Concept awareness biological width– a sign of the evolution of the orthopedist. At every seminar, at every meeting, doctors are tormented by the same questions - “how to sharpen correctly? up to the gum or below? where should I hide the edge of the crown?” The answer to these interrelated questions is given by knowledge of the sizes and types of tissues surrounding the tooth or implant.
Schematically shows the main components that form biological width
Biowidth is formed by connective tissue attachment ( otherwise called "circular ligament"), epithelial attachment ( actually the “bottom” of the periodontal groove) and thickness of the mucous membrane ( which forms the dental-gingival groove or groove). The total biological width is 3 mm.
If you prepare a tooth to the gingival contour and carry out standard retraction with a thread, you will notice a certain reserve of subgingival space, which is mistakenly used by orthopedists to place the edge of the preparation. The error becomes noticeable already when taking an impression - the corrective mass does not get into the space behind the shoulder - there is simply no room for it. Therefore, during retraction, the visually identifiable shoulder may undergo rigorous polishing and leveling.
If you fold back the flap and check the value of the biological width, it will be equal to 3 mm.
So, there are 3 main types of observed preparation levels:
- gingival level (allowing high-quality polishing of the ledge to facilitate the preparation of the edge of the restoration, taking an impression and performing fixation according to any protocol)
- subgingival level (those “half a millimeter under the gum”, which make it difficult to take an impression, and therefore the “readability” of the impression by a dental technician, make it difficult to fix using an adhesive protocol due to injury to the gums by the rubber dam clamp)
- deep subgingival level (actual preparation error or work dictated by circumstances of non-contact with the patient)
At the gingival level of preparation, it becomes possible to manually polish the shoulder or polish the connection line between the root and the crown.
The interproximal area of preparation is also regulated during preparation by the values of biological width to create adequate interdental papillae that are not inflamed when wearing an indirect restoration. Providing a “bypass” of the gingival papilla can be done by installing a wedge at the time of tooth preparation. When preparing a tooth, the position of the contact point must be taken into account and indicated to the dental technician. In fact, if we have a distance from the preparation line to the bone part of 3 mm, then according to the Tarnow relationship, the contact point should be located within 1.5-2.5 mm from the ledge line.
Otherwise, the gingival papilla will not occupy the entire contact point, forming a “black triangle”, so disliked by orthopedists. By adjusting the position of the contact point to the dental technician, we protect ourselves from problems with the papillae in 100% of cases.
However, the health of the gingival papilla is primarily based on the fact that it must be supported by the root of the tooth, and not by the crown. In this photo, a metal-free crown is installed on a tooth, with the help of which we determined the distance from the ledge line to the bone part by folding back the flap. The absence of immersion “by half a millimeter” does not in any way affect the aesthetic appearance of the crown.
Many doctors appeal to the fact that their patients cannot afford metal-free crowns and they are “forced” to work with standard metal-ceramic crowns. Taking this into account and in order to “hide the transition of the edge of the crown into the tooth,” they prepare below the gingival contour. Since the postulates of biological width work not only on cosmetic types of crowns, but on all types in general, the placement of the ledge level will be the same.
In order for the work to look aesthetically pleasing, the exact edge of the preparation line is important - the rest can be decided.
Even without a ceramic shoulder...
Metal-ceramic crowns in the anterior segment on the day of installation. The gingival contour looks good even after controlled cleaning of the post-marginal area from cement residues.
Biological width should also be a leading factor when planning orthopedic work.
When correcting the zenith level, the ledge preparation line is formed by retreating 3 mm from the new (corrected) level of the alveolar part.
During surgical lengthening, it is very convenient to mark the preparation line.
And carry out the final preparation 8 weeks after surgery.
Removing the behind-the-stage zone – required condition quality work. If, after retraction, we still immerse the line of the ledge into the vacated space, the behind-the-ledge zone in the impression will be imprinted to a lesser extent. Therefore, after retraction, polishing is strict.
The retraction area and the penetration of the base and corrective mass into this area are clearly visible on the underlay.
The epithelial attachment and thickness of the mucous membrane precisely regulates the position of the ledge line for each specific tooth being prepared. Therefore, a periodontal probe is an integral attribute of the work of not only a periodontist, but also a good orthopedist.
The quality of the imprinted post-abrasive zone allows the dental technician to solve the problem of the aesthetic appearance of the crown edge as efficiently and beautifully as possible.
