OVERVIEW OF GINGIVITIS

 

Definition: Inflammation of the gingiva.

Types of Gingivitis:

A. Acute Gingivitis:

Painful condition that comes on suddenly and is of short duration.  Example: Acute necrotizing ulcerative gingivitis, acute herpetic gingivostomatitis

B. Chronic Gingivitis:

Painless, comes on slowly and is of long duration. This is the most common type of gingivitis.  Example:
Plaque associated gingivitis.
Medication - influenced gingivitis.

Acute and chronic forms of gingivitis can be either LOCALIZED, i.e. affecting a single tooth or group of teeth or GENERALIZED, i.e. involving all teeth. Gingivitis can also be affecting only the Marginal or Papillary gingiva or can be diffuse, i.e. affecting Marginal, Papillary, and Attached gingiva.

Etiology:

The PRIMARY cause of almost all types of gingivitis is the BACTERIAL PLAQUE. The SECONDARY causes include: Plaque Retentive Factors such as calculus, overhanging margin, etc. Other secondary factors that induce gingival overgrowth are
                    1. Drugs
                    2. Pregnancy
                    3. Puberty etc.
The most common form of gingivitis is Plaque Associated Gingivitis which affects about 45% of the adult U.S. population. The peak prevalence of gingivitis is observed in children during. 
The plaque is predominantly Gm (+) ve with members of the genus Actinomyces and Streptococcus predominating in both supra and subgingival plaque.

Diagnosis:

Clinical examination of gingiva is most often adequate to diagnose gingivitis. ( See Chart Bleeding on probing is easily detectable clinically and therefore is of great value for early diagnosis of gingivitis.

Treatment:

Gingivitis is reversible. Treatment includes removal of plaque and calculus by scaling and instructions in plaque control. Presence of other secondary etiological factors such as overhanging restoration should be treated. Topical antimicrobials in the form of mouthwash may also be prescribed.
If no treatment is rendered, the severity of gingivitis may
                    1. increase or
                    2. remain the same or
                    3. the disease may resolve on its own and
                    4. may appear again.
 
Furthermore, in some cases the inflammation progress to periodontitis.

 

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