This document discusses different types of gingivitis, including acute and chronic gingivitis. Acute gingivitis can be caused by local factors like poor oral hygiene or systemic diseases. It commonly presents with pain, bleeding, and halitosis. Treatment involves maintaining oral hygiene and using antiseptics. Chronic gingivitis is caused by long-term plaque and calculus buildup and presents as red, swollen gums that bleed easily. Treatment for chronic gingivitis includes scaling, oral hygiene maintenance, and antibiotics in some cases.

1. Gingivitis
Inflammation of gingival tissues commonly associated with
dental plaque & calculus
Acute gingivitis
Causes: Local
 Poor dental hygiene
 Food stagnation (soft sticky)
 Badly restored filling
 Prosthesis - Orthodontic appliance
 Mouth breathers
 Trauma/ Traumatic bite
 Infection
Dr S Chakradhar 1

2. General causes
 Vitamin deficiency: Vit C , Vit B2, Vit A
 Hormonal effect
 Pregnancy
 Puberty
 Systemic diseases: DM, TB, severe anemia and leukemia,
HIV
 Drugs: nifedipine, phenytoin, OCP
Dr S Chakradhar 2

3. Types
 Acute necrotising ulcerative gingivitis
 Herpetic gingivitis
 Nonspecific gingivitis
 Leukemic gingivitis
Dr S Chakradhar 3

4. ANUG
 Etiology
Borellia vincenti
Fusiform bacilli
 Predisposing factors
Smoking
Poor oral hygiene
Alcohol
Immunocompromised condition
Dr S Chakradhar 4

5. Clinical features
 Pain
 Ulcer
 Bleeding
 Salivation
 Halitosis
 Metallic taste
 Fever, malaise and enlarge cervical LN
Dr S Chakradhar 5

6. Management
 Maintaining oral hygiene
 Prevention of plaque & Calculus
 Wash the lesion with 3% Hydrogen
peroxide
 Paint with 10% chromic acid gel
 Advice antiseptic mouthwash eg 0.2%
chlorhexidine
 Analgesics as needed
 Metronidazole 400mg PO TDS for 7 days
Dr S Chakradhar 6

7. Acute herpetic gingivitis
 Caused by Herpes simlex virus, Herpes labialis
 Occurs usually in children of 3 to 6 yrs
Clinical features
 Small painful vesicles
 Ulcer
 May involve the lip, cheeks, tongue and palate
 Halitosis
 Fever, enlarged LN
Dr S Chakradhar 7

8. Management
 Maintaining oral hygiene
 Prevention of plaque & Calculus
 Self limiting disease (1 or 2 weeks)
 Bed rest
 Soft diet
 Analgesics
 Tetracycline mouth wash
250mg in 30ml water 6hrly
Dr S Chakradhar 8

9. Acute non specific gingivitis
 Probably due to overgrowth of normal
bacteria
 Cl/F similar with pain and swelling of gums
 Bleeds on probing and pus may also be
seen
 Treat by H2O2 wash
 Advise proper oral hygiene
Dr S Chakradhar 9

10. Chronic gingivitis
Causes
Plaque and calculus around
gingival margin
Mouth breathers and incompetent
lip seal
Traumatic bite
Inadequate treatment of acute
gingivitis Dr S Chakradhar 10

11. Clinical features
 The classic triad of redness, swelling, and bleeding on
gentle probing are diagnostic
 Usually complain that 'gums bleed on brushing‘
 Color change: from pink to beefy red/purple
 Gingival pockets
Dr S Chakradhar 11

12. Treatment
Oral hygiene maintenance
Brushing
Mouthwash
Regular scaling
Gingivoplasty / Gingivectomy
Antibiotics: tetracycline
Dr S Chakradhar 12