Periodontal Videonet Diagnosis and Treatment of Gingivitis,

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Gingivitis This document provides information concerning the cause and self-care of gum diseases. The causes for the diseases of the gum and tooth attachments are described.The presentation aims at giving oral health students an introduction to the clinics of gingivitis. The documents may also be used for professional information for patients about the disease. The treatment and the treatment effects are illustrated by images and videos. The focus for the information is what the patient can do him or herself for the prevention of gum diseases and maintenance of achieved treatment results. Click on the images to retrieve videos illustrating the text below the images. Disclaimer Materials, methods, instructions, recommendations, conclusions etc., found on these pages may be related to a particular, situation, area or country only. Any use - or misuse - of our information is totally at each user's own risk. Images and text may be freely downloaded and used if the source is acknowledged

and no changes made. Anyone using our information (for example in the treatment of patients) must check that it is in accordance with local standards, regulations, legislation's etc, and that the procedures are approved by local authorities concerned. Pointers to other departments, databases, servers etc., do not mean that we approve or take any responsibility for the material included in those databases. The pages may be changed or withdrawn without any notice. For some pages, a line at the bottom will tell when the last change was made.. Rolf Attstrom, Professor and Chairman, Department of Periodontology, Centre for Oral Health Sciences, 21421 Malmo, Sweden Published August 1998 updated November 1999

This patient is around 23 years old. Gingivitis is diagnosed by the alterations of the gingival margin which develop when bacteria are allowed to accumulate along the junction between the tooth surface and the gingiva. Redness, swelling and a soft consistency of the marginal tissue are the most common symptoms.	The swelling of the gingiva often leads to the formation of pseudopockets in particular in approximal regions where the clinical probing pocket depth often approaches 5 mm. It shall be noted that this does not mean that an attachment loss has occurred.	The diagnosis of gingivitis is often obvious when a young person complains of bleeding during tooth brushing or when flossing. The whole mouth is a screen for the presence of gingivitis symptoms and particular emphasis should be placed at the approximal regions where the periodontitis most frequently starts.
The position of the teeth might sometimes complicate the diagnostic procedures. Irregularly placed teeth force the clinician to move the instruments unevenly and there is a risk of over-diagnosis of the gingivitis due to fact that the alignment of the teeth influences the appearance of the gingiva.	The cause of the gingivitis- bacterial accumulations on the teeth are difficult to see. It is therefore mandatory that the patient is made aware and shown where the dental plaque is located by staining the teeth with a discoloring solution. Here it is done in the dental office.	The patient is shown where the dental plaque resides and shown proper ways to remove the accumulated bacteria masses. In particular the presence of bacteria in relation to the gingival inflammation should be demonstrated.
Following the information to the patient regarding the cause of the disease and instruction in oral hygiene procedures, the teeth are carefully professionally cleaned and the cleanliness checked by restaining the teeth after the clinical procedures.	This demonstrates the condition around 3 months following the first visit. In most sites the symptoms of gingivitis have decreased or vanished. The diagnostic procedures are performed in the whole dentition and the patient informed about the results.	In the lower jaw at the mal-aligned teeth symptoms of gingivitis remain. The professional cleaning is repeated and the patient given additional instruction in oral hygiene procedure. A frequency of supportive treatments once every 6 to 8 month is scheduled for the patient
Three years later and following a regular follow up with professional cleanings and reinstruction in oral hygiene procedures, the gingiva is by and large healthy and the patient maintains a high level of oral cleanliness	In the lower jaw at the malaligned teeth the patient has succeeded in maintaining the teeth cleaning and the symptoms of gingivitis are minimal. The level of oral health of the patient is less than 15 % of the tooth surfaces with dental plaque and less than 10% of the gingival units show bleeding following gentle probing.	These videos were produced by Rolf Attstrom and Danish Dental Association in collaboration with Goof Video, Denmark. Camera and videoediting Tommy Ols, Videocompiling and Sound Recording Anders Nattestad

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Rolf Attstrom & Anders Nattestad 1999

 

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Updated 991112

Centre for Oral Health Sciences, Malmoe University,
Malmoe, Sweden
School of Dentistry, Faculty of Health Sciences, University of Copenhagen,
Copenhagen, Denmark.
Copyright Rolf Attstrom et al Interactive Periodontology, Council for Higher Education, National Agency of Higher Education, Stockholm,Sweden.