Gum pain
Gum pain occurs with gingivitis, periodontitis, periodontal disease, stomatitis, developing against the background of local changes or somatic diseases. It is detected in cases of malocclusion, mechanical damage. It can be weak, intense, permanent, short-term. It often appears when eating, brushing teeth. The cause of the symptom is determined based on complaints, dental examination data and additional studies. Treatment is carried out using general and local remedies: antiseptics, anesthetics, analgesics, antibiotics, anti-inflammatory drugs. According to the indications, dental operations are performed.
General characteristics
Why do the gums hurt
Gingivitis
Periodontal disease
Periodontitis
Stomatitis
Malocclusion
Mechanical damage
Allergic reactions
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
General characteristics
The pain is caused by changes in the gums and periodontal, which occur under the influence of local factors: poor oral hygiene, the presence of tartar, functional periodontal insufficiency due to a decrease in chewing load when eating too soft food. Smoking plays a significant role. Common factors affecting the condition of the oral cavity tissues are gastrointestinal diseases, infectious and endocrine pathologies, natural changes in hormone levels, harmful professional influences.
These reasons entail the formation of an environment favorable for the activity of pathogenic microorganisms, the development of inflammation, a violation of local blood supply and nutrition of the gum, a change in its structure. As a result, there is a pain syndrome. Often, periodontal disease is involved in the pathological process, the disease is chronicled, leads to gross local changes and loss of teeth.
Why do the gums hurt
Gingivitis
It can be local or widespread. It is manifested by soreness, swelling, redness, an increase in local temperature, bleeding, the formation of spot hemorrhages or areas of ulceration. Hypersalivation is observed. The clinical picture varies somewhat depending on the type of gingivitis:
Catarrhal. The pain is minor, it occurs in contact with food. The main symptoms are pronounced signs of inflammation, sensitivity of the gums to temperature changes. The general condition is not disturbed.
Ulcerative-necrotic. Against the background of the formation of areas of necrosis and ulceration, the gums become sharply painful. Eating is difficult. The breath is fetid. There is a deterioration in the general condition: weakness, weakness, subfebrile or febrile temperature.
Hypertrophic. It is asymptomatic for a long time, it is detected accidentally during dental examinations. Subsequently, in the absence of treatment, pain in the gums gradually progresses due to touching, eating. Pronounced unpleasant sensations when brushing teeth make patients refuse this procedure, which further worsens the condition of the oral cavity.
Desquamative. It occurs more often in women during menopause, due to a decrease in the number of keratin-containing cells and increased mucosal permeability. It is manifested by soreness and bleeding of the gums, even with weak influences.
Periodontal disease
The disease is based on periodontal atrophy with loosening of the gums, destruction of the dentoalveolar joints, penetration of plaque into them and subsequent tissue damage. As a result, the gums begin to bleed. There is pain when any stimuli act. Recurrent inflammatory processes develop against the background of periodontal disease. Pathology may be primary, but it is more often diagnosed in patients with hypovitaminosis, diseases of the digestive tract, cardiovascular and endocrine systems.
Gum pain
Gum pain
Periodontitis
The cause of periodontal damage is plaque, which transforms into tartar. Pain with periodontitis is rarely observed, mainly at the initial stage, with gum inflammation (gingivitis). In the future, redness, bleeding, edema, local hyperthermia prevail. There is an increase in sensitivity to the action of stimuli, which some patients interpret as minor soreness.
As in the previous case, the disease may develop initially, but it is more often detected against the background of other pathologies. Periodontitis in diabetes mellitus is particularly persistent. The disease develops rapidly or progresses during pregnancy, breastfeeding and menopause, especially if there is a history of gingivitis. It is observed in endemic goiter and Itsenko-Cushing’s disease.
Stomatitis
Gum pain is most characteristic of Vincent’s stomatitis. Soreness and bleeding of the gums become the first symptoms of the disease. This is due to the fact that the pathological process begins with the gingival margin, and only then spreads to other areas of the mucosa. Subsequently, erosions and ulcers appear. There is a putrid smell from the mouth, subfebrility.
