Chronic Gingivitis: A Case of Successful Treatment in a Young Man with Chronic Gastric Duodenitis
Introduction
A 17-year-old young man presented to the medical center with complaints of severe bleeding from all gums in the mouth.
Complaints
The patient was also concerned about a foul odor and plaque on the teeth that could not be completely removed. He also noticed that his gums had acquired a strange shape.
Bleeding occurred during tooth brushing and eating. The bad breath disappeared only when eating.
History
He had not previously consulted a dentist. He did not practice professional oral hygiene. He cleaned his teeth in a standard way irregularly.
He had no harmful habits. He did not follow a proper diet. He considered the quality of his diet unsatisfactory: he ate a monotonous, unbalanced diet. He abused carbonated drinks. He consumed milk in large quantities (up to 1.5–2 liters per day).
He was under observation by a gastroenterologist for chronic gastric duodenitis. His mother also suffers from gastritis.
Examination
On examination, the skin around the neck and mouth was of normal color. Palpation of the chewing muscles did not cause pain. The lymph nodes were soft, painless, not adhered to surrounding tissues. The temporomandibular joint (TMJ) was unremarkable, with painless and symmetrical movements.
On oral examination, an improper bite was determined. Multiple carious lesions were observed on the teeth. The DMF index (Decayed, Missing, and Filled teeth index) was 4 (moderate). The mucous membrane of the lips, cheeks, palate, tongue, and floor of the mouth was pale-pink and moderately moist. Both gums were red, swollen, and bled upon palpation.
Upon probing the gingival sulci with a probe, false gingival pockets were identified due to swelling and thickening of the gums, as well as soft and hard dental deposits in the subgingival area of all teeth.
According to the results of other examinations:
- Oral Hygiene Index (OHI-S, index of dental deposits) – 2.5 (unsatisfactory);
- PMA index (gingivitis) – 60% (moderate severity);
- Hygiene index – 3.7 points (very poor level).
Diagnosis
Chronic gingivitis.
Treatment
The patient underwent treatment:
- Application anesthesia was performed;
- Subgingival dental deposits were removed with ultrasonic instruments;
- Supragingival dental deposits were removed with a brush on a mechanical tip and polishing paste;
- Gingiva and oral cavity were medicated with a 0.05% Chlorhexidine solution;
- Teeth were covered with fluoride varnish.
For home care, he was prescribed a soft toothbrush for one week, toothpaste with a plant component, and dental floss.
The patient was also advised to consult a gastroenterologist.
One week after the treatment, bleeding and intensity of mouth odor decreased. Examination showed a reduction in gum swelling covering the gingival area of the tooth. There were minor soft dental deposits left, and there were no subgingival dental deposits.
Professional oral hygiene helped reduce gum swelling, redness, and bleeding, and improved hygiene index scores. Breath became fresher. The patient was advised to undergo such a procedure at least once every six months.
Conclusion
This clinical case shows that actively progressing gingivitis against the background of inflammatory diseases of the gastrointestinal tract can take on a chronic, generalized character.
In such cases, professional hygiene becomes an integral part of comprehensive treatment together with therapy conducted by specialists in related fields: gastroenterologists and endocrinologists.