What is stomatitis: where do ulcers on the tongue, palate, and gums come from?

One of the most common diseases associated with damage to the mucous membrane in the human oral cavity is stomatitis, which occurs in approximately a quarter of the entire world population. Children are most susceptible to the disease, the development of stomatitis in the mouth is accompanied by severe symptoms and requires immediate medical attention. But even among adults, stomatitis is not such a rare occurrence.

Therefore, even if you have never encountered the formation of painful ulcers on the palate, mucous membrane, throat or tongue, it will still be useful for you to know what stomatitis is, how it manifests itself, and most importantly, how such a disease is treated with medications . Dentistry "LeaderStom" will tell you about this, as well as how to prevent the occurrence and development of the disease through preventive measures for the hygiene of the human oral mucosa.

Stomatitis: what kind of disease is it, the mechanism of appearance of stomatitis ulcers

Scientists have not yet fully studied the mechanism by which stomatitis occurs on the mucous membrane in a person’s mouth. The manifestation of symptoms of the disease is associated with the specific reaction of a person’s immune system, which he exhibits in relation to irritants present on the mucous membrane of the mouth.

Bacteria, fungi, viruses and other microorganisms act as irritants. Normally, they are always present on human mucous membranes in one quantity or another. But when a person’s immunity is weakened, or other reasons provoke an increase in the number of microorganisms and the development of infectious diseases in the mouth (staphylococcal, streptococcal, candidal, etc.), this fact can trigger a stomatitis reaction.

Ulcers on the human mucosa, which are stomatitis in nature, are formed as a result of the fact that lymphocytes (white blood cells of the human immune system) begin to attack molecules that they cannot recognize. This reaction of the body is similar to that which occurs in the case of organ transplantation. As a result of such a lymphatic attack, stomatitis ulcers are formed on the oral mucosa, which usually go away on their own in one to two weeks without scarring.

Causes of sores on the gums

Ulcers form on the gums for a variety of reasons. The leading prerequisites leading to mouth ulcers are dental diseases , among which the most common are stomatitis and gingivitis. These pathologies are characterized by acute inflammatory processes in the oral cavity.

Photo: ulcer on the gum

In most cases, in adult patients, acute inflammation of the soft tissues near the tooth occurs due to insufficient oral hygiene, as a result of which plaque appears on the teeth, transforming into hard stone, which leads to inflammation of the gums (gingivitis), the development of caries and other diseases.

A common cause of ulcerative formations on the gums are scratches and wounds caused by mechanical damage to the mucous membrane. In most cases, injuries occur due to excessively intensive brushing of teeth, ingestion of hard and rough foods, and thermal and chemical burns.

Aphthae on the mucous membranes of the mouth can occur as a result of an allergic reaction, and systemic infections (syphilis, tuberculosis) can also provoke ulcerative lesions of the soft tissues of the oral cavity.

In addition to the above, a number of diseases of internal organs contribute to the appearance of ulcerative wounds (ulcerative wounds) on the gums:

• kidney dysfunction;
• pathologies of the endocrine system;
• tumor formations of various localizations;
• infectious and inflammatory processes in the intestines (enteritis, colitis).

The severe course of these diseases often causes hypovitaminosis. Lack of vitamins A, C, group B, selenium, zinc, iron leads to excessive dryness of the skin and mucous membranes. As a result, cracks appear on the gums, into which infection easily penetrates, causing ulcerative tissue damage. In addition to internal diseases, vitamin deficiency is caused by poor nutrition, an unbalanced diet, and a lack of plant foods.

Types of stomatitis, causes and symptoms of the disease

Based on the peculiarities of the mechanism of occurrence, stomatitis manifests itself not only as a separate disease, but also as a concomitant sign of the presence of infection in the human body. Depending on what mechanisms provoked the appearance of stomatitis ulcers in the mouth of a child or an adult, various types of stomatitis disease are distinguished.

