European International Journal of Pedagogics
44
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TYPE
Original Research
PAGE NO.
44-49
DOI
OPEN ACCESS
SUBMITED
25 October 2024
ACCEPTED
27 December 2024
PUBLISHED
17 January 2025
VOLUME
Vol.05 Issue01 2025
COPYRIGHT
© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.
Gingivitis - Symptoms and
Treatment
Djumaev Asliddin Abdusamadovich
Clinic Resident of the Department of Orthopedic Dentistry Samarkand
State Medical University, Samarkand, Uzbekistan
Islamova Nilufar Bustanovna
PhD, Assistant Department of Orthopedic Dentistry Samarkand State
Medical University Samarkand, Uzbekistan
Abstract:
The inflamed gum becomes soft, rough, and
does not adhere tightly to the crowns of the teeth.
According to the World Health Organization, more than
90-95% of adults have inflammatory processes of the
soft tissues of the oral cavity, and tooth loss due to
inflammation of the gums and periodontium (tissues
surrounding the tooth) occurs 5 times more often than
from carious lesions.
Keywords:
Soreness, swelling, bleeding, and the release
of exudate.
Introduction:
Gingivitis is an inflammatory gum disease that is
manifested by soreness, swelling, bleeding, and the
release of exudate (fluid that tissues produce in
response to inflammation).
The inflamed gum becomes soft, rough, and does not
adhere tightly to the crowns of the teeth. According to
the World Health Organization, more than 90-95% of
adults have inflammatory processes of the soft tissues
of the oral cavity, and tooth loss due to inflammation of
the gums and periodontium (tissues surrounding the
tooth) occurs 5 times more often than from carious
lesions.
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European International Journal of Pedagogics
In most cases, gingivitis occurs due to plaque buildup
as a result of poor oral hygiene. Plaque plaques
constantly irritate the mucous membrane, form
pockets (increase the distance between the tooth and
soft tissues), in which bacteria actively multiply. That
is, bacteria are most often the cause of gum
inflammation. In addition, gingivitis can be caused by
allergies, fungal and viral infections.
Provoking factors in the development of gum
inflammation:
• hormonal changes;
• diabetes mellitus;
• vitamin def
iciency;
Acquired (HIV) and congenital immunodeficiency (Di
Giorgi syndrome);
• pregnancy;
• leukemia;
• lack of vitamin C;
• burdened heredity (there are close relatives who
suffered from inflammatory gum diseases);
• gum damage.
Mucosal damage can occur with malocclusion, dental
manipulations, exposure to aggressive chemicals, the
use of a hard toothbrush, and the consumption of solid
foods. Even a minor injury to the epithelium is an
entrance gate for infection.
Iatrogenic (related to medical manipulations) factors
contributing to inflammation include the sharp edges
of dentures, crowns, and unpolished fillings adjacent
to the gum.
Symptoms of gingivitis
At the initial stage of the disease, patients complain of
discomfort in the oral cavity. On examination, the
affected gum area is hyperemic (i.e., there is redness)
and enlarged. Bleeding may occur during eating solid
foods and brushing teeth. There is usually no pain at an
early stage of the disease. Many patients complain of
increased salivation.
The inflamed gum lags behind the surface of the tooth,
food residues accumulate in the formed cavity, and bad
breath appears. If the disease is not treated, bacteria
actively multiply in the pocket, caries of the tooth neck
develops.
Over time, pain in the gums appears, which increases
during meals and during dental examinations. The pain
syndrome is especially pronounced when eating hot,
cold and sour. With severe inflammation or a
widespread process, not only local, but also general
symptoms may appear: fever, weakness, fatigue,
irritability.
Upon examination, the dentist sees a discoloration of
the affected areas of the mucous membrane,
hypertrophy (increase in volume) of the interdental
papillae and the edges of the gums. Plaque, tartar, and
caries lesions are usually present in the area of
inflammation. When examined with a dental
instrument, the gums may bleed. With chronic
inflammation, the clinical picture is erased, but severe
soft tissue hypertrophy may occur. With a long-term
ongoing process, the overgrown gum can cover almost
the entire crown of the tooth. With desquamative (with
the appearance of blisters on the gums) and ulcerative
gingivitis, blisters and sores can form on the gums.
Pathogenesis of gingivitis
The development of gingivitis begins with the formation
of plaque from plaque. They form after the absence of
proper oral hygiene for 1-2 days. The most common
places of plaque formation are the interdental spaces
and the cervical zone.
A pellicle film is formed from saliva and secreted gum
fluid. Normally, it performs a protective function, but in
the initial stages of gingivitis, it promotes the adhesion
of bacteria that are present in the oral cavity, even in a
healthy person. These are usually aerobic cocci and
sticks.
Microorganisms actively multiply, and an anaerobic
(oxygen-free) environment is formed in the depths of
their colony. This creates optimal conditions for the
reproduction of aggressive gram-negative microflora.
These bacteria produce toxins that are able to penetrate
into the tissues and destroy the mucous membrane,
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European International Journal of Pedagogics
which leads to erosive changes in the epithelium.
The div tries to resist the damaging effect and in
response triggers an inflammatory reaction in order to
destroy pathogenic factors. In some cases, the immune
system can cope with the microflora on its own, but
more often the inflammation progresses or becomes
chronic.
