Gummy Lesions: Acute One’s

In this new article, I will be talking about different acute gum lesions. But before that, let me explain the difference between acute & chronic lesions. Acute lesions are those with a sudden onset & often manifested by pain, while chronic lesions, are those with slow gradual onset & increase in severity, they are often asymptomatic unless the lesion is big enough to compress on nerves & cause pain.

I will be referring to gums in this article to the term Gingiva for accurate scientific understanding.

Acute Gingival Lesions, as the name implies they occur in the gingiva & they are of acute type. They include: Acute Gingival Abscess, Acute Herpetic Gingivostomatitis, Pericoronitis, Acute Necrotizing Ulcerative Gingivitis, Acute Candidiasis, Aphthous Stomatitis, where I will be talking about them separately.

  • Acute Gingival Abscess

Its a painful rapidly expanding lesion of a sudden onset but of shorter duration & its localized to a specific area rather than affecting the whole gingiva. Its due to impaction of foreign objects such as tooth brush bristles or fibrous food. The appearance of such lesion is limited to marginal gingiva (the margin around the tooth) & interdental Papilla (the gingiva between each tooth) with a red swelling & smooth surface. Lesions may become filled with pus within 24-48 hours. Adjacent teeth will often be mildly painful. The treatment to such lesions is to prevent the cause. Meticulous oral hygiene with a soft tooth brush twice a day & flossing once a day will help prevent the development of such lesion.

Periodontal-Abscess-in-mouth

  • Acute Herpetic Gingivostomatitis = A.H.G.S

Its an infection of the oral cavity caused by Herpes Simplex Virus which is responsible for the development of chicken pox in children, Hence the disease is contagious. The gingiva will be red & shiny. In the initial stage of the disease, its characterized by the presence of discrete spherical grey vesicles that may take place in the gingiva, roof of the mouth, pharynx & tongue. This disease has both oral & extra oral symptoms, orally, there will be generalized soreness of the mouth. Extraorally, involvement of the lips & face along with inflammation & enlargement of the lymph node in your neck. Fever is also common. Management of this disease is a series of protocols including the removal of any debris, scaling & root planning & administration of mouthwashes & antibiotics.

A_CAREY_2_00000003_2008111116275_00000003_20081128204635

  • Pericoronitis

Pericoronitis is an inflammation of the gingiva in relation to the crown of impacted tooth. Most commonly occurs in lower wisdom teeth. This occurs when there is a space between the gingiva & the tooth where food accumulates causing inflammation. This is a painful condition & will require extraction of the impacted tooth.

38_pericoronitis_with_pus

  • Acute Candidsis

Please refer to the article where Candidiasis is deeply explained.

  • Aphthous Stomatitis

Please refer to the article Aphthous Stomatitis that I have previously published.

  • Acute Necrotizing Ulcerative Gingivitis = A.N.U.G

Its a rare inflammatory destructive disease of the gingiva that presents with a marked characteristic clinical features. The cause is still debatable & unknown for the moment although certain bacterial strains have been involved. This is a disease that affects most commonly the elders with no definitive duration. The patient will be complaining of a sudden onset along with a constant radiating gnawing pain followed by an episode of debilitating disease or an acute respiratory infection. The characteristic clinical features of the disease is that it appears as a punched-out crater like depression at the crest of interdental Papilla (at the tip of the gums in between the teeth) where it will be covered by a grey pseudomembranous sloughs demarcated by a linear redness from the rest of the gingiva & that will subsequently extends to involve the marginal gingiva, this lesion is extremely sensitive to touch. Gingival bleeding occurs spontaneously along with a metallic foul odor (bad breath) & increased salivation. This disease will progressively destroy the gingiva & underlying periodontal tissues. Extraoral signs & symptoms include slight elevation of temperature in mild to moderate cases. In severe cases, it will be marked by a serious systemic complications including meningitis, pulmonary infection & fatal brain abscess, etc. Treatment however, do exist with the advancement of dentistry. There are a number of protocols that the dentist will have to follow in order. First of all, is the removal of necrotic psuedomembrane with a cotton pellet saturated with hydrogen peroxide then superficial scaling with ultrasonic scalers followed by manual scaling by some days later. Systemic antibiotics will have to be prescribed these include Penicillin or {Erythromycin (for Penicillin sensitive patients)} either 250-500mg every 6 hours for 5-7 days depending on the severity of the condition. Metronidazole may sometimes be prescribed with either 250-500mg every 8 hours for 5-7 days. Fluids, analgesics, & nutritional supplements may be prescribed as well. After the symptoms subside, recontouring of the gingiva may take place.

For patients diagnosed with this condition, they should:

  1. Avoid Alcohol, Tobacco, & Condiments since these will worsen the condition.
  2. Rinse with equal amounts of water and 3% hydrogen peroxide every 2 hours.
  3. Avoid excessive physical exertion.
  4. Use soft toothbrushes with bland dentifrices (toothpaste).

image032

This pretty much summarizes the main gingival lesions. Help keep yours gums healthy by brushing your teeth twice daily & flossing once daily. Eat healthy foods & stay away from junk foods. These are not only bad for your teeth, but also bad for your body in overall.

If this article really has benefited you, please let me know as this makes my day!

I will be reading each & every comment!

Haider Maitham, DDS

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6 thoughts on “Gummy Lesions: Acute One’s

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    1. Hello,

      I’m sorry to hear that you are finding trouble understanding my article. I have updated the article with more simplified words to understand. Please feel free to comment back for any complications you find.

      Thanks for your comment.

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      Like

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