Gingivitis

Classification according to ICD-10
K05.0	Acute gingivitis
K05.1	chronic gingivitis
ICD-10 online (WHO version 2019)

Gingivitis, above before, below after tartar removal and debridement. The gingival reddening on the gumline due to the inflammation is subsiding

Gingivitis is an inflammation of the marginal gums (gingiva), usually caused by bacteria . Deeper structures of the periodontium (periodontium) are not affected. Gingivitis can be exacerbated by other factors.

Symptoms and Risk Factors

The symptoms of gingivitis are similar to those of inflammation and manifest themselves on the gums with more reddening, edematous and hyperplastic swelling, bleeding on probing and ulceration (ulcerative disintegration). In addition, bad breath ( halitosis ) can occur and the orange peel-like stippling of the gums disappears.

Chronic gingivitis usually does not cause pain. In principle, all bacteria occurring in the oral flora can be considered as pathogens . A persistent chronic gingivitis can in a periodontal disease pass or accelerate the course in an existing periodontitis.

The risk factors for gingivitis are the same as for periodontitis. Poor oral hygiene, smoking, psychosocial stress and genetic factors have an influence both on the likelihood of development and on the course of the disease. In addition, some underlying diseases (e.g. diabetes ) can also promote a more severe course of the disease.

In January 2019, a possible link between gingivitis and Alzheimer's disease was identified.

causes

The most common cause of gingivitis is bacterial plaque on the teeth, which triggers the patient's immune response. The immune response is supposed to counteract the bacterial invasion and causes the typical signs of inflammation and, if left untreated, can lead to the destruction of the gum tissue and, as a result, the periodontal supporting apparatus. Most often, dental plaque is found in the interdental spaces in the area of ​​the gum sulcus , which the toothbrush cannot reach. Otherwise, areas that are difficult to clean, so-called plaque traps , are often covered with plaque and can be found, for example, on protruding filling edges and regions with tartar . The bacteria that accumulate in the plaque produce degenerative enzymes and toxins (such as endotoxins or lipoteichoic acid ) that can increase the inflammatory response of the tissues. In addition to plaque-induced gingivitis, there are also rarer variants that can be caused, for example, by specific colonization by bacteria, viruses or fungi. Very rare genetic variants have also been described. Injuries and foreign objects can also cause gingivitis.

therapy

Intensive oral hygiene is both a prophylaxis and a therapy for plaque-associated gingivitis, as this removes the causative bacterial biofilm and food residues from the mouth. Professional oral hygiene with tartar removal and possible removal of plaque retention sites are part of the therapy. If symptoms do not improve despite good oral hygiene , other forms of gingival disease must be considered and treated if necessary. In addition to mechanical cleaning with toothbrushes, dental floss and other aids, oral disinfectants in the form of mouthwashes , gels or mouth sprays can also be used for a short time. Depending on the composition of the ingredients, these agents reduce the number of bacteria in the mouth and throat for a few minutes or for several hours (depot effect). The number of bacteria on the toothbrush can be reduced by regularly disinfecting the toothbrush (dental spray, UV disinfection for electric toothbrushes).

nomenclature

The currently valid nomenclature was established in 1999 as part of the "International Workshop for a Classification of Periodontal Diseases and Conditions". This replaced older, often country-specific nomenclatures.

1. Plaque-induced gingival diseases
   1. Gingivitis caused by plaque alone
      1. without other local factors
      2. with other local factors
   2. Gingival diseases modified by systemic factors
      1. associated with hormonal influences
         1. Gingivitis During Puberty
         2. Gingivitis during menstruation
         3. Gingival Disorders During Pregnancy
            1. Pregnancy gingivitis
            2. Pregnancy granuloma (pyogenic granuloma)
         4. Gingivitis in Diabetes Mellitus
      2. associated with blood disorders
         1. Gingivitis in leukemia
         2. Gingivitis in HIV
         3. other
   3. Gingival diseases modified by medications
      1. Gingival disease due to medication use
         1. Gingival growths affected by medication
         2. Gingivitis affected by medication
            1. Gingivitis associated with oral contraceptives
            2. other
   4. Gingival diseases modified by malnutrition
      1. Gingivitis due to vitamin C deficiency
      2. other
2. Gingival disease not induced by plaque
   1. Gingival diseases caused by specific bacteria
   2. Gingival diseases of viral origin
   3. Gingival fungal diseases
   4. Gingival diseases of genetic predisposition
   5. Gingival manifestations of systemic conditions
   6. Traumatic lesions
   7. Foreign body reactions
   8. not specified

See also

• Feline gingivitis-stomatitis-pharyngitis complex
• Viral herpetic gingivostomatitis ( oral rot )

Web links

Wiktionary: Gingivitis  - explanations of meanings, word origins, synonyms, translations

Commons : Gingivitis  - Collection of Images, Videos, and Audio Files

• Gingivitis - Dental Health Working Group - independent consumer and Patient advice

Individual evidence

1. ^ Herbert F. Wolf, Edith M. Rateitschak, Klaus H. Rateitschak: Parodontologie . Georg Thieme, 2004, ISBN 978-3-13-655603-0 ( google.com ).
2. ^ Symptoms , Gingivitis, Mayo Clinic staff, Retrieved June 11, 2015.
3. ↑ ^{a b} Gum inflammation: causes. In: Olobot. Archived from the original on March 4, 2016 ; accessed on February 9, 2019 . 
4. ↑ Stephen S. Dominy, Casey Lynch et al. a .: in Alzheimer's disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. In: Science Advances. 5, 2019, p. Eaau3333, doi : 10.1126 / sciadv.aau3333 .
5. ^ Research, Science and Therapy Committee of the American Academy of Periodontology: Treatment of Plaque-Induced Gingivitis, Chronic Periodontitis, and Other Clinical Conditions . Journal of Periodontology 72 (12): 1790-1800.
6. ^ U. Klages, AG Weber, H. Wehrbein: Approximal plaque and gingival sulcus bleeding in routine dental care patients: relations to life stress, somatization and depression. In: Journal of clinical periodontology. Volume 32, Number 6, June 2005, ISSN  0303-6979 , pp. 575-582, doi: 10.1111 / j.1600-051X.2005.00716.x , PMID 15882214 .
7. ↑ What is gingivitis? What causes gingivitis?
8. ↑ Gum Disease (gingivitis)
9. ↑ PM Sinclair, CW Berry et al. a .: Changes in gingiva and gingival flora with bonding and banding. In: The Angle orthodontist. Volume 57, Number 4, October 1987, ISSN  0003-3219 , pp. 271-278, doi : 10.1043 / 0003-3219 (1987) 057 <0271: CIGAGF> 2.0.CO; 2 , PMID 3479031 .
10. ^ Position Paper on the Oral Prophylaxis , American Dental Hygienists' Association.

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