Gingivitis: symptoms, treatment in children, adults,pregnant

Update: December 2018


  • What does normal gingivitis look like?
  • Causes of gingivitis and provoking factors
  • Symptoms of gingivitis
  • Diagnostics
  • Gingivitis treatment

Gingivitis is an inflammation of the gums only, while the infection is not
destroys the joint “gum-tooth” and does not affect the ligaments of the tooth and bone.
It is distributed in almost 100% of the adult population, 80% of schoolchildren.
And only in 30% of cases it is found in younger children.

The main cause of gingivitis is poor oral hygiene, therefore
данное заболевание называют еще болезнью грязных teeth. Many
people it is not detected, others manifest the most frequent
symptom – bleeding gums. Gingivitis begins with inflammation
papilla of the gum, then its other parts. He quickly takes
chronic course alternating exacerbations with remissions
(remission of the disease).

Oral bacteria are quite aggressive, therefore
people with inflammation of the gums and other tissues surrounding the tooth on
25-50% выше риск заболеваний сердца, а также sugar diabetes, а у
pregnant – вдвое выше риск преждевременных родов.

What does normal gingivitis look like??

  • Color – pale pink
  • The contours are smooth, tight fit the tooth
  • There is no edema and other prominent pathological changes.
  • Does not hurt
  • Does not bleed when eating, and when using dental


Gingivitis is classified according to the form, flow, phase of the process and

Catarrhal gingivitis

Catarrhal gingivitis

Ulcerative gingivitis

Ulcerative gingivitis

Hypertrophic gingivitis

Hypertrophic gingivitis

  • Forms: catarrhal, ulcerative, hypertrophic
  • Current: acute, chronic
  • Phases of the process: aggravation, remission
  • Prevalence: localized (only in one place),
    generalized (all teeth)

Отдельно рассматривают гингивит pregnant и гингивит у

Causes of gingivitis and provoking factors

The main cause of gum disease is microbes contained in
plaque. Together with the predisposing factors they
can cause inflammation of the gums of different shape and severity. Scientists
proved that on the gum isolated from bacteria never
gingivitis is found.

Местные факторы, способствующие скапливанию зубного raid

Anatomical: the shape of the tooth, the close arrangement of the teeth in a row,
malocclusion. Medical actions:

  • Mechanical damage to the gums during dental treatment
  • Incorrectly placed seal to facilitate attachment
    microbes (overhanging, unpolished and unpolished
  • Removable dentures (damage the gums, accumulate plaque)
  • Bridges that complicate tooth brushing
  • Oral surgery, including tooth extraction
  • Installation of orthodontic appliances (straighten teeth: bad
    are cleared, promote reproduction of bacteria)

Dental calculus: is the site of attachment of microorganisms,
затрудняет чистку teeth. Injury: aggressive brushing, harmful
habits (scratching the nails of the gums), sticking food, hot,
spicy food, chemical damage. Qualitative and quantitative
saliva composition change.

Systemic factors

This group of factors include medication,
diseases of the body and pathological conditions that change
defenses or cause an atypical gum reaction.

  • Age
  • Emotional and psychological stress
  • Genetic disorders
  • Endocrine disorders
  • Blood pathology
  • Metabolic disease
  • Lack of vitamins, microelements and essential nutrients
  • Constant medication that causes strong side effects.
  • Bad habits
  • HIV, severe chronic diseases
  • Chronic intoxication.

Proved that the occurrence of gingivitis is influenced by gender (in men
more often) race (in the African race, the disease is more severe) and
socio-economic status.

Causes of gingivitis in children

The main cause of children’s gingivitis is the same dental
raid But in children, the main predisposing factor is
нарушение самоочищения teeth. The following can lead to this:

  • early removal of milk teeth
  • orthodontic treatment
  • pathology and attachment of bridles of the lips, tongue
  • sticky saliva, poor diet with a lack of solid food and
    abundance of soft food and sweets
  • frequent chewing gum
  • mouth breathing, improper swallowing
  • multiple caries and pulpitis (inflammation of blood vessels and nerves)
  • congenital diseases of the salivary glands.

Причины гингивита pregnant

В развитии гингивита у pregnant женщин главную роль снова
играет зубной raid Pregnancy changes hormones and
the functioning of all organs and systems of a woman, which is almost 100%
cases provokes the occurrence of bleeding gums.

It has been scientifically proven that under the influence of an increased number of
estrogen and progesterone gums become more sensitive to
microbes of dental plaque, which provokes swelling and inflammation.
Микробный состав raid у pregnant несколько иной, так как
некоторые виды бактерий вместо основных питательных substances
start using female hormones.


Symptoms of gingivitis

Symptoms of gingivitis можно discover yourself. However for
exceptions to a more serious illness should be visited.
a dentist.

Symptoms of catarrhal gingivitis

According to research data, gastroenterological patients
catarrhal gingivitis occurs most often.

