dental disorders
Gingivitis
Symptoms and Signs of Gingivitis
Simple gingivitisfirst causes a deepening of the sulcus between the tooth and gingiva, followed by a band of red, inflamed gingiva along one or more teeth, with swelling of the interdental papillae and easily induced bleeding. Pain is usually absent. The inflammation may resolve, remain superficial for years, or occasionally progress to periodontitis. Pericoronitisis acute, painful inflammation of the gingival flap (operculum) over a partly erupted tooth, usually around mandibular 3rd molars (wisdom teeth). Infection is common, and an abscess or cellulitis may develop. Pericoronitis often recurs as food gets trapped beneath the flap and may be exacerbated by trauma from an opposing maxillary 3rd molar. The gingival flap disappears when the tooth is fully erupted. Many wisdom teeth do not erupt and are termed impacted. During menopause,a desquamative gingivitis may occur. It is characterized by deep red, painful gingival tissue that bleeds easily. Vesicles may precede desquamation. The gingivae are soft because the keratinized cells that resist abrasion by food particles are absent. A similar gingival lesion may be associated with pemphigus vulgaris, bullous pemphigoid, benign mucous membrane pemphigoid, or atrophic lichen planus. During pregnancy,swelling, especially of the interdental papillae, is likely to occur. Soft, reddish pedunculated gingival growths often arise in the interdental papillae during the 1st trimester, may persist throughout pregnancy, and may or may not subside after delivery. Such growths are pyogenic granulomas that are sometimes referred to as pregnancy tumors. They develop rapidly and then remain static. An underlying irritant is common, such as calculus or a restoration with a rough margin. These growths also may occur in nonpregnant women and men. Uncontrolled diabetescan exaggerate the effects of gingival irritants, making secondary infections and acute gingival abscesses common. In leukemia,the gingivae may become engorged with a leukemic infiltrate, exhibiting clinical symptoms of edema, pain, and easily induced bleeding. In scurvy,the gingivae are inflamed, hyperplastic, and engorged, bleeding easily. Petechiae and ecchymoses may appear throughout the mouth. In pellagra,the gingivae are inflamed, bleed easily, and are susceptible to secondary infection. Additionally, the lips are reddened and cracked, the mouth feels scalded, the tongue is smooth and bright red, and the tongue and mucosa may have ulcerations. 