Types of stomatitis:

1. Aphthous stomatitis.
   This is a common form of the disease that occurs in humans at any age. It appears in the form of yellow-gray ulcers (ulcers) surrounded by a red halo. Oral ulcers occur in groups or singly; they hurt and cause discomfort to a person.
2. Herpetic form of the disease.
   This stomatitis reaction develops against the background of a herpetic infection in the human body. Herpetic stomatitis appears in the form of painful small blisters on the oral mucosa, which are located in groups. Such bubbles burst after 3-4 days. The herpetic form of the disease in both children and adults is accompanied by fever, gingivitis develops on the mucous membrane in the mouth, and a person’s saliva becomes viscous. To treat the disease, the doctor usually prescribes the drug acyclovir to the patient.
3. Vesicular stomatitis.
   In this case, a person with such a disease is contagious, since the causative agent of the disease is an RNA virus. In order to avoid infection, the patient’s personal belongings should be disinfected and separate utensils and personal hygiene products should be provided.
4. Allergic stomatitis reaction.
   The disease occurs due to allergens entering the human body, to which it reacts by forming stomatitis ulcers. Allergic substances enter our body with food or drinks. Foods such as citrus fruits, red berries (strawberries, raspberries), tomatoes, peanuts, chocolate or cereals (since they contain gluten) can provoke an allergic reaction, the development of stomatitis and the formation of ulcers on the mucous membranes of a person’s mouth.
5. Traumatic stomatitis.
   The occurrence of the disease is associated with injuries to the mucous membranes in the human mouth. They appear when a person eats rough food or drinks hot drinks. In addition, an adult or child can simply bite their tongue or scratch an area of ​​the oral mucosa, and this will provoke a stomatitis disease.
6. Catarrhal stomatitis.
   This form of the disease develops if a person does not follow the rules of oral hygiene: neglects daily brushing of teeth, rinsing, and flossing.

Only a doctor can diagnose one or another form of stomatitis disease in an adult or child. Do not try to do this yourself at home, studying photos from the Internet, and prescribe treatment for yourself. Each case is individual, so if you suspect stomatitis in the mouth, you should seek advice from a dentist or therapist. Competent doctors from the LeaderStom network of dental clinics will help you cope with the disease and cure wounds on the oral mucosa, palate, throat and tongue.

Abscess on the gum with periodontitis -

Gum suppuration can look completely different, but in any case, the formation of an abscess on the gum always occurs in the projection of the causative tooth. If the cause of suppuration is an infection in the root canals, then you will always see an old filling or crown on the causative tooth, or the tooth will be partially destroyed. In this case, infection in the root canals gradually leads to the development of a focus of chronic inflammation at the apex of the tooth root.

In dentistry, such inflammation of the tooth is called chronic periodontitis. From time to time, an exacerbation of chronic inflammation may occur, and in this case, pus begins to form at the apex of the tooth root, which comes out through the bone tissue and penetrates under the gum, forming an abscess there. Therefore, please note that with periodontitis, an abscess on the gum most often forms not at the gingival edge, but closer to the projection of the apex of the root of the causative tooth.

Abscess on the gum with periodontitis: photo

Symptoms - an abscess with periodontitis may look like a slight swelling of the gums in the area of ​​1 tooth or in the area of ​​several teeth, if a significant purulent abscess has formed - flux (Fig. 4). Typically, the appearance of gum swelling is preceded by pain when biting one of the teeth. The pain can be acute, but sometimes purulent inflammation can occur without pain. Sometimes, in the projection of gum suppuration, swelling of the soft tissues of the face appears.

The abscess formed under the mucous membrane of the gums can burst with the formation of a fistula opening (Fig. 7-8). The fistula opening is connected through a fistulous tract to the source of inflammation at the apex of the tooth root. Therefore, gradual discharge of pus may be observed from the fistula openings. As soon as the acute inflammation at the root apex subsides and the process of pus formation stops, the fistula openings can close, but only until the process worsens again.

