Microbial gingivitis is diagnosed through a inflammation of the gum tissue around one or more teeth. It appears due to the bacterial plaque from the gums sulcus as result of the absence of a proper brushing. The gums sulcus surrounds the teeth and has a depth between 1 ans 3 mm.
Premature symptoms (clinical sign) of the gingivitis is the bleeding the gums both at mastication (feeding) and at tooth brushing. If on this stage does not begin a proper sanitation, the inflammatory processes will lead to the hypertrophy and hyperplasia of the gum, characterized by increasing of interdental papillae or of the free gum edge. Could appear even a unpleasant smell of the mouth (bad breath) due to releasing from bacterial plaque level, of some metabolic products (hydrogen sulphide). In this stage is necessary a dentistry treatment into a consulting room.
Microbes from oral cavity are mesophyll heterotrophic bacteria, characterized by a development to a temperature between 20 and 40 C. degrees by the oxidation of the organic substrates (feeding) present into oral cavity. Their presence is normal to this stage and constitutes oral saprophytic flora. But their number is too big, a drop of saliva containing about 100.000.000 bacteria. Their classification is varied and grants important information related to the shape, pathogenicity, virulence etc.
By mobility, the bacteria are divided into mobile and immobile.
By pathogenic are divided into saprophytic and pathogenic. Pathogenicity is the capacity of microbes to produce an infection into an organism, exceeding its immune defense mechanism. But in some conditions as lack of oral hygiene, avitaminose etc, the saprophytic bacteria may become pathogenic.
By virulence are divided into non virulent bacteria, bacteria with small virulence and bacteria with big virulence. The virulence is the quantitative notion which assesses the bacteria number from the same species, able to cause an infection in body.
By cellular breath, the prokaryotes, are divided into aerobic and anaerobic.
By Gram stain are divided into G(-) bacteria and G(+) bacteria.
Having in view all above mentioned, as well as appearance in time of the dental scale which will prevent the returning to a proper and voluntary, requires a complex treatment into the dentistry consulting room.
The treatment is performed into the dentistry consulting room into 3-4 sessions.The dentistry treatment consist in:
After ending of treatment, the patient have to continue by himself performing of oral hygiene. Also is necessary returning at a dentistry consulting room two times on year for a medical consultation.
Untreated chronic microbial gingivitis within the Dental Office, evolves to chronic periodontitis which generates bone resorption around the teeth. This once started, will go on in time and in several years will cause the mobility, moving and dropping of the teeth.
Generalized chronic gingivitis due to bacterial plaque accumulated through the lack of oral hygiene. Gums bleeding appears. This stage may evolve in the lack of good oral hygiene into the case 2 presented below.
Generalized chronic gingivitis due to supragingival tartar and bacterial plaque. There is a strong inflammation at the interdental papillae level and bone resorption and gingival retraction begin. This stage can evolve in the lack of treatment within the dental office into the case 3.
Generalized chronic periodontitis given by upper and subgingival tartar with bacterial plaque. In this stage the accentuated bone resorption determines the appearance of the spaces between the teeth, but also their mobilization and displacement. Due to the lack of treatment into the dental office, this stage can evolve to case 4.
* the present article has an informative role and does not address the subject comprehensively.