Ulcerative gingivitis is an inflammation of the gums, accompanied by necrosis and ulceration of its tissues. At the heart of these processes of ulcerative gingivitis with necrosis of gum tissue is the predominance of tissue alteration processes. In the cause of ulcerative gingivitis, the leading role belongs to a decrease in the resistance of the gingival mucosa to the fusospirochete microflora of the oral cavity. In the clinical setting of the dental practice, as a rule, acute ulcerative gingivitis occurs.
Diagnosis and symptoms of ulcerative gingivitis
The clinical picture of ulcerative gingivitis is quite typical and is characterized by an acute onset. A patient with ulcerative gingivitis complains of intense pain in the gums, putrid breath, bleeding gums. Usually, in patients with ulcerative gingivitis, the general condition is disturbed: body temperature rises, weakness, headache, decreased performance is noted.
When examining the oral cavity in patients with ulcerative gingivitis, it is found that the gingival margin is covered with a gray fetid plaque, after removal of which a bleeding sharply painful surface is exposed. The tops of the gingival papillae are as if cut off, the contours of the gingival margin are broken. A patient with ulcerative gingivitis is characterized by abundant non-mineralized dental deposits, "tartar". Regional lymph nodes (submandibular, behind the ear) are enlarged and painful on palpation.
In the blood plasma of patients with ulcerative gingivitis, leukocytosis and an increase in the erythrocyte sedimentation rate (ESR) are noted. With ulcerative gingivitis, protein may be found in the patient's urine.
When examining a patient in the acute period of ulcerative gingivitis, interrogation, examination, palpation of regional lymph nodes, measurement of body temperature, clinical blood, and urine tests are carried out.
After the acute inflammatory phenomena of ulcerative gingivitis subsided, it is advisable to conduct an in-depth examination of the patient to identify the reasons for the decrease in the body's resistance and the development of the disease.
Ulcerative gingivitis treatment
Ulcerative gingivitis treatment should be especially active at the first visit to the dentist. With the correct treatment of ulcerative gingivitis, the patient has a significant improvement in 12-24 hours.
First, anesthesia is performed on the gum areas affected by ulcerative gingivitis. It is better to anesthetize the gums using applications or oral baths with 0.5-2% solutions of novocaine, lidocaine, or another local anesthetic.
Then necrotic gum tissue is removed. A good result is obtained by the application of proteolytic enzymes (chymopsin, chymotrypsin, etc.) to the gums. With ulcerative gingivitis, the patient should strive to remove all necrotic plaque from the gums at the first visit. At the same time, dental deposits are eliminated, sharp edges of the teeth that injure the mucous membrane are polished off.
After cleansing the gums from necrotic masses, antimicrobial drugs are topically applied: 0.06% chlorhexidine solution, 1% hydrogen peroxide solution, metronidazole suspension, sanguirithrin, etc. in the form of applications or oral baths.
Therapeutic measures for patients with ulcerative gingivitis at home:
- metronidazole - 0.5 g 2 times a day
- diphenhydramine - 0.05 g each morning and evening
- acetylsalicylic acid - 0.5 g up to x3 times a day
- oral baths with antiseptic solutions (chlorhexidine, hydrogen peroxide, furacilin), herbal decoctions (chamomile, sage, calendula)
- plentiful drink
- a gentle, nutritious diet
From the second visit to a patient with ulcerative gingivitis, with an improvement in the general condition and local status, applications of agents that improve the epithelization of ulcerated surfaces are used: sea buckthorn and rosehip oils, carotolin, solcoseryl, oil solutions of vitamins A and E, Actovegin.
After the relief of inflammation in a patient with ulcerative gingivitis, thorough debridement of the oral cavity is performed.