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gingivitis
Inflammation of the gums covering the maxilla & mandible.
Etiology:
1) anaerobic bacteria are the usual cause
2) associated with accumulation of bacterial plaque
3) risk factors
a) poor oral hygiene
b) tobacco use
c) excessive alcohol
d) xerostomia
2) severe gingivitis may occur during pregnancy
Pathology:
1) starts as inflammation of the marginal gingiva
a) generally painless
b) may bleed with brushing
2) spreads to involve the periodontal ligament & alveolar bone
3) resorption of the periodontal ligament results in loss of attachment between the tooth & bone
4) the soft tissue separates from the tooth surface on chewing, brushing, probing
5) acute inflammation by superimposed on chronic process
6) periodontal abscess may occur
Complications:
- may increase risk of Alzheimer's disease [3]
Management:
1) prophylaxis
a) teeth brushing
b) antibacterial mouth rinses (mouthwash)
c) flossing
d) dental cleanings
2) treatment
a) as above for prophylaxis
b) debridement of pocket lining (separation of tooth from soft tissue)
c) metronidazole 250 mg PO TID
d) clindamycin 300 mg PO TID
e) amoxicillin clavulanate 250 mg PO TID
Related
stomatitis (includes oral ulceration)
Specific
acute necrotizing ulcerative gingivitis; Vincent's angina; trenchmouth; cancrum oris novum; fusospirochetosis (ANUG)
General
periodontal disease; gum disease; gingival disease
inflammation
References
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY,
1994, pg 199, 518
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Demmer RT, Norby FL, Lakshminarayan K
Periodontal Disease and Incident Dementia: The Atherosclerosis
Risk in Communities Study (ARIC).
Neurology. July 29 2020
PMID: 32727837
https://n.neurology.org/content/early/2020/07/29/WNL.0000000000010312