Gingivitis in children
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms of Gingivitis in Children
- Diagnostics
- Treatment of gingivitis in children
- Possible complications and consequences
- Forecast
- Prevention
Gingivitis in children is an inflammatory gum disease in which the margins of the gums and interdental papillae are primarily affected.
The gums are the mucous membrane that covers the alveolar ridge of the upper and alveolar parts of the lower jaw, and also covers the teeth in the neck. There are few nerves and no glands in the gum tissue. The gum consists of the marginal part (free part), the alveolar part (the attached part of the gum), and the interdental (gingival) papillae. The mucous membrane of the gums is tightly attached to the periosteal hymen of the jaw bones, passes into the mucous membrane of the palate and the floor of the mouth, as well as the mucous membrane that lines the inner surface of the lips.
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In childhood, morphological changes in the gum tissue, the formation of the roots of the teeth, the eruption of teeth, the formation of the occlusion occur. During puberty, periodontal tissues are affected by changes in hormonal levels. These factors are responsible for the high prevalence of gingivitis in children. The disease is diagnosed in about 2% of children aged 2–4 years, by 10–13 years, the pathological process is observed in 80% of children. According to epidemiological studies, the chronic form of catarrhal gingivitis is most common in childhood.
Causes and risk factors
The main cause of gingivitis in children is microorganisms that multiply in dental plaque. This factor accounts for 80-90% of all cases of the disease. The development of the pathological process in childhood, first of all, is facilitated by the accumulation of plaque for 1–5 days and longer.
Risk factors for developing gingivitis in children include:
- infectious diseases;
- diseases of the gastrointestinal tract;
- endocrine diseases;
- allergic processes;
- immunodeficiency states;
- rheumatism;
- carious cavities in the teeth;
- adentia;
- malocclusion;
- the presence of soft and hard dental plaque;
- shortened hyoid ligament;
- teething;
- mobility of milk teeth;
- poorly ground fillings between teeth;
- insufficient oral hygiene;
- injury to the mucous membrane of the gums (cuts, biting, scratches, burns);
- lack of vitamins in the body, poor nutrition.
Forms of the disease
According to the clinical course, gingivitis in children is divided into acute and chronic. Depending on the severity, the disease can be mild (the interdental papillae are affected), moderate (the inflammatory process takes place in the marginal gum) and severe (damage to both the marginal and alveolar parts of the gums) forms.
Depending on the severity of changes in the mucous membrane of the gums, gingivitis is:
- catarrhal;
- ulcerative;
- atrophic;
- hypertrophic.
Depending on the nature of proliferation, hypertrophic gingivitis in children is divided into granulating (fibrous) and inflammatory (edematous).
Depending on the prevalence of the pathological process, gingivitis is classified into local and generalized.
Symptoms of Gingivitis in Children
The clinical picture depends on the form of the disease.
The main symptoms of gingivitis in children at the initial stage are hyperemia, swelling, bleeding of the gums. Later, gingival hypertrophy, ulceration of the mucous membrane may join. Sometimes symptoms of indigestion (bloating, defecation disorder, etc.) can join local signs.
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The catarrhal form of gingivitis in children usually occurs during the period of teething or tooth replacement. An acute form of catarrhal inflammation can develop as a result of a burn or injury to the mucous membrane of the gums, it can accompany an acute respiratory viral disease, exacerbations of somatic diseases or an allergic process. In this case, patients experience itching or other discomfort in the gums, bleeding of the gums while eating and / or brushing their teeth, taste perversions and bad breath may be observed. Painful sensations in the gums are aggravated by eating hot or spicy food, exposure to chemical factors. The body temperature can rise to subfebrile numbers, in this case, patients complain of weakness and malaise, but in general, the general condition is assessed as satisfactory. The mucous membrane of the gums of patients with catarrhal gingivitis gradually acquires a cyanotic hue, thickens, becomes loose, as a rule, limited foci of desquamation are found on it. The chronic form of catarrhal gingivitis in children, as a rule, occurs against the background of non-observance of the rules of oral hygiene and is characterized by a sluggish long course.
Hypertrophic gingivitis is one of the forms of a chronic inflammatory process in the gums, which is characterized by pronounced proliferative phenomena. The main signs of inflammatory hypertrophic gingivitis in children are itching and pain in the gums, as well as bleeding from the gums that occurs during meals and can interfere with normal chewing. This form of the disease is characterized by a pronounced proliferation of papillae, which leads to a change in the shape of the gums. The overgrown gums, as a rule, partially cover the crowns of the teeth, also in patients there is swelling and looseness of the gingival papillae, which makes them easily traumatized, false gingival pockets appear, the teeth are usually covered with a large amount of plaque. Hypertrophic gingivitis is most commonly diagnosed in prepubertal and puberty children due to exposure to sex hormones. With the hypertrophic form of gingivitis, the pathological process usually involves the gums on one of the jaws or on both, much less often localized hypertrophic gingivitis occurs, in which the gum area limited to several teeth is affected.