In addition to your own teeth, you need to maintain the proportions of the biological width and around the implants. There is a significant difference between these two types of meanings. First of all, it is worth considering that the collagen fibers that form the connective tissue attachment to your own tooth have a transverse direction, and in the tissues surrounding the neck of the implant or abutment, it is strictly longitudinal. Therefore, the difference in values is 1 mm. The biological width of the implant is 4 mm.
A standard healing abutment with a height of 7 mm is installed.
Emergency profile
A small disadvantage of A-silicones will be demonstrated here. The fact is that when working with implants, polyester impression compounds are preferable - they have greater fluidity and do not displace the gingival profile apically. A-silicones (and even more so C-silicones) imperceptibly deform the gingival contour, the consequences of which you will see further.
The biological width of the tissues surrounding the implant is 4 mm.
Individual zirconia abutment with a neck height of 4 mm.
Standard metal-ceramic crown without any shoulder.
Abutment installed
A metal-ceramic crown was installed. The “revenge of A-silicone” is clearly visible here. More elastic than polyester, A-silicone causes creasing of the thin edge of the gum. Therefore, when working with A-silicone, indicate to the dental technician the necessary adjustment for the placement of the abutment shoulder: for a thick biotype, 0.5 mm, and for a thin biotype, 1 mm.
The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
Gingivitis is an inflammation of the mucous membranes of the gums, which can be infectious or non-infectious, acute or chronic.
For gingivitis is involved in the process of the gum without the circular ligament between the attached gum and the neck of the tooth. When such a connection between the gum and tooth is involved, periodontitis develops, which can result in tooth loss.
Types and forms of gingivitis (classification)
According to the flow there are:1. Acute gingivitis– has a pronounced course; with proper treatment and elimination of the causes of gum development, the gums are completely restored and recovery occurs. Possible transition to chronic form. This form of gingivitis most often affects children, adolescents and young adults.
2. Chronic gingivitis– the symptoms of the disease are often erased, patients sometimes get used to them. In a chronic course, periods of exacerbations and remissions are observed. Over time, irreversible changes form in the gums, possibly forming pockets between the tooth and gum and exposing the tooth root.
According to the prevalence of the process, gingivitis is:
1. Local or focal gingivitis– the gums are affected in the area of one or more teeth and interdental spaces.
2. Generalized or widespread gingivitis– the gums are affected throughout the jaw, most often both the upper and lower ones. Generalized gingivitis is a reason to think about the presence of more serious illnesses in the body, resulting in problems with the gums, for example, diabetes, immunodeficiencies, including AIDS, digestive diseases.
Types of gingivitis depending on the form of gum inflammation:
1. Catarrhal gingivitis– This is the most common form of gum inflammation and can occur acutely or chronically. Catarrhal gingivitis is characterized by serous inflammation, manifested by swelling, pain, redness and mucus discharge from the inflamed mucous membranes of the gums.
2. Ulcerative gingivitis (Vincent ulcerative-necrotizing gingivitis)– this form of gingivitis is less common and is usually the result of catarrhal inflammation. Associated with the activity of bacteria that destroy mucosal tissue with the formation of ulcers and pus.
3. Hypertrophic (hyperplastic) gingivitis– always has chronic course. This form usually occurs as a consequence of prolonged inflammatory process in the gums. Characterized by the proliferation of tissue of the mucous membrane of the gums ( medical term– proliferation).
There are two forms of hypertrophic gingivitis:
- Edema form – in the tissues of the mucous membranes of the gums there is pronounced swelling, blood circulation is increased, that is, a chronic inflammatory process is observed. This form is partially reversible, meaning that with proper treatment, gum overgrowth can be reduced.
- Fibrous form - Connective (scar) tissue grows in the mucous membrane, but there are no longer signs of inflammation; this is the outcome of a chronic process and, unfortunately, irreversible. This is a visible cosmetic defect and discomfort when eating solid food.
Separately, the following forms of gingivitis can be distinguished:
1. Gingivitis in pregnant women- This is a fairly common phenomenon that a woman in an interesting position encounters. Usually this is hypertrophic gingivitis, its edematous form. The development of such gingivitis is associated with hormonal changes in the body of the expectant mother.
2. Adolescent gingivitis– oddly enough, it is adolescent children and young people who are the most common patients diagnosed with gingivitis (8 out of 10 visitors dental clinics with complaints of gum problems). In most cases, this contingent is diagnosed with acute catarrhal gingivitis, so to speak " mild degree" disease, but in the presence of hormonal imbalances, the development of a chronic hypertrophic form of the disease is possible.
