GINGIVITIS.pptx

GINGIVITIS

1. Gingivitis PRESENTED BY: V.RAMYA TUTOR , SRMTCON

2. INTRODUCTION Gingivitis is inflammation of the gums . Gingivitis is a common and mild form of gum disease (periodontal disease) that causes irritation, redness and swelling (inflammation) of your gingiva, the part of your gum around the base of your teeth. It's important to take gingivitis seriously and treat it promptly. Gingivitis can lead to much more serious gum disease called periodontitis and tooth loss.

3. G ingivitis

4. DEFINITION INFLAMMATION OF GINGIVA IS TERMED AS GINGIVITIS. • Gingivitis is a non- destructive disease that occurs around the teethGingivitis is inflammation of the gums. Periodontitis occurs when inflammation or infection of the gums (gingivitis) occurs and is not treated. Infection and inflammation caused by plaque buildup spreads from the gums (gingiva) to the ligaments and bone that support the teeth .

5. Epidemiology Epidemiology • Around 50-60% population > 35 years • Up to 80% of children and adolescents Llodra JC. Oral Health Survey in Spain 2010 .

6. CAUSES 1.Accumulation of bacterial plaque 2 . Some diseases like diabetes , HIV 3 . Drugs 4 . Smoking 5 . Ages 6. Poor diet 7. Family history

7. PRIMARY CAUSES : PRIMARY CAUSES : Bacterial /viral infection • Mechanical irritation from dentures • Tobacco, hot food, alcohol, burns • Allergy to toothpaste, mouthwash 2. Secondary causes • Iron deficiency anemia • Pernicious anemia • Vitamin B deficiency • Syphilis • Ulcer • HIV /TB

8. Secondary causes Secondary causes • Iron deficiency anemia • Pernicious anemia • Vitamin B deficiency • Syphilis • Ulcer • HIV /TB

9. TYPES DEPENDING ON COURSE AND DURATION DEPENDING ON DISTRIBUTION DEPENDING ON COURSE & DURATION: 1.ACUTE GINGIVITIS 2.SUBACUTE GINGIVITIS 3.RECURRENT GINGIVITIS 4. CHRONIC GINGIVITIS

10. 1.ACUTE GINGIVITIS IT IS OF SUDDEN ONSET AND SHORT DURATION AND CAN BE PAINFUL .

11. ANUG The other form of gingivitis is known as the acute necrotizing ulcerative gingivitis (ANUG),Vincent’s stomatitis , or trench mouth . rarely seen these days. ANUG is more likely to develop in a person with an impaired immune system or in those with severe malnutrition. This is a more acute and invasive form of gingivitis which may cause foul – smelling breath (halitosis), Fever and painful gums in addition to other symptoms . ANUG may develop in people with a history of gingivitis who experience a stressful event and is more common in smokers than in non smokers.

12. SUB ACTUE GINGIVITIS  A LESS SEVERE FORM OF ACUTE CONDITION IS CALLED SUB-ACUTE.

13. RECURRENT GINGIVITIS RECURRENT GINGIVITIS  REAPPEARS AFTER ELIMINATED BY A TREATMENT OR DISSAPPEARING SPONTANEOUSLY.

14. CHRONIC GINGIVITIS CHRONIC GINGIVITIS:  SLOW IN ONSET AND LONG DURATION  IS PAINLESS  INFLAMMATION PERSISTS OR RESOLVES AND NORMAL AREAS BECOME INFLAMMED .

15. CLINICAL MANIFESTATIONS bright-red, or purple gums • shiny gums • gums that are painless, except when pressure is applied

16. CLINICAL MANIFESTATIONS • gums that easily bleed, even with gentle brushing, and especially when you floss • receding gumline • Bad breath (halitosis) • Inflammation (swollen gums) • Soft gums

17. DIAGNOSTIC EVALUATION Historycollection Physical examination

18. DIAGNOSTIC EVALUATION Dentists usually diagnose gingivitis based on : Review of your dental and medical history and conditions that may contribute to your symptoms. Examination of your teeth, gums, mouth and tongue for signs of plaque and inflammation.

19. DIAGNOSTIC EVALUATION Measuring the pocket depth of the groove between your gums and your teeth by inserting a dental probe beside your tooth beneath your gum line, usually at several sites throughout your mouth. In a healthy mouth, the pocket depth is usually between 1 and 3 millimeters (mm). Pockets deeper than 4 mm may indicate gum disease.

20. DIAGNOSTIC EVALUATION Dental X-rays to check for bone loss in areas where your dentist sees deeper pockets.

21. Treatment Professional dental cleaning. Your initial professional cleaning will include removing all traces of plaque, tartar and bacterial products — a procedure known as scaling and root planing . Scaling removes tartar and bacteria from your tooth surfaces and beneath your gums.

22. Treatment Root planning removes the bacterial products produced by inflammation, smooths the root surfaces, discouraging further buildup of tartar and bacteria, and allows proper healing. The procedure may be performed using instruments, a laser or an ultrasonic device.

23. Treatment Dental restoration, if needed. Misaligned teeth or poorly fitting crowns, bridges or other dental restorations may irritate your gums and make it harder to remove plaque during daily oral care. If problems with your teeth or dental restorations contribute to your gingivitis, your dentist may recommend fixing these problems.