The destructive effect of microorganisms and the
inflammatory process lead to a deterioration of
microcirculation in the gums, a decrease in the activity
of antioxidant defense mechanisms. This leads to an
aggressive effect on the epithelium of the complement
system factors (protective proteins circulating in the
blood), which causes progressive destruction of the
mucosa. In patients with immune defects, hormonal
disorders, blood diseases, traumatic gum damage and
thinned mucous membranes, soft tissues are more
vulnerable, and the process of their destruction is
more active.
If the pathological process is actively developing, the
number of cells of the immune system (lymphocytes
and macrophages) increases in the soft tissues. They
destroy cells and fibrillar structures of the cytoplasm
(rigid, parallel fibers that determine the shape of the
cell). This leads to an expansion of the space between
the gum and the tooth, and a thinning of the epithelial
layer.
The inflammation can completely disappear with the
onset of recovery, or become chronic. In the second
case, the regeneration processes are disrupted, the
epithelium is replaced by granulation tissue
(connective tissue that forms during the healing of
tissue defects), which can grow strongly, covering the
crown of the tooth.
Classification and stages of gingivitis development
According to the International Classification of
Diseases 10 revision (ICD-10), acute and chronic
gingivitis are distinguished.:
1. In acute cases, the patient feels pain and discomfort,
bleeding is common, and the soft tissues are
hyperemic.
2. Chronic inflammation sometimes causes discomfort,
the patient is concerned about bad breath, the edge of
the gum is often thickened in the form of a roller. The
chronic form of gingivitis is divided into the following
types:
3. chronic without additional clarifications;
4. desquamative (with the appearance of bubbles on
the gums);
5. Hyperplastic (manifested by gum growth);
6. simple marginal (affecting the edge of the gum);
7. Ulcerative.
According to the prevalence of the inflammatory
process, gingivitis can be local or generalized
(widespread). In the latter case, common symptoms are
often detected in the form of fever and weakness.
According to the severity of the current:
• Mild mucosal lesions —
only interdental papillae are
affected.
• Moderate lesions —
the free edge of the gum is
involved in the inflammatory process.
• Severe mucosal lesions —
the soft tissues attached to
the tooth become inflamed.
According to morphological features:
• Catarrhal gingivitis. It is characterized by the release of
a large amount of exudate, pronounced redness of the
mucous membrane, swelling, soreness, and local fever.
• Hypertrophic gingivitis. The papillae between the
teeth increase, and over time they can completely cover
the crowns of the teeth. The gum acquires a bluish tinge,
bleeds during meals, brushing teeth or during a dental
examination, and deep gingival pockets form.
Ulcerative gingivitis. The mucous membrane acquires a
gray tint, foci of destruction are visible.
Complications of gingivitis
Gingivitis is not as harmless a disease as it seems to
some patients. Many people believe that the
inflammation will pass by itself, leaving no trace. This is
possible only with a small lesion and good immunity. It
should be remembered that inflamed gums are a source
of infection that can spread in the oral cavity and cause
serious consequences. That is why, at the first
symptoms, you need to seek medical help. The most
common complications of gingivitis:
• ulcerative
-necrotic changes of the mucous membrane;
• periodontitis (periodo
ntal inflammation);
• periodontitis (inflammation of the connective
ligament that fixes the tooth in the jaw bone);
• the spread of infection beyond the oral cavity.
In gingivitis, the oral mucosa is affected by the div's
immune forces (lymphocytes and macrophages) and
toxins secreted by bacteria. If the inflammatory process
is not stopped in time, the epithelium will begin to
collapse. In the initial stages, this process is reversible,
but with a prolonged course of gum disease, the gum is
hypertrophied due to granulation tissue. In this case,
therapeutic treatment may be ineffective.
The microflora that has affected the gum can spread to
periodontal tissues. This leads to shakiness of the teeth,
and eventually to their loss. Thus, due to gum diseases,
you can lose perfectly healthy teeth.
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European International Journal of Pedagogics
Forecast. Prevention
With the timely initiation of treatment of the disease,
especially with catarrhal form (characterized by
redness and swelling of the gums), the prognosis is
always favorable. The soft tissues are fully restored,
and when the cause of the inflammation is eliminated,
it does not develop again.
With extensive damage and overgrowth of the gum, it
is necessary to partially remove the gingival papillae,
this can lead to exposure of the necks of the teeth. If
such patients do not regularly take preventive
measures, periodontitis develops rapidly.
If you do not undergo treatment, gum inflammation
usually results in tooth loss. The microflora affects the
periodontal tissues that fix the tooth, it begins to
wobble and eventually falls out.
Patients with diabetes mellitus often have an
unfavorable prognosis for gingivitis. Violation of
microcirculation caused by the underlying disease
leads to a violation of tissue trophism, slows down the
regeneration processes. Such patients need constant
supportive therapy, which slows down the onset of
irreversible changes, as well as blood glucose control.
For the prevention of gingivitis, the following
recommendations should be followed::
• brush your teeth regularly (2 times a day);
• use a brush with soft bristles;
• Use dental floss and mouthwash after meals.;
•
Have your teeth professionally cleaned by a dentist
every six months;
• do not miss scheduled visits to the doctor;
• timely treatment of caries;
• if the filling or crown injures the gum, contact your
dentist immediately.;
• Avoid eating solid foods that
injure the gums.
If bleeding gums is observed for more than three days,
you do not need to self-medicate, you need to seek
medical help. The initial stages of gingivitis can be
cured quickly with local therapy. An advanced disease
is difficult to treat and can have irreversible
consequences.
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