X-ray diagnostics - if you have a fistula or a purulent sac on your gum, treatment is only possible at the dentist. Before starting treatment, you need to take an x-ray to confirm the presence of inflammation at the apex of the tooth root (24stoma.ru). The image will also show the quality of root canal filling, if it was performed previously. It’s sad, but according to official statistics, dentists fill root canals poorly in as many as 60-70% of cases.

The most common mistake dentists make is not filling root canals up to the apex of the tooth root, as a result of which infection begins to multiply in the part of the root canal that is not filled with filling material. As a result, a focus of chronic inflammation develops at the apex of the tooth root, for example, in the form of a cyst or granuloma. Below you can see what cysts and granulomas look like on a diagram, an x-ray, and also on the apex of the root of an extracted tooth.

Treatment of gum suppuration during periodontitis -

If, against the background of an exacerbation of chronic periodontitis, an abscess appears on the gum, then what to do will depend on the results of examining the tooth and analyzing the x-ray. In some cases, it may turn out that the tooth can no longer be treated, and then you will be referred to a surgeon for removal. However, in most cases, it is possible to cure such a tooth, and then the doctor’s algorithm for further actions will depend on whether root canal filling was previously performed in this tooth.

1) If the root canals are not filled –

This greatly facilitates the doctor’s work, because... in this case, the dentist will not have to go through the trouble of unsealing poorly filled root canals. In this case, a standard method of treating periodontitis is used, which includes mechanical treatment of the root canals + treatment of the inflammation at the root apex. On your first visit, the dentist will remove your old filling or crown, drill out tooth tissues destroyed by caries, and perform a mechanical expansion of the root canals to allow pus to drain out through them.

After this, the dentist will prescribe you antibiotics, antiseptic rinses, and will most likely send you to a surgeon to make an incision in the gums, which is necessary to create a good outflow of pus. After 3-4 days, the dentist will make an appointment for you again to complete the mechanical treatment of the root canals and seal them. If the lesion is small at the apex of the tooth root, the doctor can immediately perform a permanent filling of the root canals with gutta-percha. But usually, the canals first have to be filled with temporary medicinal paste for a period of 1-2 months, and only after that permanent filling with gutta-percha is carried out.

How the gum incision is made - the incision is usually completely painless and is performed under local anesthesia. If the abscess is small, the size of the incision usually does not exceed 5-7 mm, but if a large purulent abscess develops (as in the video below), the incision is made up to 1.5 cm. After opening, pus comes out of the gum, then the wound is washed with antiseptics and into it a small rubber drain is inserted. The latter prevents the edges of the wound from sticking together, which is necessary so that the inflammatory purulent exudate does not accumulate, but continues to separate from the wound. The drainage is usually left for several days.

2) If the canals in the tooth are sealed poorly -

If the dentist sees on an x-ray that the cause of suppuration lies in poor-quality root canal filling performed earlier, then there are 2 possible treatment options. This is either a standard treatment of periodontitis with preliminary filling of the root canals, or a minor surgical operation (resection of the root apex)…

• Standard therapeutic treatment - on the first visit, the dentist drills out the old filling, removes the crown and tries to unfill poorly filled root canals.
  Next, the canals are washed with antiseptics, the tooth is left open for several days + antibiotics are prescribed. If necessary, the patient is also sent to a surgeon for a gum incision. Thus, unlike the previous treatment option, only 1 point has been added here - unsealing the root canals. When the inflammation subsides after a few days, first, either temporary filling of the canals with medicinal paste, or immediate permanent filling with gutta-percha can be carried out. The medicinal paste is left in the canals for a period of 1 to 3 months. During this period, an x-ray will be taken to record a decrease in the size of the focus of chronic inflammation at the apex of the tooth root. When the lesion disappears or becomes small, the canals will be sealed with gutta-percha and a permanent filling or crown will be placed.
• Resection of the root apex (Fig. 13) –

