What is epulis on the gum - photo and how to get rid of it

Soldatova Lyudmila Nikolaevna

Candidate of Medical Sciences, Professor of the Department of Clinical Dentistry of the St. Petersburg Medical and Social Institute, Chief Physician of the Alfa-Dent Dental Clinic, St. Petersburg

The human oral cavity has its own microflora and its own specific diseases arise. Let's talk about one of them - fibrous epulis of the gums: what kind of disease it is, what are the causes of its occurrence, how is the treatment carried out.

What it is

Epulis is a tumor-like neoplasm that develops on the alveolar process of the jaw. It also has other names - epulid, supragingival, giant cell granuloma. More often it is localized in the area of ​​incisors, canines and small molars of the upper jaw, less often the tumor is detected in the lower jaw. The growth has a round or irregular shape and a wide stalk; the size of the formation varies from 3 mm to 5 cm.

Despite the fact that such a tumor looks frightening, it practically does not cause concern to the patient, unlike, for example, a burn, with the exception of a violation of aesthetics and the sensation of a foreign body in the oral cavity. Large tumors may cause difficulty chewing and swallowing food.

If epulis is accompanied by bleeding, infection may occur, which will lead to complications.

The disease mainly affects adults, but the neoplasm can also appear in children; in the latter, it occurs during teething. Studies have shown that women are more susceptible to developing epulis than men.

The appearance of growths in a child

Most often in children, this disease manifests itself during the period when teeth are being cut . In this case, this is mostly due to trauma to the gums and mucous membranes. The angiomatous variety is most often diagnosed, but sometimes others are also found.

Parents should seek professional help from an experienced specialist as soon as possible . This is necessary to prevent the spread and growth of tumors. Girls are diagnosed several times more often.

In adolescence, the appearance of epulis on the gums of a child can be associated not only with chronic injury. It may also be hormonal disruptions during puberty . A similar failure in teenage girls can also be caused by taking inappropriate hormonal medications.

It should also be noted that in childhood it is possible to change the type of epulis, that is, the transition from one form or type to another. More often it all starts with granulomatous epulis, which, as it grows, turns into angiomatous and then into a fibrous form.

Recurrent forms are observed in a large number of cases - about 14%.

Varieties of epulis

Conventionally, there are 3 types of epulis:

• Fibrous. The neoplasm is dense, the basis is coarse fibrous tissue. Characterized by slow growth. There is no pain or bleeding.
• Angiomatous. The tumor contains a large number of blood vessels and is localized mainly in the lateral parts of the jaw. With this form of the disease, bleeding is observed even with slight pressure, for example, with a toothbrush or food. When pressed, the tumor is painless and has a soft consistency.
• Giant cell. The tumor can reach large sizes, displacing teeth that are located in the epulis growth zone. The mucous membrane of the epulis is bluish-red in color. On palpation, the neoplasm is painless, but may bleed moderately if injured.

Depending on the nature of the process, epulis can be benign or malignant. In the first case, the neoplasm is characterized by slow development and, as mentioned above, in most cases does not cause pain. The tumor size in this case rarely exceeds 10–20 mm. When the process becomes malignant, rapid tissue growth is observed. In this case, the process is often accompanied by pain, bleeding gums and affects the root canals of neighboring teeth.

Causes

The etiology of the appearance of epulis is not fully understood. Its formation can be caused by hormonal imbalance or changes occurring in the body (for example, during pregnancy). But among the main factors in its development, experts name regular injury to the mucous membrane and gum tissue.

It can be provoked by the following factors:

• a filling protruding or hanging over the gum;
• massive rock deposits;
• sharpened edges of destroyed units;
• abnormal bite;
• an error in the production of orthodontic products and long-term use of them without adjustment;
• soft tissue injury;
• poor hygiene;
• burns of the mucous membrane (thermal or chemical).

Separately, it should be noted that 2 types of growths - angiomatous and fibrous - develop as a response to chronic inflammation with regular damage to the gums. Giant cell can appear spontaneously from the bone or soft tissue of the jaw.

Diagnosis and treatment of epulis

Diagnosis of epulis comes down to collecting complaints, clinical examination, radiography and histological examination of the material.

The primary task in making such a diagnosis is to eliminate the provoking factor: professional cleaning of dental plaque, treatment of caries and its complications, replacement or correction of orthopedic structures according to indications. In fibromatous and angiomatous forms, dynamic observation is indicated, since after sanitation of the oral cavity and elimination of the causes of the disease, the tumor may decrease in size until it disappears completely.

Treatment of epulis is carried out surgically. The growth on the gum under local anesthesia or general anesthesia is excised with a scalpel or laser within the healthy tissue along with the periosteum. The second method is preferable, since the laser simultaneously coagulates the vessels and stops bleeding. With giant cell epulis, the area of ​​bone tissue involved in the process is also removed. To do this, use a bur or cutter. The wound is closed with gauze with an iodoform mixture or a formed mucoperiosteal flap. If necessary, the material is sent for histological examination.