In other types of pathology, the presence or absence of painful sensations in the gum area is determined by the affected area. In patients with ulcerative stomatitis, the symptom is observed when defects are located near the edge of the gum and the inflammatory process spreads to nearby tissues. Manifestations are especially pronounced in the presence of severe somatic diseases and in childhood.
Malocclusion
Pain in the gums with malocclusion develops against the background of the dental pathologies listed above (periodontal disease, periodontitis, etc.), which are secondary in nature and arise as a result of violations of contact between teeth, improper distribution of chewing load and chronic traumatization. The symptom is observed in some patients with deep and cross bite. It can occur with distal and mesial bite.
Mechanical damage
Gum injury can be acute or chronic. Acute injuries are the result of accidents in everyday life (for example, a blow or fall), scratching with hard pieces of food (fish bone, the edge of a cracked nut) or medical instruments during dental procedures. The pain is local, sometimes accompanied by bleeding or hemorrhage. They disappear after a few days. Chronic injuries are associated with poor fitting of dentures. The pain is not intense, persists for a long time, increases during meals.
Allergic reactions
Allergy to prosthetic materials, as a rule, is a type of stomatitis (contact allergic stomatitis). Along with pain when eating, it is manifested by dryness, burning and the presence of a metallic taste in the mouth. It can develop many months or even years after the installation of prostheses. It is combined with swelling of the mucous membrane of the cheeks, soft palate and tongue, burning in the tongue, impaired taste sensitivity.
Diagnostics
The dentist is responsible for determining the cause of gum pain. Dental examination involves assessing oral hygiene, studying the condition of soft tissues, identifying signs of inflammation and mucosal defects, determining the presence and severity of periodontal pockets and tooth mobility. As part of an additional examination , the following procedures are prescribed:
Radiography. With inflammatory periodontal diseases, osteoporosis is visible in the pictures. Horizontal destruction indicates a chronic course of pathology, vertical destruction indicates the formation of abscesses. In periodontal disease, osteoporosis is combined with sclerotic changes. According to the results of radiovisiography or orthopantomography, the type and severity of malocclusion are evaluated.
Bacteriological or bacterioscopic examination. It is performed for Vincent’s stomatitis, inflammatory periodontal diseases. This type of stomatitis is characterized by a large number of borrelia of Vincent. In other cases, various types of pathogenic bacteria are detected, less often fungi.
Other laboratory tests. The inflammatory process is accompanied by leukocytosis and an increase in ESR in the general blood test. If an allergy is suspected, intradermal, scarification, cutaneous drip, exposure and elimination allergic tests are carried out.
Dental examination
Dental examination
Treatment
Conservative therapy
Mandatory measures for pathologies accompanied by gum pain are professional oral hygiene and treatment of carious teeth. In case of allergies, mechanical injuries due to errors in the installation of prostheses, repeated prosthetics or correction of structures is necessary. Patients with malocclusion undergo orthodontic treatment. Taking into account the nature of the disease, therapeutic schemes may include:
Gingivitis. Means to improve local immunity are shown. After eating, it is recommended to rinse your mouth with herbal decoctions and antiseptic solutions. With intense pain syndrome, analgesics are prescribed.
Periodontal diseases. Antibiotics and anti-inflammatory drugs are used for periodontitis. In periodontal disease, electrophoresis, hydro- and vacuum therapy are used to improve local blood supply. Movable teeth are fixed with temporary splints.
Vincent’s stomatitis. As part of local treatment, local anesthetics, sorbents, drugs with proteolytic, antimicrobial and antiprotozoal effects are applied. At the resolution stage, keratoplasty is effective, accelerating tissue repair. Common remedies include antibiotics, NSAIDs, antihistamines, antipyretics, and pain medications.
Surgical treatment
Gingivectomy is performed in patients with hyperplastic gingivitis accompanied by persistent hyperplasia. Treatment of periodontal diseases includes gingivotomy, curettage of periodontal pockets. 3-4 degree of mobility of teeth is an indication for their removal with subsequent prosthetics .