3. Herpetic gingivitis– gum inflammation caused by a virus herpes simplex. In most cases, this is acute ulcerative-necrotizing gingivitis against the background of chronic herpetic infection. Herpetic ulcers are usually located not only on the gums, but also on the mucous membranes of the entire oral cavity. Typically, such gingivitis indicates problems with the immune system.
4. Desquamative gingivitis. With this form of gingivitis, partial rejection of the surface epithelium of the gum mucosa occurs. First, red spots appear that form blisters; after they open, painful ulcers appear. The peculiarity of this gingivitis is that the causes are unknown; it is always a generalized and chronic process with an undulating course.
Causes of gingivitis
There are many reasons for the development of gum inflammation, and each of us encounters them in everyday life. There are two groups of reasons that lead to gingivitis. Firstly, this internal reasons, that is, those processes that normally or pathologically occur in the body and act on the gums. Secondly, this external factors, traumatic, irritating and inflamed gums. The main causes of gingivitis are dental disease, infection and poor oral care. Other factors in most cases predispose to gum inflammation, although they can also act as separate causes.
External causes of gingivitis development
1. Infections and disorder hygiene oral cavity– pathogenic bacteria settle on the teeth, mucous membranes of the gums and oral cavity, and can cause inflammation. Infections enter through food, the remains of which remain in the mouth, dirty hands, toys, pacifiers, kitchen utensils, and when using dirty toothbrushes. Gingivitis can also be caused by so-called “childhood infections”, that is, chicken pox, measles, rubella, scarlet fever and others.
2. Tartar is a plaque on the teeth that is saturated with calcium salts and hardens; its color ranges from yellow to brown. Such plaque forms over time in almost every person; it is difficult to remove at home. A dentist can handle this task better. Tartar is often deposited in the gingival crevices, pushing the gums back and injuring them. In addition, dental plaque is a good environment for the development of various bacteria. As a result, gingivitis is inevitable.
3. Caries– always a source of chronic infection.
4. Going to the dentist may result in gingivitis. This is an incorrect filling, tooth extraction, trauma to the mucous membrane during dental treatment, prosthetics, the use of mouth guards to correct the bite, and so on.
5. Dental implant failure.
6. Physical irritants: high and low temperatures, trauma from solid food or various objects, rough brushing of teeth, and the effects of radiation.
7. Chemical irritants. Alcohol, the use of low-quality toothpaste, mouthwash and other “dental chemicals,” a love of candy, vinegar, spices, and accidents ingesting various solutions lead to chemical burns. A burn damages the mucous membrane, preparing the ground for bacteria to attach.
8. Smoking– combined effect on the oral mucosa. Cigarette smoke is a chemical and physical factor irritation. In addition, smoking reduces local and general immunity, accelerates the deposition of tartar, and affects nervous system, which contributes to impaired salivation. Smoking is one of the reasons for the development of atrophic gingivitis.
Photo: smoker's teeth.
9. Breathing through the mouth and snoring – this causes the mucous membranes of the mouth to dry out, which promotes the growth of bacteria.
10. Habits foods also contribute to gum inflammation. This is a love for sweet, spicy, sour and salty foods, the predominance of soft foods in food, and a lack of raw plant foods in the menu. This all irritates and injures the mucous membranes of the oral cavity.
Internal causes of gingivitis development
| Cause of Gingivitis | A form of gingivitis that can develop | How does gingivitis develop? |
| Teething | Acute catarrhal gingivitis | A growing tooth always injures the gum from the inside. Most often, children suffer both when they grow baby teeth and when they are replaced with permanent ones. Adults encounter this problem with the growth of so-called “wisdom teeth” or 3 molars (eights). |
| Malocclusion and other abnormalities of the jaw | Chronic catarrhal gingivitis, Less commonly, ulcerative and hypertrophic forms. | Incorrectly positioned teeth during chewing periodically or constantly injure the gums and other mucous membranes of the oral cavity. |
Immunity disorders:
| Chronic gingivitis, generalized forms. | Reduced general or local (in the oral cavity) immunity cannot fight various bacteria, viruses and fungi, as a result - any physical or mechanical irritation of the gums leads to the development of gingivitis. |
| Lack of vitamins– vitamin deficiency and hypovitaminosis | Catarrhal and ulcerative gingivitis can occur acutely or chronically. | The most classic manifestation of gingivitis is scurvy, a deficiency of vitamin C that occurs in cold countries and deserts. Lack of vitamin C leads to disruption of the formation of collagen - a building material connective tissue, which is present in absolutely all organs and tissues. Deficiency of vitamins A, E, and group B also predisposes to gingivitis. |
| Digestive disorders and helminthic infestations | Chronic gingivitis | In case of malfunction digestive system Various conditions arise:
|
Hormonal disorders:
| Any forms of chronic gingivitis, generalized forms often develop. Hormonal imbalances are most often the cause of the development of hypertrophic gingivitis. | Hormonal problems lead to metabolic disorders. Collagen metabolism suffers - as a result, a more rapid transition of chronic gingivitis into hypertrophic form. In addition, due to disturbances in protein metabolism, immunity and resistance to many infections suffer. |
Taking certain medications - to a greater extent these are hormones (hormonal contraceptives, steroids), as well as anticonvulsants.
