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Dental affections Chronic gingivitis

Dentistry, frequent issues - Chronic microbial gingivitis

Microbial gingivitis diagnosys

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 form are divided into:
  • bacilli (with small stick shape);
  • fusiform bacteria (with small stick shape with sharp ends);
  • cocci (with elliptical, spherical form or with drop shape of coffee bean);
  • vibrio (in comma shape);
  • spirili (with filaments shape with mobile cilia);
  • spirochete (with shape of helical filaments very mobile).

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.

Photo chronic gingivitis
Papillitis

Treatment

The treatment is performed into the dentistry consulting room into 3-4 sessions.

The dentistry treatment consist in:
  • scaling and professional tooth brushing;
  • local irrigation with antiseptic;
  • application of the antibiotics at the gums level.

Advices for patients:
  • use of floss immediately after meals;
  • use of the indexes of bacteria plaque;
  • proper tooth brushing;
  • use of anti-scale tooth paste and interdental brushes into interdental spaces;
  • rinsing with mouthwash at the end.

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.

Photo post-treatment
Cured gums

Evolution of untreated chronic microbial gingivitis

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.

The evolution stages of these diseases encountered in the practice of the dental office

Case1

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.

Photo bacterial plaque
Bacterial plaque

Case2

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.

Photo dental tartar
Dental tartar

Case3

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.

Photo chronic periodontitis
Chronic periodontitis

Case4

Advanced generalized chronic periodontitis given by supra and subgingival tartar with bacterial plaque. In this stage the bone resorption is very high and causes teeth loss.

Photo Teeth loss stage
Teeth loss stage

* the present article has an informative role and does not address the subject comprehensively.

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Last modified: January 3rd, 2021.

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