This document discusses different types of gingivitis, including acute gingivitis, acute necrotizing ulcerative gingivitis (ANUG), acute herpetic gingivitis, nonspecific gingivitis, and chronic gingivitis. It outlines the causes, clinical features, and management approaches for each type. The types of gingivitis are distinguished based on their etiology and presentation, with acute forms involving ulcers and fever and chronic gingivitis presenting as red, swollen, bleeding gums aggravated by dental plaque. Treatment focuses on oral hygiene and hygiene procedures as well as antibiotics in some cases.

1. GingivitisGingivitis
Inflammation of gingival tissues commonly associated withInflammation of gingival tissues commonly associated with
dental plaque & calculusdental plaque & calculus
Acute gingivitisAcute gingivitis
Causes: LocalCauses: Local
 Poor dental hygienePoor dental hygiene
 Food stagnation (soft sticky)Food stagnation (soft sticky)
 Badly restored fillingBadly restored filling
 Prosthesis - Orthodontic applianceProsthesis - Orthodontic appliance
 Mouth breathersMouth breathers
 Trauma/ Traumatic biteTrauma/ Traumatic bite
 InfectionInfection
11Dr S ChakradharDr S Chakradhar

2. General causesGeneral causes
 Vitamin deficiency: Vit C , Vit B2, Vit AVitamin deficiency: Vit C , Vit B2, Vit A
 Hormonal effectHormonal effect
 PregnancyPregnancy
 PubertyPuberty
 Systemic diseases: DM, TB, severe anemia and leukemia,Systemic diseases: DM, TB, severe anemia and leukemia,
HIVHIV
 Drugs: nifedipine, phenytoin, OCPDrugs: nifedipine, phenytoin, OCP
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3. TypesTypes
 Acute necrotising ulcerative gingivitisAcute necrotising ulcerative gingivitis
 Herpetic gingivitisHerpetic gingivitis
 Nonspecific gingivitisNonspecific gingivitis
 Leukemic gingivitisLeukemic gingivitis
33Dr S ChakradharDr S Chakradhar

4. ANUGANUG
EtiologyEtiology
Borellia vincentiBorellia vincenti
Fusiform bacilliFusiform bacilli
Predisposing factorsPredisposing factors
SmokingSmoking
Poor oral hygienePoor oral hygiene
AlcoholAlcohol
Immunocompromised conditionImmunocompromised condition
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5. Clinical featuresClinical features
 PainPain
 UlcerUlcer
 BleedingBleeding
 SalivationSalivation
 HalitosisHalitosis
 Metallic tasteMetallic taste
 Fever, malaise and enlarge cervical LNFever, malaise and enlarge cervical LN
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6. ManagementManagement
Maintaining oral hygieneMaintaining oral hygiene
Prevention of plaque & CalculusPrevention of plaque & Calculus
Wash the lesion with 3% HydrogenWash the lesion with 3% Hydrogen
peroxideperoxide
Paint with 10% chromic acid gelPaint with 10% chromic acid gel
Advice antiseptic mouthwash eg 0.2%Advice antiseptic mouthwash eg 0.2%
chlorhexidinechlorhexidine
Analgesics as neededAnalgesics as needed
Metronidazole 400mg PO TDS for 7 daysMetronidazole 400mg PO TDS for 7 days
66Dr S ChakradharDr S Chakradhar

7. Acute herpetic gingivitisAcute herpetic gingivitis
 Caused by Herpes simlex virus, Herpes labialisCaused by Herpes simlex virus, Herpes labialis
 Occurs usually in children of 3 to 6 yrsOccurs usually in children of 3 to 6 yrs
Clinical featuresClinical features
 Small painful vesiclesSmall painful vesicles
 UlcerUlcer
 May involve the lip, cheeks, tongue and palateMay involve the lip, cheeks, tongue and palate
 HalitosisHalitosis
 Fever, enlarged LNFever, enlarged LN
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8. ManagementManagement
Maintaining oral hygieneMaintaining oral hygiene
Prevention of plaque & CalculusPrevention of plaque & Calculus
Self limiting disease (1 or 2 weeks)Self limiting disease (1 or 2 weeks)
Bed restBed rest
Soft dietSoft diet
AnalgesicsAnalgesics
Tetracycline mouth washTetracycline mouth wash
250mg in 30ml water 6hrly250mg in 30ml water 6hrly
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9. Acute non specific gingivitisAcute non specific gingivitis
Probably due to overgrowth of normalProbably due to overgrowth of normal
bacteriabacteria
Cl/F similar with pain and swelling of gumsCl/F similar with pain and swelling of gums
Bleeds on probing and pus may also beBleeds on probing and pus may also be
seenseen
Treat by H2O2 washTreat by H2O2 wash
Advise proper oral hygieneAdvise proper oral hygiene
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10. Chronic gingivitisChronic gingivitis
CausesCauses
Plaque and calculus aroundPlaque and calculus around
gingival margingingival margin
Mouth breathers and incompetentMouth breathers and incompetent
lip seallip seal
Traumatic biteTraumatic bite
Inadequate treatment of acuteInadequate treatment of acute
gingivitisgingivitis 1010Dr S ChakradharDr S Chakradhar

11. Clinical featuresClinical features
 The classic triad ofThe classic triad of redness, swelling, and bleeding onredness, swelling, and bleeding on
gentle probing are diagnosticgentle probing are diagnostic
 Usually complain that 'gums bleed on brushing‘Usually complain that 'gums bleed on brushing‘
 Color change: from pink to beefy red/purpleColor change: from pink to beefy red/purple
 Gingival pocketsGingival pockets
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12. TreatmentTreatment
Oral hygiene maintenanceOral hygiene maintenance
BrushingBrushing
MouthwashMouthwash
Regular scalingRegular scaling
Gingivoplasty / GingivectomyGingivoplasty / Gingivectomy
Antibiotics: tetracyclineAntibiotics: tetracycline
1212Dr S ChakradharDr S Chakradhar