Intoxication of the body due to drug use, salt poisoning heavy metals, severe infectious pathologies, tuberculosis, liver or kidney diseases.
Etiology of gingivitis
Gingivitis can be caused by various infections, both those that are normally present in the oral cavity, and pathogenic ones that come from outside. Most common cause gingivitis are staphylococci, streptococci, Escherichia coli, fungi of the genus Candida, herpesvirus. Infections such as tuberculosis and syphilis can also lead to gingivitis.Symptoms
The first signs of gingivitis
The first sign of gingivitis – This bleeding gums. The intensity of bleeding depends on the severity of the inflammatory process. Brushing your teeth and eating solid foods (such as an apple) usually cause bleeding. But during severe processes, blood may appear without any particular irritation of the gums, especially after sleep.Main symptoms
- Bleeding gums;
- soreness in the gum area, which increases while eating, especially when eating irritating foods, such as hot or cold, sweet, spicy or salty;
- itching, swelling and redness of the gums in a limited area or throughout the entire mucous membrane of one or both jaws;
- bad smell from mouth;
- the presence of ulcers, ulcers, blisters;
- increase or decrease in gum volume;
- increased body temperature and other symptoms of intoxication - weakness, poor appetite, even refusal to eat, bad feeling And so on.
Symptoms of gingivitis depending on the type
| Type of gingivitis | Patient complaints | Changes during examination of gums, photo |
| Acute catarrhal gingivitis |
| The gum bleeds when pressed on it, is swollen, bright red, loose, and the interdental papillae are enlarged. It is possible to identify single small ulcers. In most cases, teeth have plaque and tartar.  |
| Chronic catarrhal gingivitis |
| The gum bleeds, has a bluish tint, its thickening is noted, the gums resemble a cushion above or below the tooth (due to swelling). Tartar deposits are detected, the teeth do not become loose. |
| Ulcerative-necrotizing gingivitis |
|
Common problem: Loss of gingival papillae and the appearance of “black triangles”.
Loss of gingival papillae, especially in the anterior maxilla, is a serious aesthetic problem and can cause significant psychological discomfort in patients with a high smile line.
The World Health Organization defines health as physical and psychological well-being. Therefore, dentists should strive to improve the patient’s appearance when restoring teeth (bridges, veneers, composite restorations) and gum correction. In other words, the goal dental care is to ensure the physical and psychological well-being of the patient by optimizing the aesthetics of teeth and gums.
Due to the prevalence of loss of interdental papillae and the aesthetic defects associated with this condition, there is a need to solve this problem (Fig. 4-3a and 4-3b).
Effective solution: Measuring biological width using bone probing.
In 1961, Gargiulo et al published the results of measurements of the depth of the periodontal sulcus, epithelial and connective tissue attachment, i.e. biological width (Fig. 4-3c). It is known that violation of the biological width leads to the development of gingivitis and periodontitis, even with careful oral hygiene (Fig. 4-3d). Tarnow et al." revealed an inverse relationship between the probability of filling the interdental space with the gingival papilla and the distance between the interdental contact and the alveolar ridge (Fig. 4-3).
In the past, dentists paid attention to the location of the contact point solely for reasons of preventing food from entering the
Rice. 4-Pros. A forced smile does not bring satisfaction to the patient. There are “black triangles” between the teeth
Rice. 4-ЗБ. Patient's smile line
Rice. 4-3d. When carrying out treatment, the biological width was not taken into account, which led to the development of gingivitis, despite careful hygiene
Rice. 4-Ze. The probability of the gingival papilla filling the interdental space depending on the distance between the contact point and the bone edge (Tarnow et al.
interdental space and, taking this circumstance into account, prosthetics were performed, including the anterior group of teeth (Fig. 4-3f and 4-H). The coronal boundary of the interdental contact is determined by aesthetic criteria, and the apical boundary depends on the distance to the alveolar bone (Fig. 4-3h).
