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Abstract: A 16-year-old male presented with symptoms of gingival swelling and pain, oral odor, and gingival bleeding during tooth brushing, and was examined for the presence of malocclusion along with dental calculus, which is a typical clinical manifestation of gingivitis. Considering the residual food residue in the teeth due to the malocclusion, coupled with improper cleaning causing calculus, long-term food residue stimulation led to gingivitis. After systematic cleaning and orthodontic treatment, the boy’s oral discomfort symptoms were better relieved.
Basic information】Male, 16 years old
Disease Type】Mismatch, gingivitis
Hospital】Qilu Hospital of Shandong University
Date of consultation】October 2020
Treatment plan】Surgical treatment (supragingival scaling) + orthodontic treatment (fixed braces)
Treatment Period】8 days of combined treatment and regular checkups
Results】Gum swelling and bleeding symptoms disappeared, and the misalignment improved
I. Initial consultation
When we first saw the patient, the patient’s left gum was swollen. He reported that he had a soreness and swelling in his mouth 1 week ago but did not care about it, but as time went by, the symptoms gradually worsened, with red, swollen and painful gums, an odor in his mouth, and gum bleeding when he brushed his teeth. After asking the patient to brush only once a day, observation of the oral cavity revealed that the patient had malocclusion, as well as yellowish-brown and brownish-black calculus at the gingival margin and obvious congestion of the gums, which could be initially diagnosed as gingivitis and malocclusion.
Second, the treatment process
After obtaining the patient’s consent, a periodontal probe was used to explore the periodontium, and blood oozing around the gingiva was found, but no caries was found and no tooth loosening. The treatment was a full-mouth supragingival scaling, with the application of a scaling instrument to remove calculus around the gums and pigmentation on the tooth surface, followed by polishing of the tooth surface. After oral scaling, the patient left the office and was reviewed after 1 week. After the gingivitis symptoms were relieved, orthodontic treatment was performed in the patient’s mouth to establish a good occlusal relationship through bone reconstruction with fixed orthodontic appliances.
III. Treatment effect
After supragingival scaling, the patient reported that the symptoms of gingival bleeding during brushing had significantly improved, and the symptoms of gingival swelling and pain had almost completely disappeared, and oral examination revealed that the symptoms of gingival congestion had basically subsided and the oral odor had significantly improved, indicating that the treatment effect was good. After wearing fixed orthodontic appliances, the symptoms of dental malocclusion have also been significantly improved, and the bite relationship is normal, but attention needs to be paid to regular re-examination to observe the orthodontic effect.
IV. Notes
Seeing the patient’s teeth aesthetically pleasing and self-confidence improving, I am sincerely happy for him, but I ask the patient to pay attention to the following matters.
1, patients need to develop good oral hygiene habits, pay attention to the use of soft-bristled toothbrush and brush teeth with the modified pasteur method, while it is recommended to brush teeth in the morning and evening, rinse mouth after meals, which can help reduce food residue in the mouth and inhibit bacterial growth.
2. Patients should pay attention to the proper intake of fresh vegetables and fruits to replenish the vitamins needed by the body, and it is also recommended to do proper exercises to help physical and mental health. It is also recommended to maintain a regular rest and relaxed mood, avoiding frequent late nights, mental tension, etc., so as not to stimulate the aggravation of symptoms.
3.After the recovery of symptoms, it is recommended to have 1-2 oral health check-ups every year to avoid tooth decay, gum inflammation and other undesirable conditions.
V. Personal insight
The presence of dental calculus, gum swelling and pain in the mouth of 16-year-old boys is mainly due to the lack of attention to oral hygiene in daily life, which should be noticed. We call on everyone to raise the awareness of oral health care, whether children, young people, or middle-aged and elderly people, should develop good oral hygiene habits, and for people with malocclusion, try to correct it in childhood and youth, which can help maintain dental health and avoid oral diseases such as gingivitis and periodontitis.