  
  This method allows you not to re-treat root canals or remove the crown from the tooth.
  It consists of making a small incision in the projection of the apex of the tooth root on the gum, through which the doctor uses a drill to cut off the apex of the root with the unfilled part of the root canal from the tooth. Also, a cyst or granuloma is scraped out of the wound. However, the operation can only be performed on those patients whose root canal is poorly filled only at the very apex of the root. Root resection is a very simple operation and usually takes only 25-35 minutes. It is easiest to carry out on the front teeth, much more difficult on the side teeth. Low cost of the operation + no need to spend money on replacing the crown and re-treating the tooth. The operation is performed after the acute inflammation has been relieved, which may require an incision and antibiotic therapy.

→ Root apex resection operation

Stomatitis in a child: symptoms, causes

The description of stomatitis in a child deserves special attention. The specificity of stomatitis that occurs in the mouth of a young child is that the disease is a consequence of a weakened or not fully formed immune system. Therefore, the stomatitis reaction manifests itself clearly and the course of the disease is accompanied by severe symptoms.

Symptoms of stomatitis in a child:

• The oral mucosa turns red and swelling appears.
• Characteristic stomatitis ulcers form in the mouth, which are located either singly or in groups. The localization of ulcerative formations during stomatitis in a child is different: wounds and blisters appear on the tongue, on the palate, mucous membrane or in the throat. The nature of the lesions depends on the form of the disease and on what factors triggered the reaction (infections, allergies, vitamin deficiency, etc.).
• The development of stomatitis in the baby’s oral cavity is accompanied by an increase in the child’s body temperature (up to 38-39 degrees).
• The baby’s submandibular lymph nodes increase in volume and become painful on palpation.
• The child becomes lethargic, drowsy, capricious and whiny.

The baby has a hard time suffering from stomatitis in the mouth, and this is a lot of stress for the young body, not to mention the fact that the disease worsens the child’s appetite and disrupts the child’s sleep pattern. Therefore, if you notice the formation of ulcers in the mouth of your daughter or son or identify other symptoms of stomatitis, immediately show your child to a doctor (dentist or therapist).

Studying pictures and photographs of other children with oral stomatitis on the Internet is pointless; you will only waste your time and may come to the wrong conclusions. The doctor will help you understand the reasons that provoked the development of stomatitis in the child’s mouth and prescribe effective treatment for stomatitis.

How not to damage white plaque after wisdom tooth removal

To eliminate the risk of complications and speed up the recovery process, you need to follow the rules of behavior after tooth extraction:

• do not eat or drink for 3 hours after surgery;
• stop smoking and drinking alcohol for a while;
• do not heat the cheek and gums, avoid overheating;
• for the first 24 hours, do not rinse your mouth or brush your teeth;
• Do not go to the bathhouse for a week, do not play sports.

Smoking is contraindicated, as it provokes vasospasm: the bleeding stops too quickly, the blood clot is not formed enough. Hot drinks, warming the cheek, sports training and visiting a bathhouse cause overheating of the body and dilation of blood vessels, which can cause re-bleeding, opening and infection of the wound.

Rinsing and brushing the mouth are acceptable 24 hours after tooth extraction, but they should not be overly vigorous. Hygienic procedures must be moderate so that the blood clot remains in the cavity and the subsequently formed fibrinous protective layer is not damaged. During the recovery period, food should be chewed only on the non-operated side of the jaw.

If you have a fever and severe pain in the first few days after tooth extraction, you can take Paracetamol - this will help reduce discomfort and improve your well-being.

Which people are at risk for stomatitis?

As already noted, children are primarily susceptible to stomatitis, since their immune system is just learning to fight infections and diseases and respond to irritants appropriately. Therefore, if, with timely consultation with a doctor and proper treatment, your baby still chronically develops stomatitis in the mouth, then perhaps the reason is due to age, and over time these problems will disappear.