Acute Chronic
What provokes?
  • Exacerbation of chronic diseases
  • recently transferred ARVI
  • Frequent colds
  • chronic stress
  • rare visits to the dentist
  • poor oral hygiene
  • abundance of fatty and carbohydrate foods
  • lack of vegetables, fruits in the diet
What can disturb?
  • Severe bleeding of the gums, not even when brushing your teeth or
  • sharp pain
  • Bad breath
  • bleeding gums when eating and using a toothbrush
What does the doctor see?
  • Abundant plaque
  • multiple caries
  • closely spaced teeth
  • the gums are red, strongly swollen, bleeding even with light
  • Plaque, stone
  • the gum is hyperemic (red), slightly swollen, bleeds when
    probing (examination of the gums with a sharp instrument)
Differential diagnostics From hypertrophic and drug gingivitis (different
provoking factors)
  • From periodontitis – with gingivitis there is no pocket inside the gums, no
    loss of bone septum between the teeth, there is no tooth mobility, it can
    distinguish only doctor
  • from lichen planus – with lichen itching, burning, pain,
    damage to the entire oral mucosa
Symptoms of ulcerative gingivitis

Unusual studies have found that one of the atypical forms
premenstrual syndrome manifests itself ulcerative

What provokes?
  • Poor Oral Care
  • severe stress, nervous strain
  • chronic lack of vitamins and trace elements
  • smoking, alcohol abuse
  • untreated chronic catarrhal gingivitis
  • hypothermia, ARVI
  • no dentist visits
What can disturb?
  • A sharp pain in the gums that does not allow to eat or even speak
  • extremely bad breath
What does the doctor see?
  • Abundant plaque
  • presence of many carious and pulp teeth
  • gingival papilla gray, covered with a bloom of dead cells, under
    which hides the wound bleeding surface
  • white-gray tongue
  • bad breath putrid
Differential diagnostics
  • From acute leukemia – with leukemia, oral mucosa
    pale foci of necrosis in non-inflammatory areas, cell composition
    blood changed
  • from syphilis – pathological formations are painless
Symptoms of hypertrophic gingivitis

Hypertrophic gingivitis известен в двух формах: отечная и
fibrous. Hypertrophic gingivitis является одним из главных
symptoms of vitamin A deficiency.

Forms Edematous Fibrous
What provokes?
  • Hormonal disorders in childhood and adolescents,
    pregnancy, menopause
  • regular use of anticonvulsants, contraceptives and
    cytostatic drugs
  • wrong bite (deep, close teeth)
  • untreated chronic catarrhal gingivitis
  • chronic intoxication
  • gum irritation with dental constructions and
    improperly installed seals
What can disturb?
  • Unsatisfactory appearance of the gums (increases in size,
    becomes ugly)
  • bleeding and soreness when eating and hygiene
Unsatisfactory appearance of the gums (increases in size,
изменяется цвет, becomes ugly)
What does the doctor see?
  • Plaque, crowded teeth, deep
  • the gums are red, swollen, bleeding and painful
  • Plaque, crowded teeth, deep
  • overgrowth and change in the shape of the gingival papillae, gum
    pale pink color, not swollen, does not bleed when
Differential diagnostics
  • From fibromatosis (fibromatosis is a developmental defect, the whole is affected
    gum with bone
  • from blood diseases (there are changes in the composition of cells


When gingivitis conduct a comprehensive survey.

Basic methods

Survey (anamnesis): a person may be asked when they started
the first discomfort with which they are connected, how they changed,
whether the treatment was carried out. External examination: the doctor notes the behavior
patient’s overall appearance, color and purity of the face, probes the lymphatic
knots. Examination of the oral cavity:

  • vestibule (space between lips and teeth): allows
    оценить bite, состояние уздечек губ и слизистой оболочки
  • inside the mouth (palate, pharynx, tongue, cheek mucosa):
    their condition is determined by their appearance
    internal diseases
  • teeth: it turns out the presence of diseases of the teeth, plaque and
    stone, the presence of a pathological pocket inside the gums
  • gum: revealed if there is a change in color and shape, swelling,
    bleeding, suppuration.

Index score: the doctor calculates using special formulas
the severity of the disease.

Additional methods
  • X-ray: allows differential
    diagnosis between gingivitis (damage to the gums only) and
    periodontitis (damage to the gums and bones)
  • Complete blood count: for differential diagnosis with
    blood disorders
  • Biochemical analysis: differential diagnosis sugar
  • Blood test for HIV and syphilis
  • Microbiological examination: to identify species

Gingivitis treatment

Gingivitis treatment у взрослых начинается с составления плана,
which depends on the severity, stage of the disease, the presence of aggravating

Chronic Gingivitis Treatment
  • Training in oral hygiene and selection of individual means
    brushing teeth, controlling learned skills later
  • Professional hygiene: removal of hard and soft tooth
  • Local therapy: the use of antiseptic,
    anti-inflammatory ointments, gels, rinses
  • Restorative therapy: vitamins, drugs that improve
  • Treatment of sick teeth
  • If necessary, bite correction or insertion
    missing teeth.
Treatment of acute gingivitis

It is distinguished by the fact that antimicrobial and
anti-inflammatory therapy. After swelling and gum subside
will cease to hurt, with catarrhal gingivitis begin to fight so
same as described above.

