gingivitis

Introduction

Inflammation of the gums covering the maxilla & mandible.

Etiology

• anaerobic bacteria are the usual cause
• associated with accumulation of bacterial plaque
• risk factors
  • poor oral hygiene
  • tobacco use
  • excessive alcohol
  • xerostomia
• severe gingivitis may occur during pregnancy

Pathology

• starts as inflammation of the marginal gingiva
  • generally painless
  • may bleed with brushing
• spreads to involve the periodontal ligament & alveolar bone
• resorption of the periodontal ligament results in loss of attachment between the tooth & bone
• the soft tissue separates from the tooth surface on chewing, brushing, probing
• acute inflammation by superimposed on chronic process
• periodontal abscess may occur

Complications

• may increase risk of Alzheimer's disease

Management

• prophylaxis
  • teeth brushing
  • antibacterial mouth rinses (mouthwash)
  • flossing
  • dental cleanings
• treatment
  • as above for prophylaxis
  • debridement of pocket lining (separation of tooth from soft tissue)
  • metronidazole 250 mg PO TID
  • clindamycin 300 mg PO TID
  • amoxicillin clavulanate 250 mg PO TID

More general terms

• periodontal disease; gum disease; gingival disease
• inflammation

More specific terms

• acute necrotizing ulcerative gingivitis; Vincent's angina; trenchmouth; cancrum oris novum; fusospirochetosis (ANUG)

Additional terms

• stomatitis (includes oral ulceration)