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Necrotizing gingivitis

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Necrotizing gingivitis

Necrotizing gingivitis

Necrotizing gingivitis (Vincent's gingivitis) is an infectious-inflammatory disease of the gums, which tends to develop independently or occur against the background of common diseases of the body, complicating the course of the pathological process. Inflammation in ulcerative gingivitis is accompanied by necrotic changes and the appearance of ulcerative defects on the surface of the gingival mucosa.

Acute ulcerative gingivitis occurs with toxic effects on the body by various harmful substances (for example, heavy metals), chronic burns with chemical compounds or intoxication of the body with serious infectious diseases (for example, with leukemia).

Lifestyle plays a significant role in the occurrence of Vincent's gingivitis. With constant tension and frequent stress, the risk of getting sick of them is almost doubled.

The onset of the disease is characterized by the manifestation of symptoms in an acute form against the background of intoxication of the whole organism or local exposure of the toxic substance to the gums.

For ulcerative gingivitis is typically acute onset and rapid course of the disease. The tissues swell, the extracellular space is filled with fibrous exudate.

The surface layer of the gum mucosa is infiltrated by leukocytes. Tissues undergo necrotic changes and erosions appear, quickly transforming into ulcers.

The healing of ulcers and the restoration of the normal state of the tissues with ulcerative-necrotic gingivitis is very slow. If treatment was started when the disease was already in a neglected state, scars from healed ulcers and even serious tissue deformities will most likely remain on the mucous membranes.

If the disease is accompanied by periodontitis, the periodontal ligaments are destroyed and the lower parts of the periodontium are exposed. Infection can easily penetrate there, since both the barrier and immune forms of protection almost no longer work.



Causes of Vincent Gingivitis

Ulcers occur against the background of inflamed gums and are accompanied by necrotic and ulcerous tissue defects. The basis of the pathological process is the prevalence of alterative processes in the mucous membrane of the gums. The leading role in the list of causes that led to the disease is played by a decrease in the degree of resistance of the tissues of the oral cavity to the fusperochemical microflora.

But, nevertheless, there are general and local factors that contribute to the development of this pathology.

Local causes:

  • Weakening of the immune system after a long illness or while maintaining an unhealthy lifestyle.
  • Brushing your teeth with the wrong technique.
  • Poor dental and oral hygiene
  • The presence of oral diseases in the advanced stage
  • The occurrence of ulcerative gingivitis as a complication during the eruption of the eighth molars.

Common causes:

  • Frequent stressful situations
  • Chronic lack of sleep
  • Chronic fatigue
  • Malnutrition, in which the body does not receive the necessary nutrients, vitamins and minerals
  • The presence of a patient with HIV infection or chronic and advanced diseases of the cardiovascular system (CVS) and the endocrine system
  • Acute poisoning of the body with chemicals
  • Intoxication with heavy metals.

It is impossible to say with certainty that it is precisely one factor that is the primary cause of the development of ulcerative-necrotic gingivitis of Vincent. The basis of pathology is a set of contributing factors, or it accompanies a more serious chronic disease of the body.

Symptoms of necrotizing gingivitis

Symptomatology is pronounced brightly and it begins with an acute period of ulcerative gingivitis. This condition is characterized by the following features:

  • Patients complain of severe pain in the affected area, bleeding gums and a putrid odor from the mouth.
  • The state of general health of the body is disturbed: the temperature rises, headaches bother, muscle weakness is observed, the patient becomes inoperative during the period of illness.
  • A fetid plaque covering the gingival margin is detected in the oral cavity. When plaque is removed, the painful and bleeding surface of the mucous membrane is exposed.
  • The contours of the gums are fuzzy, the gingival papillae (which normally have the shape of an acute triangle) are now trapezoidal, without a sharp apex.
  • There is a large amount of soft plaque and hard dental deposits on the teeth.
  • The patient notes insomnia, a disorder of the digestive tract and loss of appetite.
  • On palpation of the submandibular region, enlarged lymph nodes are found.
  • A blood test shows an increase in ESR, leukocytosis, and protein elements in the urine (in some cases).

In some cases, ulcerative gingivitis occurs as a complication of untreated catarrhal gingivitis. According to statistics, the peak of exacerbation of symptoms occurs in the winter months, during the period of the greatest weakening of the body after colds, viral infections and flu.

Perhaps the sudden onset of Vincent gingivitis is the first sign of AIDS infection.

The disease often affects individuals in adolescence. It is in adolescence that oral hygiene is not given enough attention, and dental visits are becoming a rare event.

Diagnosis of the disease

If the patient came to the medical institution for help when the ulcerative gingivitis is still in the acute period, the doctor will:

  1. Inspection
  2. Poll
  3. Palpates regional lymph nodes
  4. Measures body temperature
  5. Writes a referral for OAK and OAM tests (complete blood count and urinalysis).

After the subsidence of acute inflammatory events, it is necessary to conduct a thorough examination of the patient in all directions, in order to identify the true cause of the decline in immunity and the development of Vincent's gingivitis.

The severity of the disease is determined by the length of the pathological process and the severity of individual symptoms of the disease.

The fact that in the oral cavity, in addition to staphylococci and streptococci, fusospirochets are found, clearly indicates a decrease in the protective properties of periodontal tissues. Low resistance may be a consequence of the pathological effects of such simple organisms as trichomonas and gum amoeba.

Treatment of necrotizing gingivitis

Necrotizing gingivitis is subject to compulsory treatment under the careful supervision of a periodontist.

Therefore, when detecting several typical symptoms, you should immediately consult a doctor, but in no case should you carry out an independent course of treatment.

Only a specialist can, after a thorough examination and collection of anamnesis, prescribe the appropriate treatment.

The process of conservative treatment can be divided into stages:

  1. The first stage is the removal of all dental deposits. A professional cleaning of the oral cavity and teeth is carried out, mineralized and non-mineralized dental deposits are removed.
  2. The second stage is the treatment of ulcers. Ulcerative defects of the mucous membrane of the gums are treated with antiseptic solutions.
  3. The third stage - the appointment of drugs. In order to completely get rid of ulcerative-necrotic gingivitis of Vincent, a course of antibiotics and anti-inflammatory drugs is necessary.

Metronidazole and penicillin are quite effective. Preference is given to metronidazole, but during pregnancy and lactation only penicillin can be used and only according to strict indications.

  1. The fourth stage - mouth baths. The doctor will probably recommend mouth baths alone with the addition of chlorhexidine and hydrogen peroxide. Also decoctions of calendula, chamomile, tincture of oak bark and St. John's wort can significantly help in the healing process of ulcers.
  2. The fifth stage is the observance of the correct daily regimen and the rules of good nutrition. For ulcerative gingivitis, a diet high in protein, vitamins, phosphorus and fluoride is recommended.

It is necessary to carefully consider the recommendations of a specialist doctor, as without proper treatment or if the requirements of the periodontist are not followed, recovery may slow down, or not at all.

Prevention

Prevention does not represent any complex action. It is simply recommended to maintain a healthy lifestyle, eat right, and maintain hygiene of the teeth and mouth (use a toothbrush, toothpaste and dental floss regularly).

In the situation when ulcerative gingivitis is a concomitant disease, it is necessary to eliminate the source of pathological processes. To do this, you need to undergo a thorough examination of the whole body by the therapist and get a referral to the right specialist.

In any case, you can not leave the signs of ulcerative gingivitis without attention. It is advisable to undergo treatment as soon as possible, since this pathology tends to serious complications.


| December 27, 2014 | | 1 455 | Dentistry
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