Ulcerative gingivitis in children develops with a decrease in immunity against the background of a catarrhal inflammatory process. In this case, symptoms of general intoxication of the body, decreased appetite, sleep disturbances, and irritability are gradually added to the signs of catarrhal inflammation. On the mucous membrane of the gums, ulceration occurs, covered with a grayish-green coating, the viscosity of saliva increases, there is increased salivation, putrid breath, an increase in cervical lymph nodes. With the progression of the pathological process, necrosis of the interdental gingival papillae may develop.
The atrophic form of gingivitis in children appears with improper orthodontic treatment, the presence of strands of the vestibule of the oral cavity, in the case of abnormal attachment of the bridles. With this form of the disease, signs of inflammation are insignificant or absent, however, dystrophic changes in the gingival margin are pronounced. In patients, the necks of the teeth are exposed, the teeth become sensitive to temperature irritants. The color of the gums in this form of the disease practically does not change. With atrophic gingivitis in children, the pathological process is usually localized in the region of the lower anterior incisors and canines.
Diagnostics
The diagnosis is established by a pediatric dentist based on visual examination and instrumental diagnostic data. At the same time, children with gingivitis usually have non-mineralized dental deposits, supragingival tartar, caries, dental filling defects, malocclusion, anomalies of lip and tongue frenum attachment.
In the course of X-ray examination of teeth, changes in bone tissue (in particular, destruction of bone tissue of interdental septa) are not detected.
Treatment of gingivitis in children
Treatment of gingivitis in children is complex. First of all, the therapy of the pathological process is aimed at eliminating the etiological factors that caused the development of the disease (treatment of caries, plastic frenum of the tongue or lip, sanitation of foci of infection, treatment of somatic diseases, etc.).
Dental interventions begin with the removal of soft and hard dental plaque. Professional cleaning can be carried out both mechanically and using ultrasound. After sanitation of the oral cavity, a course of anti-inflammatory measures is carried out. Patients are advised to rinse the mouth with antiseptic solutions and / or decoctions of medicinal herbs (chamomile, mint, eucalyptus, sage, etc.) twice a day after dental hygienic cleaning. Children who are not able to rinse their mouth on their own are shown applications and treatment of the mucous membrane with antiseptic preparations. If necessary, antibacterial drugs are prescribed (orally or parenterally). In addition, the treatment can be supplemented with physiotherapeutic procedures: laser therapy, electrophoresis, ultraviolet radiation therapy.
With an increase in body temperature and signs of intoxication, antipyretic drugs are used, and an abundant drinking regimen is also recommended.
With a severe course of the disease and the ineffectiveness of conservative therapy, surgical treatment may be required. Depending on the indications, methods of cryodestruction of the papillae (exposure to liquid nitrogen), gingivoplasty (surgical correction of the shape of the gums), diathermocoagulation (cauterization of tissues with alternating current of high frequency) can be used.
Of no small importance in the treatment of gingivitis in children is the general improvement of the body, including adherence to the diet. The use of fast carbohydrates (sugar, confectionery, baked goods, fast food) is limited, a sufficient amount of vegetables and fruits is introduced into the diet.
A prerequisite for successful treatment is thorough oral hygiene. For gingivitis, you should opt for soft-bristled toothbrushes and toothpastes that contain herbal extracts. It is necessary to persistently form hygiene skills in the child, as well as teach him to self-massage the gums.
Possible complications and consequences
As the inflammatory process progresses, it can spread to adjacent tissues. Periodontitis, ulcerative stomatitis, abscesses in the gums, and infectious processes in the jaw bones may develop. Lack of adequate treatment can lead to irreversible changes in the gum tissue. The disease can cause loosening of the gums with subsequent loss of teeth.
Forecast
With timely, correctly selected treatment, the prognosis is favorable. In the case of a severe course of the ulcerative form of gingivitis with the formation of foci of necrosis, the prognosis worsens.
Prevention
In order to prevent the development of gingivitis in children, it is recommended:
- teaching children how to properly brush their teeth with the formation of the skill of regular oral care;
- regular check-ups at the dentist with professional teeth cleaning if necessary;
- avoiding injury to the gums;
- correct selection of toothbrushes and pastes;
- timely replacement of the toothbrush;
- balanced diet;
- strengthening the body's defenses.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