Sometimes, the doctor prescribes
hydromassage gums. It helps to effectively remove soft plaque and
улучшить circulation. Gum massage can be done at home
special irrigator.

Treatment of ulcerative gingivitis
  • Fight against dental deposits. This stage includes
    mandatory antiseptic treatment of the entire oral cavity and
    superficial anesthesia with gel
  • Treatment of ulcers: first anesthesia is done, then using
    enzymes and instruments the gums are cleared of ulcers
  • Local antibiotic therapy with metronidazole
  • After the start of healing, use local wound healing
    drugs (oil solutions of vitamins A, E, sea buckthorn)
  • Antibiotics (metronidazole inside)
  • Anti-inflammatory therapy
  • Antiallergic drugs
  • Restorative therapy: vitamins, possible appointment
  • After recovery – treatment of diseased teeth.

With ulcerative gingivitis are required to issue a disability certificate
(sick leave) for a few days.

Treatment of hypertrophic gingivitis

In this case, the treatment plan is the same as that of the catarrhal
gingivitis, only after the stage of rehabilitation of sick teeth
surgical removal of overgrown gums. In this case, before the operation
fibrous hypertrophic gingivitis is treated as chronic
catarrhal, and edematous – as acute catarrhal. With leukemia
only symptomatic treatment is performed, overgrown parts of the gums
do not delete.

Gingivitis treatment при беременности

Catarrhal gingivitis is treated according to the same plan, except for
self-prescription drugs used inside: they can
use only after permission of the gynecologist. When
hypertrophic gingivitis treatment is only symptomatic

However, this treatment plan is not always effective due to
special position of women. More and more come to the rescue
research. In 2007, a warm compress was introduced on the gum with
Mexidol and paraffin, recommendations to brush your teeth with toothpaste
Mexidol and use the same cavity rinse
mouth In 2012, the effectiveness of another drug for
topical treatment of gingivitis – ointment vulnusan.

In traditional medicine, pregnant women to combat
bleeding gums is recommended to drink cow’s milk, decoction
rose hips, birch, maple, orange, lemon,
grapefruit juice, rinse your mouth with saline, warm
infusion of nettle and just cold water, and do not eat solid
food and gently brush your teeth.

Gingivitis treatment у детей

To begin to struggle with a children’s gingivitis with lessons of hygiene of a cavity
mouth for children and parents. In a playful way using
The dyes show how well the guys brush their teeth. For children
также проводят профессиональную гигиену полости mouth When
severe forms of the disease (ulcerative gingivitis) first perform those
same stages as adults, and then proceed to the control of cleansing

If one of the factors of gingivitis was an incorrect bite,
the child is sent to the orthodontist. When наличия общих заболеваний
recommend consulting relevant professionals. Important
the moment is the proper nutrition of the child, walks,
parental responsibility.

Gingivitis treatment в домашних условиях

If you can not visit a doctor, how to help yourself
on your own?

If signs of catarrhal gingivitis are found,
brush your teeth well. Excellent against toothpaste plaque
ROCS. From bleeding need to use “Forest Balsam”,
“Paradontaks” or “Lacalut” in the complex (toothpaste plus
rinse). Effective is the use of gels – balms.
for gums “Asept.”

Лесной бальзамАсепта ЛокалютЛокалют Парадонтакс Рокс

Mandatory daily cleaning of the interdental spaces using
threads. Rinsing with a shepherd’s bag or
rhizomes of sabrelnik marsh. Broths of chamomile and sage good
relieve inflammation. Self symptomatic treatment
hypertrophic gingivitis will be exactly the same.

In non-severe ulcerative gingivitis:

  • Plentiful drink, sparing diet
  • Preparations for oral administration: metronidazole (0.5 g 2 times a
    day), diphenhydramine (0.05 g, 2 times a day), acetylsalicylic acid
    (0.5 g 3 times a day)
  • Local treatment:
    • first Miramistin or Chlorhexidine in the form of baths
    • then Metrogil Dent gel (all this 5-6 times a day)
    • in between – gargling chamomile and sage
    • after inflammation and pain subsides: to the place of former ulcers –
      Kolkosaril, Carotinol, rosehip oil or sea buckthorn for


Prevention любой формы гингивита заключается в тщательной
daily teeth cleaning, professional hygiene
oral cavity 2 times a year, as well as the elimination of provoking general and
местных factors.

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