But besides age, there are other factors that increase the risk of stomatitis ulcers in a person’s mouth. They are associated with various reasons, some of which we have already named when characterizing the types of stomatitis, but now we will try to specify each factor separately.

Those at risk for possible development of stomatitis include:

• People with a hereditary predisposition to the disease. Scientists have proven that the likelihood that stomatitis will develop in a person’s mouth (on the palate, mucous membrane, throat or tongue) increases if one or both parents have ever encountered similar problems. The best way out in this situation is to follow the rules of oral hygiene and take vitamin and immunomodulatory complexes as prescribed by your doctor.
• People with current somatic diseases. Quite often situations arise when stomatitis chronically develops in a person’s mouth without any obvious reason. During a complete examination of the body of such a person, any diseases are usually revealed, in particular, diseases of the gastrointestinal tract (giardiasis or helminthic infestations). Parasites, while in the body, may not manifest themselves in any way and not bother a person for years, but they reduce his immunity and prevent resistance to infections and other diseases. In this case, in order to get rid of stomatitis in the oral cavity, a person should undergo a course of treatment that will allow him to get rid of other concomitant diseases.
• People with reduced immunity. Human immunity is reduced not only by somatic diseases, but also, for example, by factors such as stress. Therefore, if you have a hard job or tense family relationships, this can cause chronic stomatitis, localized on the oral mucosa. In addition, frequent occurrence of ulcers in a person's mouth may indicate more serious problems with the immune system caused by a disease such as AIDS. Therefore, in this situation, a person is recommended to get tested, undergo a full examination of the body and get plenty of rest.
• People with bad habits. Bad habits such as alcohol, smoking and drug use can cause stomatitis and the formation of painful ulcers in the mouth. The fact is that such a lifestyle weakens the immune system and undermines human health. In addition, cigarette smoke and alcohol create favorable conditions in the oral cavity for the development of bacteria, viruses and fungal infections, which provoke the appearance of stomatitis ulcers on the human mucosa.

If you have seen photographs of people with stomatitis in the mouth, then you have probably noticed how unattractive this disease looks, not to mention how much discomfort it causes to a person. Therefore, if you are at risk for the possibility of developing stomatitis ulcers on the mucous membrane, palate, throat or tongue, then you should take measures to reduce the chances of getting stomatitis: quit bad habits, undergo a course of treatment for somatic diseases, increase your immunity and take vitamin complexes. But these measures should be taken only after consulting a doctor.

Pus in the gums with periodontitis -

Very often, the patient’s complaints that his gums near the tooth are festering are not associated with inflammation at the apex of the tooth root during periodontitis, but with the formation of periodontal pockets in local or generalized forms of periodontitis. With periodontitis, there is destruction of the attachment of the gingival margin to the necks of the teeth, destruction of the alveolar bone around the teeth, as well as periodontal fibers, with the help of which the tooth is attached to the bone tissue.

All this leads to the formation of so-called periodontal pockets between the gum and the surface of the roots of the teeth (Fig. 14). They create good conditions for the proliferation of pathogenic bacteria and the development of chronic inflammation. When one of the periodontal pockets becomes too deep, this can lead to disruption of the discharge of inflammatory serous-purulent exudate through the lumen of the pocket. As a result, an abscess forms in the projection of the periodontal pocket on the gum, which dentists call the term “periodontal abscess” (Fig. 15-16).

You can immediately suspect that gum swelling is associated with periodontitis, and not with periodontitis, if the tooth is completely intact (i.e., externally healthy and does not have a filling, crown or caries), if it has mobility, and mobility was present in this tooth and before the gums become suppurated, and also if, with slight gentle pressure on the abscess, pus comes out from under the gums (as in Fig. 16).

The differences between local and generalized periodontitis are that they are caused by completely different reasons and, accordingly, the treatment will also be different. With local periodontitis, the inflammatory process occurs only in the area of ​​1-2 teeth - due to exposure to a traumatic factor. For example, a pocket may appear as a result of trauma to the gum margin by the overhanging edge of a filling or crown. The cause may also be the premature closure of several teeth, which leads to chewing overload and destruction of the bone tissue around them.