Intact teeth in the area of ​​tumor localization must be removed with a high degree of mobility and severe exposure of the roots. If the bone lesion is extensive or epulis recurs, partial resection of the alveolar part along with the teeth is performed.

To speed up the healing of a fresh wound, the doctor prescribes compresses with medicinal ointments and rinses to the patient.

Features of the course during pregnancy

During pregnancy, the female body undergoes a very complex restructuring. Hormonal disruptions and surges at this time are a completely natural phenomenon. This is why pregnant women can also often develop epulis on the gums .

The initial cause may be the same chronic injury. However, in this case, the growth of the tumor and all the processes taking place in it are significantly accelerated . This also accounts for a fairly large number of relapses. Moreover, during the period of bearing a child, new formations appear much faster.

Preventive actions

Monitoring the condition of the teeth and oral cavity will reduce the likelihood of tumors.

• Timely sanitation of the oral cavity. Visiting the dentist for a preventive examination and professional hygiene twice a year will prevent the growth of caries, the appearance of defects in fillings and the formation of tartar, leading to gum injury and the appearance of epulis.
• Prevention of gum injury. If systematic injury to soft tissue occurs as a result of poorly fitted orthopedic or orthodontic structures, consult your doctor about this problem. He will adjust the crowns or dentures.

If these preventive measures are followed, the prognosis is favorable and epulis does not recur.

We hope that our article about epulis will be for informational purposes only. And if you want to soothe your gums, make them strong and strong, try the unique two-component mouth rinse ASEPTA ACTIVE.

This is the only rinse with a combination of chlorhexidine + benzydamine for the treatment of inflammatory periodontal diseases. The product has a combined effect: antimicrobial, anti-inflammatory and analgesic. Instant anesthetic effect allows you to quickly reduce pain.

Prevention

Since it is impossible to exclude the factor of hormonal imbalances in the body, among the preventive measures only timely and regular sanitation of the entire oral cavity is mentioned .

This will help to timely identify and eliminate the causes of chronic injuries, and, accordingly, the main reason for the appearance of such a formation as epulis.

Sanitation of the oral cavity is a large complex of measures that are carried out in a clinical setting. This includes not only professional cleaning and removal of tartar from the enamel, but also the elimination of any pathologies that may arise.

Part of the rehabilitation may also include orthodontic treatment , that is, correction of the bite. This is important, since incorrect positioning of teeth in most cases leads to chronic injuries to the oral mucosa.

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Clinical researches

Repeated clinical studies have proven that the two-component mouth rinse ASEPTA ACTIVE more effectively combats the causes of inflammation and bleeding compared to single-component rinses - it reduces inflammation by 41% and reduces bleeding gums by 43%.

Sources:

1. Clinical and laboratory assessment of the influence of domestic therapeutic and prophylactic toothpaste based on plant extracts on the condition of the oral cavity in patients with simple marginal gingivitis. Doctor of Medical Sciences, Professor Elovikova T.M.1, Candidate of Chemical Sciences, Associate Professor Ermishina E.Yu. 2, Doctor of Technical Sciences Associate Professor Belokonova N.A. 2 Department of Therapeutic Dentistry USMU1, Department of General Chemistry USMU2
2. The effectiveness of the use of Asept “adhesive balm” and Asept “gel with propolis” in the treatment of chronic generalized periodontitis and gingivitis in the acute stage (Municipal Dental Clinic No. 4, Bryansk, Kaminskaya T. M. Head of the therapeutic department Kaminskaya Tatyana Mikhailovna MUZ City Dental Clinic No. 4, Bryansk
3. Study of the clinical effectiveness of treatment and prophylactic agents of the Asepta line in the treatment of inflammatory periodontal diseases (A.I. Grudyanov, I.Yu. Aleksandrovskaya, V.Yu. Korzunina) A.I. GRUDYANOV, Doctor of Medical Sciences, Prof., Head of Department I.Yu. ALEXANDROVSKAYA, Ph.D. V.Yu. KORZUNINA, asp. Department of Periodontology, Central Research Institute of Dentistry and Maxillofacial Surgery, Rosmedtekhnologii, Moscow
4. The role of anti-inflammatory rinse in the treatment of periodontal diseases (L.Yu. Orekhova, A.A. Leontyev, S.B. Ulitovsky) L.Yu. OREKHOVA, Doctor of Medical Sciences, Prof., Head of Department; A.A. LEONTIEV, dentist; S.B. ULITOVSKY, Doctor of Medical Sciences, Prof. Department of Therapeutic Dentistry of St. Petersburg State Medical University named after. acad. I. P. Pavlova

Therapy

To combat pathology, surgical, laser (as the newest surgical method), medicinal methods and traditional medicine are used as a means of complementing the main therapy.

