Forms of gingivitis: classification of types of gingivitis

Medical classification of gingivitis according to the clinical course of the disease distinguishes such forms of gingivitis as aggravated, acute, chronic, or such, in which the disease is in remission. Also the disease can be generalized or localized depending on the localization of inflammatory processes. The first in humans, the disease affects the gums many teeth, and the second only a few. Also, the disease is divided according to the forms of inflammation. There are several types of the disease:

  • ulcer;
  • karataldy;
  • hypertrophic;
  • atrophic.

All types of gingivitis have their own clinical features and require different methods of treatment.

Gingivitis catarrhal form

Catarrhal gingivitis is an inflammatory lesion of the upper layers of the gum tissue, which does not affect the dentogingival connection.

The reasons for the development of the disease

This type of gingivitis often occur due to the effects on the oral cavity of unfavorable factors of General and local character.

The most common local factors include:

  • injury to teeth or jaws as a whole;
  • dental deposits in form of stones;
  • insufficient care for the oral cavity;
  • the number of defects in the orthodontic treatment type.

Among the General factors that influence the occurrence of disease include:

  • the abuse of alcohol;
  • Smoking;
  • immune system disorders;
  • diseases of the blood;
  • hormonal imbalance;
  • allergies;
  • infectious diseases and various viruses;
  • lack of vitamins in the body;
  • genetic predisposition;
  • environmental factor;
  • some medical drugs(cytostatics, immunosuppressants, hormones).

The main trigger, which contributes to the development of disease — rapid growth of microorganisms of pathogenic character.

In other words, karataldy gingivitis occurs if a person in the mouth has a biological film, which consists of anaerobic and aerobic microorganisms.

The types karatelei form of the disease

The nature of inflammation, the disease is divided into several main types: acute and recurrent. The severity of gingivitis is determined based on the degree of destruction of the periodontium. If the inflammation has affected only the gingival papillae, the disease occurs in mild severity. If inflammatory processes extend between and along the edges of the teeth, it suggests that patients with middle severity of the disease. When the inflammation extended to the alveolar part of the gums, then this indicates the presence of severe disease.

If you do not give the gingivitis proper attention and do not start treatment, there is a great risk that it will go to the ulcerative form of the disease or in the following types of dental diseases:

  1. periodontitis;
  2. periodontitis;
  3. periodontal disease;
  4. abscess.

Diagnosis of the disease

The diagnosis of catarrhal gingivitis is based on the results obtained after conducting the oral examination and study of history. The severity of the disease is assessed by indices of dental type, through which you can estimate the number of bacterial film, the degree of inflammation and the intensity of gingival bleeding. To determine the exact performance of indexes on the specialist runs some tests.

The symptoms of catarrhal gingivitis

In the acute form the main symptoms are:

  • bad smell from the mouth;
  • pain caused by mechanical or thermal influences;
  • swelling and burning of the affected gums;
  • bleeding.

When the disease is severe, the patient can also result in such symptoms as General debility of the organism, hyperthermia, feeling of nausea, muscles pain and many others.

In the chronic form the main symptoms are:

  • titanicheskie change gums;
  • persistent bleeding of the gums;
  • the sense of enlargement of the gingival tissues;
  • burning of the gums;
  • a sharp thickening of the gums;
  • bad breath;
  • change of taste functions.
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At exacerbation of disease symptoms become more intense, and in remission, on the contrary, almost disappear.


Therapeutic action in the treatment of catarrhal gingivitis is aimed at eliminating microflora that provokes inflammation and the suppression of all factors contributing to the development of the disease.

Local treatment consists of a series of mandatory procedures which include:

  1. elimination of caries;
  2. the installation of the implant;
  3. prosthetics;
  4. cleaning of the oral cavity;
  5. fillings.

In the number of procedures for local treatment include:

  • massage the gums;
  • rinse the mouth with antiseptic solutions;
  • paraffin;
  • electrophoresis.