But with chronic generalized periodontitis, gum suppuration occurs for other reasons. You can immediately suspect this form of periodontitis if you have symptoms of bleeding and pain when brushing your teeth, swelling, redness or bluishness of the gum margins in the area of ​​most teeth. The cause of generalized periodontitis is soft microbial plaque and hard tartar, which accumulate on the teeth as a result of insufficient oral hygiene.

Bacteria in plaque and tartar produce toxins and various pathogens that trigger an inflammatory reaction in the gums. With prolonged inflammation, first the dental-gingival attachment is destroyed, and then the periodontal fibers and bone tissue around the teeth are destroyed. With this form of periodontitis, pockets are found in almost all teeth, and not just in 1-2 (as with local periodontitis). When the outflow of inflammatory serous-purulent exudate in one of the pockets is disrupted, a periodontal abscess is formed in the gums.

Treatment of local periodontitis –

Based on the examination, the identified amount of tooth mobility, probing the depth of the periodontal pocket and analysis of the x-ray, the doctor will determine the possibility of saving the tooth and the algorithm for further treatment.
If the tooth can be saved, then the first thing to do in case of local periodontitis is to eliminate the impact of the traumatic factor. This means that you need to remove the overhanging edge of the filling or crown, and selectively grind the contacts of the chewing surface of the causative tooth and its antagonists. Next, under anesthesia, the periodontal abscess is opened to allow the outflow of pus and to rinse the periodontal pocket with antiseptics. If pus comes out of the pocket without an incision, but only little by little, then after anesthesia you still need to widen the mouth of the pocket with a stroker. Next, the doctor prescribes systemic antibiotic therapy, anti-inflammatory drugs, and antiseptic rinses.

Opening of periodontal abscess –

Next, the issue of the need to fill the root canals in the causative tooth is resolved. This must be done if the depth of the periodontal pocket reaches 2/3 or more of the length of the root of this tooth. Removing the nerve from the tooth and filling the canals is required here because infection from a deep pocket very easily penetrates through the bloodstream into the neurovascular bundle (tooth pulp), as a result of which the pulp itself becomes a source of infection. But all this is just initial basic treatment!

The main treatment consists of open curettage of the periodontal pocket. This operation allows you to remove inflammatory granulation tissue (which forms at the site of destroyed bone tissue) from under the gums, as well as fill the periodontal pocket cleared of granulations with bone material, which allows you to partially restore the level of bone tissue around the tooth.

Progress of open curettage operation –

During open curettage, the gums are first moved away from the teeth and bone tissue to create good access to the periodontal pocket. Then the granulations are removed from the pocket, the root surface is polished and the pocket is filled with material based on artificial or bovine bone tissue. Next, the flaps of the gum mucosa are placed in place and the gum is sutured. Figure 19 shows that the bone level differs between radiographs taken before and 4 months after surgery (an increase in bone level of approximately 2.5 mm).

Moreover, if an abscess on the gum occurs near a moving tooth, then in addition to all of the above treatment, splinting of the moving tooth may be required. For this purpose, fiberglass and filling material are used, with the help of which the movable tooth is fixed to the adjacent stable teeth. Detailed information on curettage and splinting in the articles:

→ How the open curettage operation is performed, → Teeth splinting technique

Treatment of generalized periodontitis –

With generalized periodontitis, periodontal pockets occur not in 1-2, but in almost all teeth. Typically, this form of periodontitis has a sluggish chronic course. Common complaints from patients include bleeding gums and inflammation of the gingival margin. In severe cases, tooth mobility, changes in the position and inclination of teeth, and suppuration from periodontal pockets occur.

