What Is Chronic Gingivitis?

Marginal gingivitis is also known as chronic gingivitis and simple gingivitis. The lesions are located in the gingival papilla and free gingival, which is the most common gum disease. Mainly caused by local irritating factors, such as plaque, calculus, food impaction and poor restorations. The incidence of this disease is extremely high, and almost everyone has it in varying degrees and ranges in their lifetime.

Chronic gingivitis

Causes of chronic gingivitis

The long-term accumulation of plaque on the tooth surface near the gingival margin is the starting factor that causes chronic gingival inflammation. Dental calculus, food impaction, and poor restorations can all promote plaque accumulation and cause or aggravate gum inflammation.

Clinical manifestations of chronic gingivitis

3.1 Chronic Gingivitis 3.1 Lesion Location and Range

The lesions of marginal gingivitis are generally limited to free gingiva and gingival nipples, and can also spread to attached gingiva in severe cases, usually the most prominent in the anterior teeth area, especially the anterior jaw area.

3.2 Chronic gingivitis 3.2 lesions

Gum color

Normal gums are pink. Free gums and gingival nipples become dark red or dark red when gingivitis occurs. This is due to hyperemia and hyperplasia of blood vessels in the connective tissue of the gums.

2. Gum shape

When suffering from gingivitis, due to tissue edema, the gingival margin becomes thicker, no longer close to the tooth surface, the gingival papilla becomes round and blunt and enlarged. When the gingival edema is attached, the spots can also disappear, and the surface is smooth and shiny.

3. Texture

With gingivitis, gums can become soft and fragile due to connective tissue edema and destruction of collagen, lacking elasticity.

4. Gingival sulcus depth

When the periodontal tissue is healthy, the depth of the gingival sulcus generally does not exceed 2 mm. When the gums are swollen or hyperplastic, the gingival sulcus can be deepened by more than 2 mm to form a pseudo periodontal pocket.

5. Probe for bleeding

Healthy gums do not cause bleeding when brushing or detecting the sulcus. Bleeding when touched with gingivitis and bleeding when visiting. Hemorrhage after diagnosis is an important basis for the diagnosis of inflammation of the gums.

6. Increased gingival crevicular fluid

When there is inflammation in the gums, gingival crevicular fluid leaks out, and some patients may also have sulcus purulent. Therefore, measuring the amount of gingival crevicular fluid can be used as an index to judge the degree of inflammation.

7. Conscious symptoms

With marginal gingivitis, patients often bleed from brushing or biting hard objects, or have blood stains on the bite. However, chronic gingivitis usually does not have spontaneous bleeding, which can be distinguished from bleeding gums caused by blood diseases and other diseases. Some patients occasionally feel discomfort, such as local itching, swelling, and bad breath.

Chronic Gingivitis Examination

Examination showed that tartar was attached to the neck of the tooth. The color of the gums changed from light red to dark red. The gums are soft and slightly swollen, causing the edges of the gums to thicken and the gingival nipples to become round and blunt. The gums bleed easily during the visit.

Differential diagnosis of chronic gingivitis

Marginal gingivitis needs to be distinguished from periodontitis. The main points of identification are whether periodontal adhesion is lost and alveolar bone resorption. In gingivitis, the sulcus can be deepened by more than 2mm, but the location where the epithelium is attached is still located at the enamel cementum. When suffering from periodontitis, a true periodontal pocket can be formed, and the bottom of the pocket is located at the root of the enamel cementum. X-rays (especially flaps) are helpful in determining early alveolar bone resorption. Early periodontitis shows that the height of the alveolar crest is reduced, the hard plate disappears, and the bone height of gingivitis is normal.

Chronic gingivitis complications

6.1 Chronic Gingivitis 6.1 Heart Disease

Studies have found that patients with gingivitis have a heart attack rate three times higher than that of ordinary people. The reason is that certain bacteria or metabolites can enter the blood through the gums, which in turn affects the liver, causing it to produce a protein that can block arteries, causing Arterial embolism. Scientists have discovered a type of oral bacteria in fatty arterial embolism. If some dental patients have cardiovascular disease at the same time, doctors will give patients antibiotics before treating oral diseases to prevent a large number of microorganisms from entering the blood during oral surgery, causing bacterial Endocarditis.

6.2 Chronic Gingivitis 6.2 Stroke

Patients with severe gingivitis are twice as likely to have a stroke than other people. Because oral bacteria can cause fat embolism in the carotid arteries, if this fat mass reaches the brain and blocks blood vessels in gray matter, it can cause stroke.

6.3 Chronic Gingivitis 6.3 Diabetes

When a diabetic suffers a bacterial attack, insulin does not work effectively and raises blood sugar levels. People with severe gingivitis have difficulty controlling blood sugar levels.

6.4 Chronic Gingivitis 6.4 Gastric Ulcer

The bacteria that cause gastric ulcers can reside on the plaque, and the relationship between oral hygiene and gastric ulcers can be inferred.

6.5 Chronic Gingivitis 6.5 Pneumonia

Bacteria living in the mouth, when people have low immunity for a certain period of time, these bacteria will invade, which may cause bacterial pneumonia.

Chronic Gingivitis Treatment

7.1 Chronic Gingivitis 7.1 Removal of Causes

Because marginal gingivitis has no deep periodontal tissue destruction, removing local irritating factors, such as calculus, food impaction, and poor restorations can effectively treat marginal gingivitis. It is recommended to periodically perform gingival scaling to thoroughly remove plaque and other stimuli. factor.

7.2 Chronic Gingivitis 7.2 Drug Therapy

If the inflammation is severe, it can be combined with local drug treatment. Generally, 1% to 3% hydrogen peroxide solution is used to flush the gingival sulcus, and the iodine preparation is applied to the sulcus. If necessary, it can be rinsed with antibacterial mouthwash, such as chlorhexidine.

7.3 Maintenance of the efficacy of chronic gingivitis 7.3

After the treatment is started, the patient should be taught how to control the plaque in a timely manner. Persistence should be maintained to maintain oral hygiene. Periodic review (6-12 months) and cleanup should be performed to consolidate the efficacy and prevent recurrence.

Chronic Gingivitis Prevention

The key is to adhere to the thorough removal of plaque every day. Oral medical staff should conduct extensive oral health education, teach patients the correct brushing method, and use toothpicks and dental floss reasonably. Insist on brushing your teeth morning and night, and gargle after meals to control the formation of plaque and tartar. These are also important for preventing the recurrence of marginal gingivitis. Marginal gingivitis is a reversible lesion with a good prognosis.