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Abstract: The patient was admitted to the hospital for poorly controlled diabetes mellitus and also presented with toothache and was treated in our outpatient clinic. Examination revealed red and swollen gums with calculus, thickened gingival margins, bleeding on probing, and a gingival sulcus depth of 4-6 mm in some teeth, which was diagnosed as gingivitis. He was given periodontal supragingival scaling and subgingival scraping, as well as compound chlorhexidine rinse for antibacterial treatment, and his symptoms improved after 4 weeks.
Basic information】Female, 62 years old
Disease Type】Gingivitis
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of Consultation】March 2021
Treatment plan】Oral medication (amoxicillin capsules, metronidazole tablets) + surgical treatment (supragingival scaling, subgingival scraping) + topical medication (compound chlorhexidine rinse, minocycline hydrochloride ointment)
Treatment period】4 weeks of outpatient treatment
Treatment effect] Toothache symptoms disappeared
I. Initial consultation
The patient is female, 62 years old. She had been hospitalized in our department for diabetes mellitus and was discharged with hypoglycemic drugs (details unknown). The effect was not good, so he was admitted to hospital for treatment. Oral examination revealed red and swollen gums, calculus in the neck of the teeth, thickening of the gingival margin and detachment from the tooth surface, bleeding when touched with a probe, and the depth of the gingival sulcus in some teeth reached 4-6 mm, which was initially diagnosed as gingivitis.
Second, the treatment process
After examination, the patient was informed of the specific oral conditions and the treatment needed, which could be periodontal supragingival scaling to remove calculus. 2 weeks later, after good glycemic control, subgingival scaling was first performed on the left upper and lower jaws, followed by topical minocycline hydrochloride ointment. 4 weeks later, subgingival scaling was performed on the right upper and lower jaws, also followed by minocycline hydrochloride ointment to help reduce inflammation. The treatment is accompanied by gargling with a compound chlorhexidine rinse, which can be used as an antibacterial treatment. When the pain is obvious, you can take amoxicillin capsules and metronidazole tablets orally, which can play an anti-inflammatory role.
Third, the effect of treatment
After the initial periodontal supragingival scaling, the patient’s cervical calculus was cleared, and when the subgingival scaling was performed 2 weeks later, it was found that the gingival redness and swelling had improved, and the bleeding when touched by the probe was less than before, and the patient reported that the pain was significantly improved. 4 weeks later, when the treatment was performed, the redness and swelling of the left tooth had disappeared, and there was no obvious bleeding when checked by the probe, and the gingivitis was better controlled, and the patient reported that the bad breath The patient’s self-reported bad breath was also improved.
IV. Notes
I was relieved to see that the patient’s toothache was relieved. At the same time, I did not forget to advise the patient to strengthen oral care on a daily basis, and to pay attention to the following points.
1, strictly follow the doctor’s instructions to take medication, control the blood sugar situation, improve the poor lifestyle and reasonable weight control, which is also helpful for the prevention of gingivitis.
2, daily oral hygiene to pay attention to, adhere to the daily morning and evening brushing, and timely rinse after meals, with dental floss, rinse to clean the gaps between the teeth.
3, regular check oral hygiene, after a toothache should be promptly consulted, avoid self-medication, drug treatment is only temporary relief, and can not control the condition.
V. Personal insight
The basic cause of gingivitis is due to the long-term gathering of bacteria on the tooth surface, and if there is also high blood pressure, diabetes, blood diseases, etc., it is more likely to induce gingivitis. The patient in this case was suffering from diabetes, which was poorly controlled and increased the risk of gingivitis. If gingivitis is not treated in time, it can easily develop into periodontitis, which is very harmful to the teeth and can cause adverse consequences such as root exposure, tooth loosening and alveolar bone resorption. Therefore, it is important to pay attention to the condition of the mouth and actively seek medical attention in case of discomfort to avoid irreversible changes in the teeth.