In an article devoted to the features of the dentogingival complex, Kois
described the use of periodontal parameters in prosthetic treatment planning and a method for determining the contour of the alveolar ridge margin. It was this author who first demonstrated the feasibility of probing the bone before prosthetics.
After local anesthesia has been administered, the periodontal probe is inserted until it makes contact with the bone (Fig. 4-3i.
Rice. 4-3f. Symmetrical arrangement of contact points in the anterior part of the upper dentition.
and 4-3j), the obtained values are documented in the patient’s chart (Fig. 4-3k). In the future, these data can be used to create a composite restoration, orthodontic movement of teeth and the manufacture of prosthetics, such as veneers and crowns (Fig. 4-31 and 4-3).
Without a thorough analysis of the parameters of the dentogingival complex, it is impossible to achieve predictable regeneration of the gingival papillae (Fig. 4-3p).
The application of the technique described above and the use of the obtained data when performing prosthetics allows us to obtain a satisfactory result (Fig. 4-3).
Rice. 4-Zd. Wax-up of upper anterior teeth (Kubein-Meesenberg et al.
). Localization of contact points is determined using interproximal cones
Rice. 4-3h. The relationship between the apical border of the interdental contact point and the level of the alveolar ridge (Tarnow et al.
Rice. 4-3j. Probing the bone crest
Rice. 4-3i. Measuring the size of the gingival papilla and the distance between the bone level and the contact point
Rice. 4-Zk. Documenting indicators in a special form
Pain, bleeding and inflammation of the oral mucosa in adults can cause no less inconvenience than toothache. In addition to discomfort, such a condition without timely and proper treatment can lead to the loss of a tooth, or even several. Why does severe and persistent inflammation occur? - Possibly as a result of injuries to the teeth or mucous membranes. If gum inflammation does not go away on its own for a long time, you need to visit a dentist. If pathological changes occur in the condition of the gums, it is necessary to urgently seek advice from a periodontist.
Why gums can become inflamed: an overview of the reasons
The doctor finds out the factors causing changes in the interdental papillae and gums and, based on the examination results, prescribes necessary treatment. Very often, redness and swelling of the gums can be caused by improper dental and oral care. Immunity plays important role in protecting the body, when its level is low, even a minor injury can become the root cause of inflammation. Many factors can trigger gum inflammation, for example:
- trauma to teeth and gums;
- chronic diseases of cardio-vascular system, diabetes mellitus, gastrointestinal diseases;
- the hereditary factor is directly related to the appearance of inflammatory processes in the body;
- presence of bad habits;
- hormonal disorders;
- Improperly organized dental and oral care can create problems;
- Treatment of inflammation is also carried out if an unsuitable crown or poor-quality filling has been installed.
On pathological change The gums are affected by the appearance of tartar. Accumulating near the tooth, it begins to put pressure on soft fabrics, injuring the mucous membrane. Over time, the problem worsens: inflammation of the gums around the tooth is accompanied by the appearance of a kind of pocket in which food debris accumulates (we recommend reading: methods for treating inflammation of the gums around the tooth). As a result, suppuration of the gum tissue and peri-gingival pocket, and swelling of the interdental papilla may occur. The causes of gum pathologies are often gingivitis and periodontitis. Gingivitis is an inflammation of the mucous membrane and area of the neck of the tooth (gingival margin).
Symptoms of gum inflammation with photos
It is necessary to understand that a disease in an advanced stage is much more difficult to treat and takes longer. To avoid these troubles, you need to make an appointment with a specialist when the first signs of the disease appear. Symptoms:
- appearance painful sensations while brushing your teeth;
- the occurrence of bleeding, the formation of pus in the gum pockets;
- swelling of the interdental papillae and marginal gums, looseness of the gingival tissue;
- change in gum color during transition from acute form to chronic (interdental perigingival papillae acquire a bluish tint);
- the upper swollen gum hurts and causes discomfort while eating;
- unpleasant appears putrid smell from the mouth (we recommend reading: why can a child have a putrid odor from the mouth?);
- tissues of the interdental peri-gingival papillae grow;
- the oral mucosa begins to react painfully to the temperature of food and drink;
- develops increased sensitivity teeth due to the lowering of the gum edge and exposure of the neck of the tooth.
