The gingiva is the mucosal tissue attached to the cervical and alveolar portions of the teeth and is pink, shiny and tough. The edge of the gingiva is called the gingival margin and is normally moon-bud shaped. The small groove between the gingival margin and the neck of the tooth is called the gingival sulcus, which is normally about 1-2 mm deep. The gingival protuberance between the two adjacent teeth is called the gingival papilla. It is also called the gingiva, commonly known as the tooth bed, and in some regions, the tooth flower. It is the mucosal tissue that envelops the neck of the tooth, pink in color, and contains many blood vessels and nerves. What kind of lesions can occur in the gums? The gums generally undergo some pathological changes including root inflammation, hyperplasia, necrosis and tumor-like changes, with inflammation being the most common. It can be divided into chronic gingivitis, acute gingival papillitis, drug gingival hyperplasia, adolescent and pregnancy pepperitis, necrotizing ulcerative gingivitis, gingival tumor, etc., with varying degrees of urgency and severity. 1, chronic gingivitis is the most common, also known as simple gingivitis. The lesion is limited to the free gingiva and gingival papillae, which can spread to the attached gingiva in severe cases. The lesions are bright red or dark red, the female papillae are rounded and enlarged, the gums are soft and fragile, lack of elasticity, deepening of the gingival sulcus, easy bleeding when brushing or biting hard objects, some patients have bad breath, but no periodontal pocket formation, pain is light. 2, acute gingival papillitis common acute dental intercept lesions. Caused by food embedding, flossing injury, hard food stabbing, denture ring tip irritation, etc.. Inflammation is confined to individual interdental gingival papillae, which are red, swollen, and bleed easily, with spontaneous swelling and obvious tenderness, mild percussion pain, and moderate hot and cold irritation pain in some patients. In addition to the similar symptoms mentioned above, other types of gum disease have some of their own characteristics. 3, adolescent gingivitis occurs in adolescents, seen in the front teeth on the labial side of the tooth question papilla and gingival margin, inflammatory reaction is heavy, the pain is light. 4, expectant gingivitis and gingival tumor onset teeth are not sure, some women can be in the 4-6 months of pregnancy during a single tooth interdental papilla gestational gingival tumor, soybean to bean size, after delivery can gradually white line shrink. 5, simple gingival tumor is mostly seen in women, easy to recur, sometimes can destroy the alveolar bone, appearing loose teeth, displacement phenomenon. The pain is lighter. 6, acute necrotizing ulcerative gingivitis is rare. This type of acute onset, gingival papillae and marginal gingiva can appear gray-white necrotic material and rapidly expand to adjacent teeth; necrotic material can be seen after the removal of the eroded bright red gingiva, worm-like, very easy to bleed, pain is obvious. Saliva is thick and sticky, with a rotten odor; fever, fatigue, swollen submandibular lymph nodes, pressure pain and other systemic symptoms can occur in severe cases. 7, proliferative like inflammation and drug tan hyperplasia both etiology is different, but are manifested as gingival margin hypertrophy, gingival papillae are spherical hyperplasia, as the disease progresses, the hyperplastic part gradually become tough and elastic. The former is locally swollen and itchy, and the degree of hyperplasia is lighter; while the latter is locally non-sensitive and the degree of hyperplasia is heavier, and can even affect the closure of the mouth and lips, causing plaque accumulation and combined gingivitis. The treatment of gingival disease should be thorough removal of plaque and tartar, reduction of food embedding and other undesirable stimuli, along with local hydrogen peroxide rinsing, iodine intra-gingival sulcus application, rinsing agent to clean the mouth, appropriate supplementation of vitamin C, etc., which have good effect on all types of gingivitis. For some special cases need special treatment, such as gingival tumor is large, need to be surgically removed. 