24. Treatment Ongoing care . Gingivitis usually clears up after a thorough professional cleaning — as long as you continue good oral hygiene at home. Your dentist will help you plan an effective at-home program and a schedule of regular professional checkups and cleaning.

25. MEDICAL MANAGEMENT Chlorhexidine ( Peridex , PerioChip , PerioGard ) is an antimicrobial used to control plaque and gingivitis in your mouth or in periodontal pockets . This medication is available as a mouth rinse, or as a gelatin -filled chip that's placed in pockets after root planing . It releases the medication over 7 days or so.

26. MEDICAL MANAGEMENT In the future, antibiotics also may be used to treat simple chronic gingivitis, but no current evidence exists to justify this practice. Treatment of gingivitis may be warranted if dental surgery is planned . Some of the most effective antibiotics for these conditions include metronidazole and amoxicillin. Gingivitis may cause toothache and painful gums . Anti-inflammatory pain relievers such as paracetamol and ibuprofen may help ease the pain, swelling and discomfort .

27. SURGICAL MANAGEMENT Gum graft surgery is a dental procedure for treating thinning gums or gum recession . Gum grafting covers exposed teeth roots and adds volume to your gum line, improving overall oral health. Recovery usually takes one week to two weeks, but it may take longer.

28. NURSING MANAGEMENT Inspect oral cavity at least once daily and note any discoloration, lesions, edema , bleeding, exudate, or dryness. Refer to a physician or specialist as appropriate. ( Oral inspection can reveal signs of oral disease, symptoms of systemic disease, drug side effects, or trauma of the oral cavity) 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 . ( Irritative and causative agents for stomatitis should be eliminated)

29. NURSING MANAGEMENT Monitor client’s nutritional and fluid status to determine if adequate. (Dehydration and malnutrition predispose clients to impaired oral mucous membranes.) 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) Determine client’s mental status. If client is unable to care for self, oral hygiene must be provided by nursing personnel.

30. NURSING MANAGEMENT Determine client’s usual method of oral care and address any concerns regarding oral hygiene. ( Whenever possible, build on client’s existing knowledge base and current practices to develop an individualized plan of care.) Educate the patient about avoiding, mouthwashes with high alcohol content, lemon swabs or prolonged use of hydrogen peroxide.

31. NURSING MANAGEMENT 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. ( The toothbrush is the most important tool for oral care. Brushing the teeth is the most effective method for reducing plaque and controlling periodontal disease) 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 .)

32. NURSING MANAGEMENT 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 Use foam sticks to moisten the oral mucous membranes, clean out debris, and swab out the mouth of the edentulous client . Do not use to clean the teeth or else the platelet count is very low, and the client is prone to bleeding gums

33. NURSING MANAGEMENT (Studies have shown that foam sticks are probably not effective for removing plaque from teeth. However , they are useful for cleaning the mouth of the edentulous client) 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)

34. NURSING MANAGEMENT If mouth is severely inflamed and it is painful to swallow, contact the physician for a topical anesthetic agent or analgesic order . Modification of oral intake (e.g., soft or liquid diet) may also be necessary to prevent friction trauma. Educate the patient on 3 ways on how to relieve dry mouth by discharge.

35. NURSING MANAGEMENT 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)

36. PREVENTION Good oral hygiene. That means brushing your teeth for two minutes at least twice daily — in the morning and before going to bed — and flossing at least once a day . Better yet, brush after every meal or snack or as your dentist recommends. Flossing before you brush allows you to clean away the loosened food particles and bacteria .

37. PREVENTION Regular dental visits . See your dentist or dental hygienist regularly for cleanings, usually every six to 12 months. If you have risk factors that increase your chance of developing periodontitis — such as having dry mouth, taking certain medications or smoking — you may need professional cleaning more often . Annual dental X-rays can help identify diseases that are not seen by a visual dental examination and monitor for changes in your dental health.

38. PREVENTION Good health practices. Practices such as healthy eating and managing blood sugar if you have diabetes also are important to maintain gum health.

39. Lifestyle and home remedies Steps you can take at home to prevent and reverse gingivitis include : Brush your teeth twice a day or, better yet, after every meal or snack. Use a soft toothbrush and replace it at least every three to four months. Consider using an electric toothbrush, which may be more effective at removing plaque and tartar.

40. Lifestyle and home remedies Floss daily. Use a mouth rinse to help reduce plaque between your teeth. Supplement brushing and flossing with an interdental cleaner, such as a dental pick, interdental brush or dental stick specially designed to clean between your teeth. Get regular professional dental cleanings on a schedule recommended by your dentist. Don't smoke or chew tobacco.

41. Conclusions Conclusions • Reversible inflammation • Very common • Mechanical and chemical prevention and treatment • Role of oral healthcare professional is key

42. Bibliography • Ansari and kaur ,medical surgical nursing ,published by pee vee ,2011 edition page referred 466 to 469. • Brunner and suddarth’s Textbook of Medical – Surgical Nursing south Asian edition Volume 1, • page no 842 -843. • https://www.slideshare.net/Dentaid/gingivitis-35701777 • https://www.slideshare.net/hydermj/gingivitis-64544387 • https://www.slideshare.net/SannahJahangir/gingivitis-presentation

43. THANK YOU