A Family Doctor's Tale - GINGIVITIS

DOC I HAVE GUM INFECTION

Gum infection are seen very commonly in a family doctor clinic even though it is under the domain of dental surgeons. Sometimes it is because of poorly constructed dentures or dentures which has become loose or too tight. There is usually pain and swelling of the gum. Many patients prefer to seek the help of family doctors than the dental surgeons because of their trust in family doctors and the higher cost of dental surgeons.

Gingivitis is an acute disease which causes inflammation and infection of the gum with redness, swelling and bleeding.


Bacterial Infections:
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1.Gram positive bacteria such as Streptococcus and Staphphylococcus may be painful and lead to upper respiratory tract infection


2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease, chlamydia( A Simple Guide to Chlamydia)


Non-infectious:
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1.malocclusion

2.food impaction

3.dental calculus

4.dental procedures

5.exposure to heavy metals

6.long term phenytoin treatment

7.Oral contraceptive pills


Systemic diseases:
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1.diabetes mellitus ( A Simple Guide to Diabetes)


2.leukemia ( A Simple Guide to Blood Cancer)


3.Debilitating diseases

4.autoimmune diseases


Symptoms:

1.Painful gum


2.Red swollen inflamed gum


3.bleeding in between the gum


4.Fever may be present


Signs:


1.Red swollen inflamed gum around neck of teeth


2.Swelling of papilla between teeth


3.Gum boils or abscess in the gum


4.Gum ulcers

5.Gum swab for bacteria and antibiotic sensitivity


6.X-rays of teeth may show tooth decay and infection


Complications of gum infection may cause:
1.damage to root canals


2.cavity in the teeth


3.upper respiratory tract infection


Treatment of the gum infection includes:

1.Rest and fluids


2.Painkiller for pain


3.Antibiotics depending on the organism found:

a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus


b.cephalosporins, gentamycin for pseudomonas


Very often the right antibiotic given to the patient will clear the gum infection but if the underlying cause such as poorly constructed dentures and poor oral hygiene is not treated then recurrence of the gum infection will recur.


4.Oral application of oral antibiotic cream


Prognosis is usually very good.


Surgery for abscess and other gum or tooth problem very rarely needed.


Prevention of gum diseases are:
1.Avoid smoking


2.Healthy lifestyle with balanced diet and exercise.


3.Regular cleaning of gum and teeth by brushing and flossing


4.Gargling of mouth after meals


5.Regular dental checkup