1. Do you know the danger signs of gum disease? Gum disease can occur at any age, and is most common in adults. If detected early, treatment is effective. The normal tooth stuffing is pink, tough and elastic, does not bleed easily, is closely connected to the neck of the tooth, and the space between the edge of the gum and the tooth forms a shallow groove, whose depth does not exceed Zmm when normal . When the normal gum appearance trait changes, you should seek medical attention promptly. ( 1 ) The gums are red, swollen, or painful to touch, ( 2 ) The gums bleed easily during brushing, flossing, or biting hard food, or blood is found on food; ( 3 ) The gums shrink and make the teeth look as if they have grown longer; ( 4 ) The gums separate or detach from the teeth, forming pockets; ( 5 ) The gums feel sore or swollen when biting; ( 6 ) There is pus between the teeth and gums; ( 7 ) Long-term bad breath. 2.How are bacteria, plaque, tartar and gingivitis related? Bacteria are the main culprit of gingivitis, and plaque is a place where bacteria reside, easily attached to the neck of the teeth, the edge of the gums, the sockets of the tooth surface and rough and uneven places. Plaque is formed a few hours after teeth are brushed, and then calcium salts in saliva gradually settle inside. After a long time, the plaque will be calcified to form yellow or dark colored, hard tartar, commonly known as “rust”, which is difficult to remove even by brushing. Tartar can appear at the junction of teeth and gums, and sometimes it falls off on its own. The calcium in tartar comes mainly from saliva, so it tends to be particularly abundant in areas close to salivary openings, such as the buccal surface of the maxillary first molars and the lingual surface of the lower anterior teeth. The surface of the tartar can be seen under the microscope is rough and porous, so the tartar provides favorable conditions for the re-attachment and growth of plaque, so that the cycle is repeated, the bacteria take the opportunity to multiply and produce toxins, destroy the gum tissue, causing gingivitis, and even gradually invade the deep periodontal tissue, developing into periodontitis. 3, brush teeth easily bleeding is gingivitis? First of all, healthy gums will not bleed when brushing. When there is a large accumulation of plaque or tartar in the mouth, inflammation stimulates the gum tissue, causing the gum capillaries to expand, permeability to increase, blood flow to increase, and the gingival epithelium in contact with the root to ulcerate and become thin and poorly protected, which can cause the capillaries to rupture and bleed when brushing and eating normally, so you should immediately go to the hospital for examination and treatment. However, in addition to this, there may be other reasons for bleeding from brushing teeth: such as vitamin C deficiency; excessive brushing force, improper use of toothpicks may also easily cause gum bleeding; various blood system diseases, such as leukemia, hemophilia, etc., often appear gum bleeding or bleeding after tooth extraction symptoms, and the general method of stopping bleeding is not effective, should cause a high degree of vigilance; other systemic diseases, such as cancer, diabetes, thyroid Other systemic diseases, such as cancer, diabetes, thyroid dysfunction, liver cirrhosis, hypersplenism, late nephritis, etc., can also occur gum bleeding. 4.What are the misconceptions about dental cleaning? Scaling, also known as “scaling”, is divided into supragingival scaling (removal of calculus, plaque and pigmented scale above the gums) and subgingival scaling (removal of tartar and plaque below the gums), in which the dentist uses special scaling instruments or ultrasonic scaling machines to separate the tartar from the tooth surface, or uses a mixture of sand powder and water at a certain pressure to impact the tooth surface to remove the tartar. A mixture of abrasive powder and water is used to remove tartar by impacting the tooth surface. Scaling is used for the prevention and treatment of gingivitis and periodontitis, or as a preparation for other oral treatments, with the aim of eliminating the potential for infection and avoiding transient bacteremia. However, there are some misconceptions about scaling, which pang the normal development of scaling work. Misconception 1: If you are not sick, you don’t need to clean your teeth. Many people think that if they brush their teeth carefully every day, they do not need to put their teeth. Teeth will have new plaque formation a few hours after thorough cleaning and brushing, threatening oral health. The various traces left on the tooth surface are also difficult to remove with a toothbrush, and over time they form tartar, pigment scale and other stubborn tartar, causing periodontal disease. Regular dental cleaning can not only prevent oral diseases, but also beautify teeth. Experts suggest that adults who have not had their teeth cleaned should go to the hospital for cleaning as soon as possible, and it is best to have a