For medical students

1. GINGIVITIS

2. DEFINITION
• Inflammation of the gingiva ( gums) without destruction of tooth
supporting tissues, periodontal ligament or bone

3. anatomy
• The gingiva is part of the soft tissue lining of the mouth
• It surround the teeth and provide a seal around them
• It is tightly bound to the underlying bone to resist the friction of food
passing over them
• Healthy gums are usually pink but may naturally be darker with
melanin pigmentation

5. • The gingiva is divided anatomically into marginal, attached and
interdental
• In periodontal disease, the immune system responds with
inflammation to oral biofilms
• The two main features of periodontal disease are gingival
inflammation ( gingivitis) and the formation of of periodontal pockets
( periodontitis)

6. Factors associated with gingivitis
• Hormonal changes
• Stress
• Smoking and alcohol
• Poor nutrition
• Drugs: phenytoin, calcium channel blockers , cyclosporine, oral
contraceptives, they cause gingival hyperplasia
• DM
• Low immunity
• Local trauma
• Dental caries
• Tooth crowding with overlapping

7. • Vitamin C defc ( scurvy disease)
• Niacin (vit.B3 defc, pellagra)

8. clinical features
• Poor oral hygiene, which leads to accumulation of dental plaque and
calculus
• Puberty
• More common in males than females due to poor oral hygiene in
males
• Redness and sponginess of the gingival tissue
• Bleeding gums on provocation
• Calculus or plaque

9. Classification/Distribution of gingivitis
• Localised gingivitis: confined to the gingiva of a single tooth or group
of teeth
• Generalised gingivitis: involves entire mouth
• Marginal gingivitis: involves the gingival margin
• Papillary gingivitis: involves interdental papillae
• Diffuse gingivitis: affects the gingival margin, the attached gingiva and
the interdental papillae