Symptoms of tissue inflammation can be seen in the photo. In cases where the mucous membrane and interdental peri-gingival papillae are inflamed, this may be the beginning of the development of periodontitis.
Effective medications for inflammation
What medications may be needed to relieve symptoms resulting from injury or severe gum inflammation? In order for therapy to give positive results, first of all it is necessary to eliminate the cause of the disease. In the dentist's office, using ultrasound, it is necessary to carry out professional cleaning and remove bacterial plaque.
After this, a course of treatment with anti-inflammatory drugs is prescribed. The fight against the disease must be comprehensive: it is necessary to take antibiotics as prescribed by a doctor, use them for daily hygiene procedures medicinal toothpaste. In addition to these measures, it may be necessary to use rinses. by special means against sore gums and swelling of the gingival papillae.
Anti-inflammatory ointments and gels
The use of anti-inflammatory ointments in dentistry for diseases of the oral cavity gives very good results. Preparations in the form of ointments for a short time able:
- relieve pain and eliminate itching;
- get rid of bleeding;
- remove redness.
Gels used in the treatment of gum tissue diseases are more effective. Due to their properties, after application they form a film on the surface that can have an effect on the inflamed area for a long time.
Toothpastes
- cleanses soft plaque formed during the day;
- help reduce inflammation and swelling;
- help eliminate tartar;
- have a healing effect;
- reduce bleeding and irritation.
Such effective pastes as Forest Balsam, Paradontax, Lakalut active, President have proven themselves well. In addition to using pastes, an excellent remedy prevention can be massage of the gums with a soft toothbrush. Prevention to eliminate gum disease is no less important than timely therapy.
Antibiotics
Antibiotic therapy is used in the most serious and advanced cases. When severe inflammation occurs, serious intoxication of the body develops. Medications not only eliminate the signs of the disease, but also contribute to the restoration of the functions of all systems. The use of antibiotics should be agreed upon with the attending physician, who will select required dose drug and draw up a treatment plan. Medicines are available in the form of tablets, capsules, and rinsing solutions.
Rinse with pharmaceutical products
Effective mouth rinses are prescribed antiseptics, such as Miramistin and. The best pharmaceutical product for inflammation - this is Miramistin. It has a disinfecting and anti-inflammatory effect on diseased, affected gums and periodontal gingival papillae. In some cases, rinsing with a solution of hydrogen peroxide is prescribed. It must be remembered that all medications should be used only as prescribed by a doctor.
Traditional recipes for inflammation and redness of gums
Treatment at home involves the use of folk remedies that will help with gum inflammation. Gingivitis can be cured at home - prescription medications traditional medicine can relieve swelling, and when the gums itch and ache, they will have a calming effect. Natural preparations prepared in the form of decoctions for rinsing or infusions for internal use.
- They use calendula, birch buds, chamomile, celandine, and sage.
- In addition to herbs for cooking medicines Beekeeping products are often used: bee bread, propolis, honey.
- When the gums become inflamed and very painful, and the periodontal papillae swell, salt treatment can help.
- Treatment of inflamed gums with salt is carried out as follows: add one teaspoon of salt to a glass of water at room temperature and mix well. Rinsing with this solution helps a lot when the gums, gingival pocket and periodontal papillae are slightly red.
Despite the fact that all products are natural, some herbs contain toxic substances in varying proportions. Treatment folk remedies should be carried out under the strict supervision of a physician.
Principles of treatment for diseases of the oral cavity
Self-medication in the event of inflammatory processes in the oral cavity may not be effective. All specific prescriptions can only be carried out by a specialist who will eliminate the symptoms and help get rid of the cause of the disease. The doctor, if necessary, will prescribe an examination and lab tests. Redness, swelling of the gums and interdental peri-gingival papillae are signs of gingivitis. Prevention of inflammation of the upper and lower gums always gives good results, so do not forget about it.
Gingivitis
In cases where the mucous membrane is inflamed and pus has formed in the gum pockets, a suspicion of gingivitis arises. In case of gingivitis, soft plaque is cleaned and hard plaque is removed using ultrasound. After this, it is assigned complex treatment, aimed at reducing tissue swelling, eliminating bleeding and getting rid of pain. When gingivitis develops, the gums become inflamed and swell (only the superficial layers of tissue are affected) - the treatment prognosis is positive, provided that the specialist’s recommendations are strictly followed.