General treatment consists of receiving the following drugs:

  1. adjuvants;
  2. painkillers;
  3. anti-inflammatory drugs;
  4. antibiotics.

If gingivitis was provoked allergic, systemic, infectious or viral diseases, for the treatment of incorporate other specialized doctors according to medical directions, such as, hematologist, immunologist, endocrinologist and others.

Gingivitis hypertrophic appearance

Hypertrophic gingivitis is inflammation of the gingival tissues, which contributes to their growth.

Gingivitis is the form most common among young children.

The reasons for the development of the disease

Hypertrophic inflammatory processes are caused by two main factors: local and General.

To local irritants, which provoke the disease include:

  1. microorganisms;
  2. thermal factors;
  3. mechanical impact;
  4. chemical adverse factors.

In the number of common factors in the development of gingivitis include:

  • vitamin imbalance, i.e. a deficiency of vitamins P, C, and K;
  • violation of carbohydrate metabolic process;
  • disorders of the thyroid gland;
  • diabetes mellitus;
  • disorders of the endocrine system;
  • rheumatism;
  • hormonal changes(pregnancy, menopause, etc.);
  • disease the blood;
  • allergies;
  • viruses and infections;
  • dentofacial anomalies.

The types and severity of hypertrophic form of the disease

Clinic of the disease has identified several forms of hypertrophic gingival inflammation: granulomatous and fibrous. As for the severity, which is hypertrophic gingivitis classification it distinguishes three levels, which differ according to the stage of overgrowth of the gum tissue. Mild gums of the patient have Velikobritanii thickening, prevailing throughout the dentition. If the edges of the gums dissolve on dental crowns, and the thickening runs along the whole row of teeth, and the patient enlarged nipples, it indicates the presence of a second severity.

When the overgrowth of the gum tissue has a maximum size, then the disease runs in the third degree. Also at this point the relief of the gums of the patient is destroyed, appear on their surface bleeding granulation, causing the zagnoenie and pain. Papillae between the teeth at the same time begin to grow and change, acquiring an oval shape.

Symptoms of hypertrophic gingivitis


When granulating the form of the main symptoms are:

  1. irritation of the gum tissue;
  2. a significant increase and change of color of the gums;
  3. inflammation of gingival tissues;
  4. discharge from the periodontal pockets of fluid;
  5. pain on palpation;
  6. bleeding.
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When the fibrous form, the main symptoms are:

  1. seal gingival edges;
  2. the distortion of the contour of the gums;
  3. swelling of the gums.


The main methods of treatment of hypertrophic form of gingivitis are: anti-inflammatory, antibacterial and immunostimulatory therapy.
To get rid of bleeding Menadione is assigned for applications and complex vitamins. Also, the patient is recommended to take drugs that accelerate regeneration of the gum tissue and capillary-strengthening effects.
Granulating form is treated by diathermocoagulation and peocedure.
Recovery of the affected gums is carried out using paraffin.
The fibrous form of gingivitis is treated through surgical intervention. At the end of the treatment the patient shows therapeutic massage your gums and rinse.

As this form of disease is one of the dental problems of recurrent nature, after her treatment, the patient eliminate the cause that triggered the disease.

Gingivitis ulcerative form

Ulcerative gingivitis is an inflammatory destructive process which occurs in the upper layer of the periodontal. This form occurs in severe, contributing to the emergence of General intoxication. There are cases when the disease becomes chronic. In addition, ulcerative gingivitis able to flow in a number of other dental disorders, such as ulcerative stomatitis or periodontitis.

The reasons for the development of the disease

Ulcerative gingivitis is a complication arising from running or improper treatment catarrhal form of the disease. Developing the disease because of several factors: local and General.

The most common local factors are:

  • launched the treatment of caries;
  • insufficient care for the oral cavity, causing bacterial film;
  • incorrect dental treatment;
  • injury to the gum tissues;
  • Smoking;
  • frequent use of alcohol.