Against the background of decreased immunity, an exacerbation of chronic inflammation may occur, and then abscess formation (i.e., the formation of purulent abscesses) may occur in the area of ​​one or more periodontal pockets. Treatment of the generalized form of periodontitis is very complex, and we have devoted a separate article to this topic, which you can read at the link above. We hope that our article on the topic: What to do if your gums are swollen turned out to be useful to you!

Sources:

1. Dental education of the author of the article, 2. Based on personal experience as a dental surgeon, 3. National Library of Medicine (USA), 4. “Outpatient surgical dentistry” (Bezrukov V.), 5. “Therapeutic dentistry: Textbook” ( Borovsky E.).

Treatment methods for stomatitis

Local treatment of stomatitis involves treating ulcers on the palate, tongue, or other areas of the oral mucosa with antiseptic agents. If stomatitis ulcers appear in the throat, the patient is prescribed gargling with an antiseptic solution or medicinal herbs.

General therapy for the disease includes drugs that are aimed at eliminating the causes of stomatitis in the mouth: antibiotics (for a bacterial infection), antiviral drugs (for example, acyclovir for herpetic stomatitis in the mouth), antifungals (if the cause of stomatitis is a fungus of the genus Candida or what -other), antihistamines (for allergic stomatitis or to relieve swelling during the inflammatory process), etc.

For prevention, increasing the defenses of the human body and in order to prevent complications and the development of chronic stomatitis, the patient is prescribed immunomodulatory agents and vitamin complexes. To relieve pain and reduce fever during stomatitis, doctors use painkillers.

The closure and disappearance of stomatitis ulcers with appropriate treatment of stomatitis disease and inflammation that occurs in the human mucosa usually occurs within 1-2 weeks, but you should take medications prescribed by your doctor strictly within the course. The fact that you felt better and stopped experiencing pain and discomfort due to stomatitis in the mouth does not yet indicate that the disease has been cured.

Strictly follow all the doctor’s recommendations and do not try to cure stomatitis yourself, using the advice of friends or photographs and recipes for preparing medicinal potions found on the Internet. At best, you simply will not achieve the desired effect, and at worst, you will increase the symptoms of the disease.

Gingivitis and periodontitis

Cause

Gingivitis is an inflammation of the gums, and periodontitis is a more severe form of the disease when not only the gums, but also the jaw bone are involved in the inflammatory process. Both diseases are often chronic and do not cause the patient much discomfort, but during periods of exacerbation more severe symptoms appear and the patient consults a doctor.

There are many causes of gum inflammation:

• hard and soft dental deposits;
• sharp edges of crowns and fillings, which constantly injure the mucous membrane;
• improperly restored contact points between teeth (due to which food accumulates in the gap, puts pressure on the gums and is an excellent place for microorganisms to settle);
• malocclusion (crowding of teeth, incorrect position in the arch);
• general diseases (diabetes, vascular problems, infectious diseases and others) can cause gum inflammation;
• changes in hormonal levels (during pregnancy, for example).

These are not all possible causes of gum disease, but most patient visits have one (or several) of these factors predisposing to inflammation in the gums.

Constant trauma (from food, the edge of a crown, tartar), microbial toxins, and impaired blood flow in the gums lead to the development of an inflammatory process. Usually, pus as such is not visible, but during periods of exacerbation, noticeable suppuration often occurs from periodontal pockets or its accumulation in the thickness of the mucosa (this formation is called a periodontal abscess).

Symptoms of gingivitis (periodontitis) in the acute stage

Patients with this diagnosis complain of:

• pain in the gums near a group of teeth;
• redness of the gums, swelling, pain when touched;
• it hurts to brush your teeth and eat;
• pus (sometimes with bloody veins) is released from the periodontal pocket or from the fistula tract (a fistula can form if the pockets are very deep);
• with gingivitis, the teeth usually do not suffer, but with periodontitis, tooth mobility, exposure of roots, pain from cold and sweet foods may be observed (since the root is more sensitive to irritants than the crown part of the tooth);
• Sometimes there is a deterioration in general health: fever, weakness, headache.