cleaning every six months to a year. Myth 2: Cleaning is simple and can be easily done by going to a general dental clinic. Scaling is a highly specialized technical task that requires rigorous training to perform. A regular dental cleaning process usually takes 1 – 2 hours or even longer, but in some informal dental clinics or beauty salons, it can be done in 10-20 minutes, which is obviously a very unscientific operation and irresponsible to the patient. In this short period of time, only the visible tartar is removed, and the deeper tartar, which is more pathogenic, is not treated, thus failing to achieve the purpose of preventing dental disease; in addition, if you do not know the skills or action of coarse food, you will often touch the teeth, causing tooth sensitivity, toothache, or aggravate the original dental disease, and may even lead to the spread of certain infectious diseases such as hepatitis B, AIDS, etc. because of imperfect disinfection measures, with very serious consequences. The consequences are very serious. Therefore, dental cleaning should also be like a major surgery, carefully selected regular gray hospital and strictly trained medical personnel, so as not to cause more trouble for themselves. Myth 3: You can clean your teeth whenever you want. Dental cleaning is good for oral health, but not everyone can have their teeth cleaned at any time. This is because dental cleaning is invasive and the process is usually bleeding, so it is not advisable for people with coagulation disorders, acute leukemia patients or other serious systemic diseases that are not under control to receive scaling to avoid more than bleeding or aggravating their condition. In the acute stage of gingivitis, only large pieces of tartar should be removed first, and then thorough scaling should be performed after the acute stage. In addition, patients with certain infectious diseases, such as acute hepatitis (active), tuberculosis, etc., should also wait for the disease to stabilize. On the one hand, it is to consider their own condition, and on the other hand, it is also to avoid infecting others. Myth 4: The teeth become sensitive and loose after cleaning, which is caused by the improper operation of the doctor. It is normal that teeth cleaning does not cause severe pain, but individual patients may experience tooth soreness. This is due to the fact that after the tartar on the surface of the teeth is removed, the teeth seem to take off the thick cotton coat and are exposed to the oral cavity, so they may feel different for a short period of time, but they will get used to it after a while. If you find that the gap between your teeth is bigger and your teeth are loose after cleaning, it means that you have periodontal disease and your gums have shrunk before the cleaning, which is unnoticed because of the tartar filling. In this case, if the teeth are not cleaned in time, the gums will further gingerly shrink and aggravate the condition. 5.What is the effect on the fetus when expecting gingivitis? Due to changes in hormone levels in pregnant women, more than 38% of pregnant women will suffer from gingivitis during pregnancy, with 2 peak periods, the first and second trimesters. Recent studies have shown that gum disease can have as much impact on fetal development as smoking or alcohol abuse and can cause the birth of a low birth weight fetus. Pregnant women with gum disease have a higher rate of preterm delivery than the average pregnant woman and are at higher risk for preterm pain. According to statistics, pregnant women with gum disease have a twofold increased risk of fetal development compared to women with normal pregnancies, and severe gum disease can increase the risk by 6 to 10 times. Therefore, pregnant women should pay attention to oral health care to maintain health, see the section on oral health care. 6.What are the dangers of gingivitis? In addition to being an eyesore and causing discomfort to the patient, gingivitis can significantly increase the risk of stroke and heart disease. If left untreated, gingivitis can develop into periodontitis. The disease progresses due to the presence of bacteria that enter the bloodstream and induce thrombosis, which can also lead to intimal damage and may increase the risk of stroke. Also the direct invasion of bacteria into the blood stream, and the repeated contact with the blood stream, has an effect on blood fats and clotting factors, which may be associated with the development of heart disease. New research has found that severe gum disease may accelerate death in patients with enuresis and can promote cardiovascular and renal vascular damage.