Symptoms, diagnosis and treatment - BMJ Best Practice
Symptoms, diagnosis and treatment - BMJ Best Practice
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Gingivitis is caused by bacterial plaque (dental biofilm) that accumulates daily on the teeth.
Results in redness, slight swelling, or “puffiness” of the gums and bleeding on tooth brushing.
Treatment involves thorough professional tooth cleaning and effective daily removal of dental plaque by tooth brushing and cleaning between the teeth.
Necrotizing gingivitis is a more serious condition that is mainly found in developing countries and is associated with people with severe malnutrition or people living with HIV with low CD4 counts.
Gingivitis is inflammation of the gingiva. The vast majority of cases are related to bacteria-induced inflammation caused by the dental plaque (bacterial biofilm) that forms daily on the teeth. Necrotizing gingivitis is an atypical, acute form of bacteria-related gingivitis that is rarely found in developed countries.[1]Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018 Jun;89 Suppl 1:S74-84.http://www.ncbi.nlm.nih.gov/pubmed/29926944?tool=bestpractice.comThis topic focuses on these two forms of gingivitis.
Many other potentially serious conditions (congenital or acquired, and a number of genetic syndromes) may feature inflammation or lesions of the gingiva and these must always be considered within the differential diagnosis.[2]Lang NP, Lindhe J. Clinical periodontology and implant dentistry. 6th ed. Hoboken, NJ: Wiley-Blackwell; 2015.[3]Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Periodontol. 2018 Jun;89 Suppl 1:S28-45.http://www.ncbi.nlm.nih.gov/pubmed/29926945?tool=bestpractice.com[4]Farah CS, Balasumbramaniam R, McCullough MJ. Contemporary Oral Medicine. A Comprehensive Approach to Clinical Practice. 1st ed. New York, NY: Springer International Publishing; 2019.
Department of Surgical, Oncological and Oral Sciences
Associate Professor of Periodontology and Dental Public Health
Department of Surgical, Oncological and Oral Sciences
Dr Giuseppina Campisi and Dr Giuseppe Pizzo would like to gratefully acknowledge Dr Bruce L. Pihlstrom and Dr Alice E. Curran, previous contributors to this topic.
BLP and AEC declare that they have no competing interests.
National Institute of Dental and Craniofacial Research
Academic Head, Oral Medicine and Special Needs Dentistry Unit
Honorary Consultant in Oral Medicine, UCLH NHS Foundation Trust
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