Necrotizing ulcerative gingivitis: acute gingivitis Vincent, treatment

Ulcerative-necrotic gingivitis is a disease of inflammatory nature, manifested in the formation of deep ulcers and areas of necrosis on the gums. Against the background of defeat the patient experiences severe pain, especially when eating, bad breath cannot be removed by rinsing, the General condition suffers.

Reasons

Gingivitis Vincent occurs in the background of already existing catarrhal lesions of the gums, rarely as a primary disease. Occurs against a background of reduced local and General immunity.
Local factors:

  1. bad habits;
  2. inadequate oral hygiene or improper brushing your teeth;
  3. untreated diseases of the oral cavity;

Common factors:

  • stress;
  • chronic sleep deprivation and fatigue;
  • the depletion of food;
  • HIV infection;
  • severe forms of disorders of the cardiovascular system and endocrine regulation;
  • disease the blood;
  • acute chemical poisoning;
  • chronic severe poisoning with salts of metals;
  • a lack of vitamin C.

These factors contribute to the activation of conditionally pathogenic and pathogenic flora of the oral cavity. Which leads to the development of severe process. Most often triggers a combination of several factors simultaneously.

Classification

In the course of the disease there are the following forms:

  1. Sharp;
  2. Subacute;
  3. Chronic.

The prevalence of the inflammatory process:

  • Localized;
  • Generalized.

Symptoms

Acute ulcerative-necrotic gingivitis Vincent to develop according to the type of inflammation usually affects young adults. In the anamnesis the patient has prolonged bleeding gums during tooth brushing or when eating hard food.

The disease begins acutely. Appears pronounced soreness of the gums, aggravated by the attempts of the meal. Bleeding the affected area and a pronounced putrid odor from the mouth, is not eliminated by carrying out hygienic procedures, rinsing, using a freshener for the mouth. The saliva becomes viscosity and malleability.
The General condition suffers greatly. There is a fever, weakness, severe headaches. The person loses work capacity and needs strict bed rest. Due to severe pain can not sleep, can not eat.

During the inspection of the oral cavity visible plaque, removing which begins to bleeding gums, the exposed areas of the eroded surface. If delayed treatment, when the eroded surface is moved to the ulcer, the formation of scar tissue. The healing process is stretched in time for an impressive period.
Gingival margin loses its usual circuit, gingival papillae are swollen.
The submandibular nodes are painful and enlarged. Manifested from the beginning of the disease.

The disease can occur in different forms: mild, moderate and severe. Depends on prevalence of process and immunity power. Treatment of ulcerative-necrotic gingivitis necessary to carry out comprehensively, focusing on the manifested symptoms and comorbidities.

Diagnosis

Diagnosis Asino-necrotic gingivitis Vincent presents no particular difficulties. A full diagnosis specifying true causes shall be made after a full set of research including:

  1. Examination of the oral cavity.
  2. History collection.
  3. Palpation of lymph nodes and measurement of body temperature.
  4. The results of the analysis (KLA and biochemical, inoculation of the pathogen, determination of immunoglobulin A in saliva).
  5. X-rays for assessment of bone done to rule out periodontitis.
  6. Consult a specialist for primary disease (internist, immunologist, virologist, endocrinologist).
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After the diagnosis is assigned a comprehensive treatment aimed at removing symptoms of disease and strengthen the immune system.

Treatment

Self-treatment of this disease is not acceptable. At the onset of symptoms should consult a periodontist. The entire treatment process is divided into local and General. Is chosen individually and changed in the process of changing phase of inflammation.

The acute phase of necrotizing gingivitis

This is the most important phase of treatment begins with the first visit and lasts about a week. Is assigned a full range of therapy. The reduction of intoxication. Elimination of plaque and Tartar on the teeth, sanitation of the oral cavity with subsequent rinsing. Prevention of transition to chronic and complications.
In the period of strong currents it is recommended to open the sick-list for full treatment.

A special diet is prescribed, requires adherence: full refusal from Smoking, consumption of strong alcoholic beverages, gentle food on the temperature criterion and consistency. When you first visit the complex of measures which in a full treatment of the oral cavity.

The processing solution having antiseptic properties, can be used:

  • Chlorhexidine 0.06% at room temperature;
  • Hydrogen peroxide 0.5%
  • A solution of potassium permanganate 1%

Under the influence of anesthetics carefully removed nekrotizirovannye tissue plaque from teeth, gum tape and is re-rinsing the oral cavity.
To remove the area of necrosis use application exposure to Trypsin or Chymotrypsin, and then clean the mechanical tool.

Applications of antibiotic to the affected gums:

  1. Metronidazole;
  2. Metrogil Dent.

Drugs are prescribed for home use with the aim of turning the inflammatory process and prevent further spread.
Additionally it is necessary to reinforce oral hygiene after each meal should rinse your mouth means having anti-inflammatory effect.
In between rinse apply tablets antiseptic properties to dissolve in mouth (about 3-4 times a day).
Use these procedures in full before epithelialization of the affected area.

Important. The use of funds, contributing to the healing of the gums (sea buckthorn oil, Solcoseryl) are contraindicated! The first thing you need to get rid of the pathogenic agent.