Periodontitis
Periodontitis is a more serious form of the disease. For a long time pathological process gingival periodontal papillae can atrophy along with the mucosal area. Periodontitis therapy is carried out according to the following plan:
Dental manipulations
If a cyst or fistula has formed in the gum tissue, surgical intervention may be required. After anesthesia, the surgeon makes an incision, removes the affected piece of periosteum and removes pus from the resulting cavity. Then the wound is washed and temporary drainage is installed.
When restoring the dentition in the event that the gingival periodontal papillae have partially atrophied, they resort to surgical intervention. The specialist forms the gingival periodontal papillae using implants followed by a course of phonophoresis.
Wisdom tooth eruption
Sometimes inflammation develops due to the eruption of wisdom teeth. The symptoms are: severe redness and inflammation, gums hurt and ache, tissue swelling appears at the end of the dentition. Based x-ray examination The specialist makes a decision either to remove the tooth or to prescribe conservative treatment.
In case of inflammation, rinses are prescribed antiseptic solutions, and in order to eliminate pain, analgesic-based drugs are used.
How to quickly relieve inflammation?
In order to quickly eliminate soreness and inflammation of the gums, you can use a solution of salt and soda for rinsing. Excellent medicinal properties has red rowan juice. Decoctions made from herbs are good for gum inflammation. Take two tablespoons of dried raw materials per glass of boiling water, after which the broth must be allowed to brew for ten minutes. The optimal temperature of the rinsing solution is about 35-40 degrees.
The health and beauty of your teeth depends on the health of your gums. The gap between the teeth is filled by the gingival papilla. This is a sensitive and vulnerable part of the soft tissue. Household injuries, improper oral hygiene, and dental diseases can lead to inflammation and excessive growth of the gingival papillae.
You can get rid of gum problems using cauterization. The procedure has a scary name for the average person. In fact, everything goes quickly and painlessly, thanks to modern technologies and drugs.
Features of gums between teeth
The areas of gum that fill the spaces between the surfaces of dental crowns are called gingival or interdental papillae. Interdental papillae protect periodontal structures. Incorrect formation or absence of structures leads to problems:
- violation of correct pronunciation;
- retention of food debris in the interdental space;
- aesthetic inconveniences.
Gingival papillae cover the spaces between teeth
Gingival papillae are a very sensitive and vulnerable part of the soft tissue. They are easily damaged from mechanical impact and violations of oral hygiene rules.
The health of teeth and gums depends on the condition of the interdental spaces. Therefore, you need to carefully monitor them and seek help from a specialist at the first symptoms of disturbances.
Inflammation of interdental papillae
Inflammation of the gingival papilla can occur due to a number of reasons. The first symptom of the disorder is bleeding and redness of the gum surface.
Causes of inflammation of the interdental papillae:
- Household injuries (using a toothpick, dental floss, too hard Toothbrush, solid food).
- Injuries during therapeutic dental treatment, stone cleaning.
- Diseases of teeth and gums.
- Malocclusion.
- Hormonal disorders.
Constant violation of the integrity of the papilla tissue leads to bleeding and the entry of foreign microorganisms into the wound.
Inflammation of the gingival papillae - gingivitis
The process of inflammation of the papillae on the gums is characterized by regular bleeding (usually observed after brushing teeth or eating), and increased sensitivity. The damage will begin to heal after the natural completion of the inflammatory process. But if it grows excessively, the surface of the nipple will increase in size. The overgrown area of the gum will become even more sensitive and vulnerable, new inflammation and bleeding cannot be avoided. Self-medication in a situation with inflammation of gum areas should not be practiced, otherwise it will be more difficult for the doctor to understand the causes of the disorder.
Gingival recession with enlarged papillae
How to treat inflammation of the gingival papillae
You should contact your dentist if you experience regular gum bleeding; this will save you from many troubles. Even a small problem with gum health cannot be ignored and left to chance.
When the gingival papilla grows, a coagulation procedure is performed. The gums are burned with electric current. The procedure is carried out very carefully, under local anesthesia. The patient does not feel pain, but discomfort may be observed after the procedure.
Coagulation in dental practice
Coagulation (diathermocoagulation) is one of the methods surgical dentistry, used for treatment and plastic surgery of soft tissues. The practice became widespread. Today there is equipment that allows many operations to be performed using electrode excision.
