Gingivitis is the earliest stage of gum disease caused by a buildup of plaque and bacteria on the teeth. It causes red, swollen gums that bleed easily when brushing. Symptoms include bad breath and gum tenderness or pain when chewing. Gingivitis is usually diagnosed during a dental exam where the dentist evaluates the gums and checks for signs of infection and inflammation. Treatment involves improved oral hygiene through proper brushing and flossing to remove plaque and bacteria from the teeth and gums. Left untreated, gingivitis can advance to a more serious form of gum disease called periodontitis.

2. Gingivitis
• Gingivitis is the earliest stage of gum disease.
• It happens when plaque and bacteria build up on your
teeth and cause infection.

3. • Definition - Causes Lat. gingiva = gingie; -itis = inflammation Gingivitis refers
to gingival inflammation induced by bacterial biofilms, also called plaque,
adherent to tooth surfaces.
• Bacterial plaque accumulates in the spaces between the gums and teeth and
in calculus (tartar) that forms on the teeth.
• These accumulations may be tiny, even microscopic, but the bacteria
contained in them, produces foreign chemicals and toxins that cause
inflammation of the gums around teeth.

4. Signs and symptoms of gingivitis
• Bad breathing that doesn’t go away, even after brushing.
• Gums that bleed easily, particularly when you brush your teeth.
• Red, swollen gums.
• Sensitivity to hot or cold foods.
• Tenderness or pain when you chew food

5. • Symptoms bright-red, or purple gums shiny gums gums that are painless,
except when pressure is applied gums that easily bleed, even with gentle
brushing, and especially when you floss receding gumline

6. Causes gingivitis
• Hormonal change such as during pregnancy
• Poor oral hygiene
• Diabetic patients
• Have a family history of gum disease.
• Smoke or chew tobacco.

7. Cont.…
• Drugs to treat epilepsy.
• Some cancer therapies.
• Calcium channel blockers for blood pressure.
• Oral contraceptives.

8. MEDICAL Diagnosed
• Bleeding.
• Signs of infection such as redness and swelling.
• Loose teeth.
• Gums that are pulling away from your teeth
• CBC

9. • Diagnosis It is recommended that a dental hygienist or dentist should be seen
after the signs of gingivitis appear. They will check for the symptoms of
gingivitis and may also examine the amount of palque in the oral cavity. A
dental hygienist or dentist should also test for periodontitis using x-rays or
gingival probing as well as other methods.

10. TREATMENT
• Dental cleaning
• Improved oral hygiene:
• Antimicrobial mouthwash
• Remove crowns, fillings or bridges

11. • Treatment The removal of plaque is usually not painful. The inflammation of
the gums should be gone between one and two weeks. Oral hygiene including
proper brushing and flossing is required to prevent the recurrence of gingivitis.

12. Nursing care
• Inspect oral cavity at least once daily and note any
discoloration, lesions, edema, bleeding, exudate, or dryness.
• Assess for mechanical agents such as ill-fitting dentures or
chemical agents such as frequent exposure to tobacco that
could cause or increase trauma to oral mucous membranes.
• Monitor client’s nutritional and fluid status to determine if
adequate.
• Encourage fluid intake up to 3000 ml per day if not
contraindicated by client’s medical condition (Fluids help
increase moisture in the mouth, which protects the mucous
membranes from damage and helps the healing process)

13. • Determine client’s mental status. If client is unable to care for
self, oral hygiene must be provided by nursing personnel.
• Educate the patient about avoiding, mouthwashes with high
alcohol content, lemon swabs or prolonged use of hydrogen
peroxide.
• If client does not have a bleeding disorder and is able to
swallow, encourage to brush teeth with a soft pediatric-sized
toothbrush using a fluoride-containing toothpaste after every
meal and to floss teeth daily.

14. • Use tap water or normal saline to provide oral care; do not use
commercial mouthwashes containing alcohol or hydrogen peroxide.
Also, do not use lemon-glycerin swabs. (Alcohol dries the oral
mucous membranes Hydrogen peroxide can damage oral mucosa
and is extremely foul tasting to clients. Lemon-glycerin swabs can
result in decreased salivary amylase and oral moisture, as well as
erosion of tooth enamel)
• Educate the patient on 3 ways on how to relieve dry mouth by
discharge.
• If whitish plaques are present in the mouth or on the tongue and can
be rubbed off readily with gauze, leaving a red base that bleeds,
suspect a fungal infection and contact the physician for follow-up.
(Oral candidiasis (moniliasis) is extremely common secondary to
antibiotic therapy, steroid therapy, HIV infection, diabetes, or
immunosuppressive drugs and should be treated with oral or
systemic antifungal agents)

15. • If client’s oral cavity is dry, the keep inside of the mouth moist
with frequent sips of water and salt water rinses (1/2 tsp salt in
8 oz of warm water) or artificial saliva. (Moisture promotes the
cleansing effect of saliva and helps avert mucosal drying, which
can result in erosions, fissures, or lesions. Sodium chloride
rinses have been shown to be effective for the prevention and
treatment of stomatitis)

16. PREVENTION
• Brush thoroughly twice a day
• Treat Diabetes Mellitus appropriately
• Don’t smoke or use other tobacco products
• Floss every day to remove bacteria between your teeth.
• Limit food and drinks containing alcohol and excess sugar.

17. • Prevention Gingivitis can be prevented through regular oral hygiene that
includes daily brushing and flossing. When the teeth are not cleaned properly,
bacterial plaque accumulates, and becomes mineralized by calcium and other
minerals in the saliva, transforming it into a hard material called calculus
(tartar), which harbors bacteria and irritates the gingiva (gums).

18. • Complications Recurrences of gingivitis Periodontitis Infection or abscess of
the gingiva or the jaw bones