Treatment of ulcerative gingivitis in the subacute phase

After the acute process stoped, starts stage 2, which includes the following aspects:

  • Selection of suitable hygiene and training of the patient in the proper care of the oral cavity;
  • Realization of professional hygiene of the oral cavity;
  • Local anti-inflammatory drugs on the affected gums;
  • Full rehabilitation of the oral cavity (treatment of carious teeth);
  • If necessary, correction of seals.
  • Removal of diseased teeth, debris and roots.

A comprehensive treatment of all diseases of the oral cavity can cause remission of the disease. Consultation of narrow specialists as needed.

Clinical management of patient

Is the monitoring of disease dynamics, control of the execution of the set procedures, early treatment of any resulting illness.
In addition to local treatment should the overall impact on the body.

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Principles of General therapy

General treatment requires a professional approach and cannot be assigned independently. The use of inappropriate treatment can aggravate the already serious condition.

During pregnancy and lactation antibiotics are only allowed penicillin drugs, under strict supervision of a physician.

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At the time of treatment necrotic ulcerative process the alcohol is eliminated entirely. Not be used even in very small amounts. Can give serious response representing a danger to life, combined with the drugs used in this case.

  1. Antibacterial treatment is used in the acute phase currents.
  2. Probiotics are prescribed for the prevention of dysbacteriosis on the background of antibacterial therapy.
  3. Nonsteroidal anti-inflammatory: reduce inflammation, help with pain and normalize body temperature.
  4. Antihistamine.
  5. Immunomodulators are assigned in case of illness on the background of low immunity.
  6. Multivitamins enhance General body resistance, promote more rapid regeneration of disturbed tissue and reduce the permeability of the capillary network for infection.

To reduce the intoxication of the action of the disease, it is recommended to drink plenty of liquids. Use fruit drinks, fruit drinks, fresh carrot juice, beets, herbal teas.

Treatment of folk remedies is only valid for the main reinforcements. Widely used rinse decoction of herbs: chamomile, calendula, sage. Good use of herbal tea with honey to increase immunity and possess anti-inflammatory properties.

From physical therapy is used, UV and electrophoresis electrodes in the special region of the oral cavity. Apply courses from 10 to 20 days.

After complete cure it is recommended to repeat course of physical treatment after 2-3 months to eliminate the return problem.

In children

Is most common at preschool ages 2 to 5 years, but can also occur in the senior school. During the development process to the form, the child refuses to eat, complains of pain, fever, determined by a plaque on the gums and bleeding sores.
All these signs indicate the need for an immediate visit to the dentist.

Reasons

If the child does not know how to brush your teeth or simply ignores the need for this procedure in the mouth begin to develop microbes that can cause serious process. Be from an early age to teach a baby to brush teeth and follow direct procedure.

Injury to the gums, malocclusion, anomalies in the development of the lip and tongue frenulum. Long teething toddler, accompanied by inflammation of the gums. Orthodontic design. Serious General diseases, especially blood and gastrointestinal tract. The excess of sweets and soft food constituting a large part of the diet. The child needs solid food (apples, carrots).

Congenital anomalies of the oral cavity and dental disease. Eating junk food (chips, Kirieshki, sparkling water, etc.). Rickets and weakening of immunity against frequent colds. The treatment selected by the doctor based on the child’s age and distribution process.
In any form it should teach a child to properly care for your teeth, provide abundant warm drink. Food sparing protein and dairy.

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Application widely used anti-inflammatory gel on the affected area, if the child is able to rinse your mouth, required rinsing before and after each meal. For children choose a vegetable broth.
Additionally connects laser therapy, electrophoresis of the mouth (if age allows) and UFO.

After elimination of the manifestations of gingivitis is assigned to the corrective treatment of the causes leading to the disease. Enhanced immunity, malocclusion, caries treatment.

Self-treatment of ulcerative gingivitis in children is not allowed!

To prevent this process it is necessary to carefully follow the personal hygiene of the baby, use a brush and toothpaste age-appropriate. Every 3 months to change the brush. Treating her every day with boiling water.
After treatment the recommended course of treatment by means of «green pharmacy», will fit well in the daily lives of chamomile tea with honey.
During the disease that would feed the child before a meal can lubricate the oral cavity natural honey, with good tolerability. This will reduce the pain.

Diet

An important factor for recovery is proper nutrition based on the condition.

  • Prohibited the consumption of fruits and vegetables increased acidity (apples, tomatoes, citrus).
  • Should be deleted conditionally allergenic products, sour, spicy and containing dyes.
  • Do not use dry food and hard products.
  • It is recommended that a large number of sour-milk products.
  • Fruits and vegetables are neutral acidity.
  • Warm porridge: semolina, rice, oatmeal.
  • Plenty of water and herbal teas.
  • After relief of the acute phase add the meat, steamed, cheese, tea without sugar.

Forecast

With gingivitis, mild, all changes disappear after the treatment, the gum returns to its original state.
In severe possible scarring in deep ulcers and a change in gingival contour.

Prevention

is the formation and maintenance of a healthy lifestyle. Here you can select the right nutritious food, timely fortification and strengthening of the immune system. Sports, hardening of the body. Clothing for the season. Treatment of all diseases at once, and when accounting specialist assignments. Self-treatment can translate the process to a chronic. It will serve as a preservation of the source of infection in the body. Avoiding harmful habits and timely hygiene and preventive checks at the dentist with treatment of detected violations.