Exacerbations most often occur against the background of a general decrease in immunity (with acute respiratory infections or other diseases). In addition, periodontitis is characterized by seasonality (in spring and autumn, exacerbations occur more often).

Diagnostics

How to distinguish periodontitis from periodontitis? Outwardly, both cases may look the same: swollen gums, redness, a fistulous tract from which pus is released. In both cases, it hurts to bite on the teeth. In addition, one disease does not exclude another (there are cases when a tooth is surrounded by inflamed bone on all sides and it is almost impossible to say with certainty what is primary: periodontitis or periodontitis).

An x-ray is required to make a correct diagnosis and choose treatment tactics. In the image with gingivitis, we will not see any changes at all, but with periodontitis, areas where there is no bone tissue will be visible, while the teeth will be either healthy or well treated.

Treatment

It must be said right away that gingivitis is a reversible process, and periodontitis cannot be completely cured in most cases (it can be stopped, put into remission, but growing back the height of the bone is very problematic, and in many cases it is completely impossible).

If in the case of periodontitis we were dealing with microbes inside the root canal, then here we also have a microbial infection, only it is localized in the gums and bone. Treatment should be aimed at combating the cause, so the following measures can be taken:

• mandatory professional hygiene – removal of soft and hard dental plaque, polishing the surface of teeth, removal of granulations from periodontal pockets;
• correction of fillings and orthopedic structures, creation of normal contact points between teeth;
• if there is mobility of the teeth, they need to be splinted (limit movement);
• active anti-inflammatory therapy (rinses, dressings, ointments with antimicrobial action, in severe cases - antibiotics);
• general therapy (at the doctor’s discretion and depending on the severity of the process, antihistamines, painkillers, immunostimulants, vitamins, etc. can be added).

Usually this is enough to stop suppuration and relieve the acute process. To prevent exacerbations in the future, it is imperative to maintain hygiene (remove tartar at least once every six months), restore the dentition (if some teeth are missing), correct the bite (if there are problems with this) and maintain general health (if the cause of periodontitis is some common diseases).

Acute and chronic stomatitis, what is the difference?

There are two forms of stomatitis disease: acute and chronic. For the first time, stomatitis usually manifests itself in an acute form, characterized by the sudden appearance of ulcers on the palate, mucous membranes in the mouth, tongue or throat of a person. The ulcers hurt and cause discomfort when talking or eating.

Acute stomatitis goes away on its own after 7-10 days, even if it is not treated, but in most cases the disease returns in a chronic form. This means that a person develops stomatitis ulcers in the oral cavity from time to time throughout his life. In order to prevent the transition of stomatitis disease from an acute to a chronic form, a person should undergo a course of treatment for the disease at the initial stage. It is very important that a plan and methodology for combating stomatitis in the patient’s mouth is developed by a competent and competent doctor who could take into account all the factors that could provoke this disease and get rid of them.

The LeaderStom clinic invites you to diagnose stomatitis and undergo a course of effective treatment under the supervision of the institution’s experienced dentists. Our doctors know modern methods of combating this disease in patients of different ages and are able not only to solve the existing problem, but also to give valuable recommendations for further oral care in order to prevent the occurrence of stomatitis ulcers on the mucous membrane, palate, throat or tongue of a person again .

Symptoms of gum injuries

Patients usually notice acute injuries immediately, while signs of chronic injuries may appear gradually. At the first stage, symptoms of inflammation appear, the mucous membrane turns red and swells. Painful sensations appear when pressing on the injured area. If the damage is mechanical, the injured area on the mucosa is usually clearly visible. With regular chemical or thermal burns, an eroded area appears on it, which becomes covered with a gray coating and bleeds easily.

Without treatment, the gum condition may worsen:

• an ulcer with a dark surface appears on the injured area;
• serous or purulent discharge appears;
• a wound may form with swelling around it. Its edges are usually roughened, and it bleeds easily;
• severe pain in the affected area appears.