Coagulation in dentistry is cauterization. The operating instrument is heated by electricity. Therapeutic effect diathermocoagulation of the gums is ensured by high-frequency alternating current. The current voltage is low, but the power is 2A.
If the operation is successful, the affected area becomes White color. The effect is primarily aimed at blood vessels. Alternating current affects the inner surface vascular wall, promotes blood clotting. Due to this, damaged blood vessels are quickly closed, and bleeding gums are eliminated.
Coagulation of the gingival papilla allows you to quickly and reliably disinfect the wound, stop the development of the inflammatory process, and stop bleeding. Using this method, you can return an overgrown nipple to its former healthy appearance.
When is coagulation used in dentistry?
Coagulation – serious surgical method. Its use in practice requires certain qualifications. The procedure can be carried out after an accurate diagnosis has been made.
Indications for the use of diathermocoagulation:
- Chronic pulpitis, pulp polyp.
- Periodontal inflammation (the contents of the tooth root canals are disinfected by cauterization).
- Removal benign neoplasms oral mucosa (papillomas, hemangiomas, fibromas).
- Gingivitis, cutting off of overgrown gum nipples.
Using coagulation, the contents of periodontal pockets are disinfected. If enlarged blood vessels are visible in the mouth, they can also be removed using an electric current.
When should coagulation not be used?
The use of coagulation is contraindicated in the following cases:
- treatment of baby teeth;
- individual intolerance to the effects of electric current;
- narrowing or enlargement of the root canal of the tooth;
- unformed root tips.
The coagulation procedure is contraindicated for people with heart and vascular diseases.
A qualified specialist will definitely ask the patient questions about his state of health. You need to tell everything, indicate if you are allergic to anesthesia, and inform about taking medications.
Set for electrocoagulation procedure
How is coagulation of the gingival papilla performed?
Coagulation of the gums can be carried out using different techniques, methods and instruments.
There are several ways to carry out the coagulation procedure in dentistry:
- Action with a heated tool. An outdated technique, rarely used today.
- Cauterization with an electrocoagulator. All modern clinics equipped with these devices.
- Laser action. The most secure and soft method treatment.
The choice of method depends on the equipment of the clinic and the characteristics of the disease. Each technique has its own advantages and disadvantages.
Heated tool
The tools for cauterizing the gums are a spatula, a dental trowel, or a plugger. Today the method is outdated.
Treatment of the gums with a heated instrument allows you to remove small areas of tissue. Using technology, they stop bleeding and cauterize wounds.
Gums immediately after coagulation
When performing the procedure, it is important to ensure complete sterility of the instrument.
Electrocoagulator
An electrocoagulator is a special device that operates at high frequency current. The main part of the tool is the loop. It is heated by electricity and cauterizes the desired area of the gum or oral mucosa. Dental electrocoagulators are either stationary or portable. You can adjust the power of the device and select different operating modes.
The device operates silently. Its effect on humans is painless (the procedure is performed under anesthesia) and safe.
Laser
Laser therapy is widely used not only in cosmetology, but also in dentistry. This is the most advanced technology for removing overgrown gums. The radiation acts quickly, reliably and painlessly.
Main advantages laser therapy– after the procedure there are no traces or wounds on the gums, sore spot completely disinfected. You cannot get an infection during laser treatment, even if you really want to.
Laser plastic surgery of gingival papillae
If you have a choice about which method to use, it is better to give preference to laser.
Electrocoagulation technologies
Coagulation of the gums with the help of devices can be carried out using two different technologies. They differ in the depth of the influence of current on a person.
Electrocoagulation technologies:
- Bipolar. Electricity is passed only through the desired area (through the gum). The current short circuit occurs at a short distance. With the help of bipolar technology, you can only get rid of small tumors on the gums. An end plate is not required when using the technique.
- Monopolar. Electricity passes through the entire human body. With the help of technology, you can get rid of serious and deep-seated gum problems. To close the electrical circuit, the patient must wear a return plate.
Dentists prefer monopolar technology. It is more versatile and reliable. Monopolar electrocoagulation should not be used for people with heart and vascular diseases, intolerance to the effects of current, or for pregnant women at any stage.
Healthy gums, without growths, neoplasms and inflammation - the basis beautiful smile. If the gums become inflamed, the interdental papillae turn red and begin to bleed, this is a reason to consult a dentist. Overgrown gingival nipples can be removed using the electrocoagulation method. The procedure should only be entrusted to a qualified specialist.