Among the common factors influencing the development of ulcerative inflammation include:

  • HIV infection;
  • diseases of the blood;
  • a lack of vitamin D and C;
  • infectious and virus diseases;
  • chemical poisoning;
  • food poisoning;
  • chronic stress;
  • diseases of the endocrine system.

When exposed to the body of the above factors in humans disrupts the function of the resistance, helping to accelerate the growth of pathogenic microflora, which provokes the appearance of disorders of blood flow and metabolism, and also violates the integrity of the gingival tissues.

Symptoms of ulcerative gingivitis

When acute course of the disease, the patient displays the following symptoms:

  1. severe headaches;
  2. the appearance of apathetic condition;
  3. sleep disturbance;
  4. the increase in body temperature;
  5. bleeding gums;
  6. swelling, burning and itching of the gums;
  7. redness;
  8. gniloy breath;
  9. severe pain in the gums.

With further development of the disease the patient displays expression of tissue(ulceration of the gums), and around them appears necrotic gingival tissue, which are gray and white. When you remove nekrotizirovannah film patients get abundant bleeding, which is quite difficult to prevent.

Also ulcerative inflammation of the gingival tissue causes the General intoxication of the body, appearing in its full weakness, nausea and intense pain of the temporal part of the head.

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Treatment of ulcerative forms of the disease consists of a complex of therapeutic measures of General and local importance. The whole period of treatment the patient must take vitamins and stick to a sparing diet.

Before treatment begins, the patient clean the mouth, removing damaged tissue, hard and soft tissue as well as grind tooth wall and remove all the factors that contribute to teeth and gums(bad embedded implants, crumbling fillings and teeth).

The local therapeutic action includes the reception of the following drugs:

  • antibiotics;
  • antiseptic;
  • decongestants funds.

In General therapy are used such medicines and therapies like:

  • antihistamines;
  • anti-inflammatory therapy;
  • immunomodulation;
  • physiotherapy.

Gingivitis atrophic form

Atrophic gingivitis is a chronic violation of the integrity of the gums, which is characterized by the decrease of the gums, exposing tooth roots and disappearance of the papillae between the teeth.

The reasons for the development of the disease

Often, the main reason for the development of disease is improper oral care mouth.

Also the main causes of atrophic gingivitis include:

  1. hepatitis;
  2. diabetes mellitus;
  3. immune system disorders;
  4. violation of metabolic processes in the body;
  5. tuberculosis;
  6. Smoking;
  7. gastritis;
  8. of peptic ulcer disease.

In addition, the occurrence of atrophic inflammation provokes:

  1. hormonal imbalance;
  2. traumatic violation of the integrity of the gums;
  3. incorrect dental treatment;
  4. congenital anomalies.

Symptoms of atrophic gingivitis

The primary symptoms are:

  • change the color of the gums;
  • loss of volume of the affected gums;
  • bleeding;
  • the hypertrophy of the tissues;

With the development of the patient have additional symptoms such as:

  • exposure of tooth necks;
  • sensitivity to external stimuli and temperatures;
  • the disappearance of the papillae;
  • exposure of tooth roots;

If you do not give proper attention to the treatment, the patient can receive complications in the form of loss of whole teeth or the occurrence of periodontitis.


Primarily in the treatment of the disease is identify and eliminate the causes that provoked the development of gingivitis. Then the patient undergoes cleaning of the mouth and prescribe therapeutic measures to improve gingival trophism. In some cases, the prescribed prosthesis or correction of orthodontic appliance.

To eliminate infections prescribe antibiotics and various antiseptic preparations. Also for the treatment of used rinsing the mouth with infusions and decoctions on the basis of medicinal herbs.

In the comprehensive treatment includes procedures such as the treatment of dental necks with a solution of fluoride, anatomicheski massage, therapeutic application and also physical therapy, which includes:

  1. light treatment;
  2. darsonval;
  3. electrophoresis;
  4. ultrasound diagnosis.

If the disease has a neglected appearance and due to some complications, the patient is prescribed gingivoplasty — operation for the restoration of the gingival tissues.