disappears, then returns. In fact, the infection continues to destroy the soft tissue, aggravating the pathological condition of the gums. In the absence of adequate treatment, complications may develop.

Diagnostics and differential diagnostics

Diagnosis of catarrhal gingivitis is not difficult.

Careful history taking (patient interview), instrumental and visual examination of the oral cavity gives a sufficiently clear picture so that the specialist can confidently recognize signs of catarrhal gingivitis.

History taking is limited to asking the patient about the duration of the disease, the manifestation of symptoms, as well as his subjective sensations.

Instrumental examination is reduced to probing the gum pockets, determining the presence or absence of abnormal tooth mobility and conducting an X-ray examination of the integrity of the bone tissue of the alveolar process (if there are any doubts about the accuracy of the diagnosis).

Differential diagnostics is carried out with other types of gingivitis and special pigmentation of the regional gums in representatives of Arab nationalities.

After the final diagnosis, the periodontist proceeds directly to the treatment process.

Treatment of catarrhal gingivitis

The treatment process is carried out strictly in accordance with the following steps:

  1. Conducting professional cleaning of the oral cavity with the removal of mineralized (supragingival and subgingival) and non-mineralized dental plaque. Removal of stones and plaque is carried out using a scaler or sandblaster. After cleaning the surface of the teeth, it is necessary to polish with a special paste and brush, as well as with rubber tips and polishing discs. Polishing is an obligatory measure, since the microscopic remains of stones create favorable conditions for the rapid accumulation of a new layer of plaque.
  2. Oral baths with a 0.06% chlorhexidine solution for ten days lasting three minutes in the morning and evening.

After the removal of the most severe symptoms and the relative normalization of the gum condition, it is advisable to conduct a course of physiotherapy procedures:

  • Massage
  • 10 sessions of hydromassage
  • Electrophoresis with a duration of one session - 20 minutes, the number of 12-15 procedures. Conducted electrophoresis with a solution of ascorbic acid 5% and a solution of aminocaproic acid 5%
  • Laser therapy of the marginal part of the gums
  • Darsonvalization
  • Phonophoresis

Treatment of acute catarrhal gingivitis or acute stage of the disease, the patient should be prescribed medications with antipyretic, desensitizing and restorative properties. It is also desirable to take complex vitamins.

If the patient has a concomitant disease of a general nature, all the actions of the therapist and the periodontist should be coordinated with each other.

| 27 December 2014 | | 1,355 | Dentistry