Surgical

It is carried out when the tumor has grown significantly by completely removing it. The operation involves its dissection and takes place in several stages:

1. Administration of anesthesia (depending on the epulis clinic, local or general anesthesia is performed).
2. As soon as the anesthetic takes effect, the doctor, stepping back 1-2 mm from the stem of the growth, makes an incision around the soft tissue of the gums to their entire depth, capturing the periosteum.
3. The flap is peeled off along its entire circumference.
4. If the disease has affected bone tissue, the affected area is dissected down to healthy tissue.
5. The wound surface is cleaned, washed with an antiseptic solution and covered with a swab soaked in iodoform composition.
6. If the affected area is large, its edges are tightened with sutures.

Teeth located nearby are pulled out only when they are mobile (grade III) or when their roots are exposed to 2/3 of their length.

Have you discovered an abscess on your child’s gum? We'll tell you what to do. On this page: https://dentist-pro.ru/lechenie/desny/gingivit/osobennosti-razvitiya-i-taktika-gipertroficheskogo.html - you can find out the etiology of hypertrophic gingivitis.

In the next review we will talk about the approximate prices of plasma lifting in dentistry.

Laser Application

In many large dental centers, lasers are used as a surgical instrument for interventions of this type. During the operation, the patient is given infiltration anesthesia.

The advantage of using this method is that the laser simultaneously eliminates (cauterizes) the tumor and disinfects the area affected by it. As a result, the rehabilitation period is significantly reduced, and postoperative complications are reduced to a minimum.

This is how epulis on the gum is removed using a laser:

Medication

Therapy includes taking drugs that stop the growth of epulis and lead to the regeneration of its tissues. The list of prescribed medications includes:

1. "Traumel S " is a homeopathic remedy that has pronounced regenerative and hemostatic effects.
   It perfectly restores weakened oxidative processes in all tissues and slows down the formation of granulations. Can be taken as tablets or drops in the dosage: 1 tablet/10 drops. three times a day in a course of 10-14 days.
2. "Dimexide" is an anti-inflammatory, antihistamine, analgesic, antiseptic drug. Its active components, penetrating into cells, have a fibrinolytic effect, which helps curb tumor growth. Prescribed by applications: applied for 20 minutes. on the pathogenic area 4-6 times/day.
3. "Miramistin" is a spray that exhibits its antiseptic activity against bacteria and viruses that cause the disease. To achieve the effect, irrigate your mouth up to 4 times during the day.
4. "Vagotil" - has a pronounced sclerosing effect due to the elimination (cauterization) of the affected tissues. During treatment, a bandage is formed, moistened with the drug and applied to the problem area for 3-5 minutes. Important: the procedure can be carried out no more than 3 times a week.
5. "Resorcinol" is an antiseptic, has strong antimicrobial, wound-healing, regenerating, anti-inflammatory, and antiseborrheic effects.
   Its use can lead to complete removal of the growth. For treatment, an ointment of 5-10% is used, which is applied to the affected tissue twice a day.

Important: all of the listed medications can be used in treatment only after they have been prescribed by a dentist. Self-medication in this case is unacceptable.

Folk recipes

Complete treatment using only traditional recipes is impossible. They can, together with medical treatments, speed up recovery during the rehabilitation period.

All recipes are based on the use of rinses with decoctions prepared from various medicinal herbs and remedies:

• Calendula: 2 tbsp.
  l. dried plant pour 1 tbsp. boiling water, leave until cool, strain and rinse your mouth up to 4 times a day. The plant has a good anti-inflammatory, wound healing and antiseptic effect. Calendula can be replaced with other equally effective plants: sage, eucalyptus, chamomile . A decoction of them is prepared in the same way.
• Baking soda : 1 tsp. dissolves in 1 tbsp. warm clean water. Rinsing with it prevents further spread of suppuration, infection and inflammation. This result is achieved due to the fact that soda has a strong disinfectant, antiseptic and mild analgesic effect.
• Salts: dissolve 1 tsp in a glass of hot water. salt, but can be used only after the solution has cooled (6-8 times a day). It relieves swelling well and prevents the spread of bacteria.

All infusions used should be at room temperature, since hot ones can lead to tissue burns, and cold ones can lead to hypothermia.

Before you start using this or that drug in treatment, you need to check with your doctor to what extent its use is indicated in this case.

Complications

As a rule, qualified specialists approach the treatment of the disease with special responsibility, which helps to avoid complications. In exceptional cases, a number of consequences appear:

• relapse;
• swelling of soft tissues after surgery;
• bleeding;
• empyema of soft tissue due to infection with pathogenic bacteria.

Patients are strongly advised to follow all specialist recommendations in the postoperative period.

Do not forget about careful oral hygiene, which will prevent the risk of infection at the wound site. If complications arise, it is not advisable to delay visiting the dentist.