Treating gum disease with homemade remedies
Desquamative gingivitis is a term used to describe a clinical reaction pattern that may be seen in a number of disease processes. It refers to a clinical condition in which the gingiva exhibits atrophy, erosion, and ulceration and possibly a positive Nikolsky sign (27,28). The term is used in a nonspecific manner, as are the terms leukoplakia and erythroplakia, which refer to white and red lesions, respectively, which cannot be attributed to any specific disease process. The designation desquamative refers to the separation of the epithelium from the connective tissue.
Tea tree oil was as effective as chlorhexidine against Streptococcus mutans, the bacteria that causes gingivitis, in a controlled study of 30 individuals (Groppo et al 2002). A more recent double-blind, randomised, longitudinal, study evaluated and compared the effects of tea tree oil gel (2.5 ) and chlorhexidine gel (0.2 ) in 49 patients with severe chronic gingivitis (Soukoulis & Hirsch 2004). Subjects brushed with the tea tree, chlorhexidine or placebo gel twice daily for a period of 8 weeks. Tea tree oil significantly reduced the papillary bleeding index and gingival index, but did not reduce plaque.
CoQ10 is used both topically and internally for the treatment of chronic periodontal disease. Topical application has been shown to improve adult peridontitis (Hanioka et al 1994) and a small open study has shown that oral CoQ10 supplementation can produce dramatic results within 5-7 days, making location of baseline biopsy sites impossible (Wilkinson et al 1975).
Hand-Schuller-Christian disease (multifocal LCH) has similar bone granulomas along with other systemic manifestations. The skeletal anatomy of the head and neck is prominently involved. Mandibular defects include severe gingivitis, loss of mandibular height, and multiple loose teeth. The skull can have a geographic skull appearance on plain films secondary to multiple lesions. Involvement of orbital bones can result in changes in vision, and blindness can occur. Sellar involvement around the pituitary can lead to hypopituitarism, resulting in short stature and diabetes insipidus (2).
FIGURE 39 Necrotizing ulcerative gingivitis. This HIV-positive adult male presented with multiple, punched-out necrotic lesions of the interdental papillae. The gingivae were exquisitely painful. A fetid odor accompanied the necrotic lesions. On the third tooth from the lower left, the fusospirochetal infection has extended from the gingival mucosa into the periodontal ligament (necrotizing ulcerative periodontitis) Source Courtesy of Department of Periodontics, School of Dentistry, University of Missouri, Kansas City, Missouri. FIGURE 39 Necrotizing ulcerative gingivitis. This HIV-positive adult male presented with multiple, punched-out necrotic lesions of the interdental papillae. The gingivae were exquisitely painful. A fetid odor accompanied the necrotic lesions. On the third tooth from the lower left, the fusospirochetal infection has extended from the gingival mucosa into the periodontal ligament (necrotizing ulcerative periodontitis) Source Courtesy of Department of...
Erosive lichen planus, MMP, and pemphigus vulgaris (PV) may have similar clinical features. All may present with desquamative gingivitis (Fig. 32). Frequently in MMP, a gentle stream of air blown tangentially at the surface of the involved gingival mucosa will balloon up the epithelium (Fig. 33). They may be differentiated by DIF testing. In MMP, DIF exhibits a smooth linear deposit of immunoreactants (C3 and IgG) along the basement membrane zone. The Nikolsky sign is positive (Fig. 34). Primary herpes simplex is a febrile illness that exhibits an acute onset of vesicles. FIGURE 32 Desquamative gingivitis in mucous membrane pemphigoid. Note the gingival erythema and erosion. Desquamative gingivitis is a clinical reaction pattern that is seen in a number of disease processes, including lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris. FIGURE 33 Desquamative gingivitis in mucous membrane pemphigoid. Note the epithelial separation produced by directing a gentle stream of...
The surface of the alveolar bone proper usually shows regions of bone resorption and bone deposition, particularly when a tooth is being moved (Fig. 15.20). Periodontal disease usually leads to loss of alveolar bone, as does the absence of functional occlusion of a tooth with its normal opposing tooth.
Topically, sage is used as a gargle for laryngitis, pharyngitis, stomatitis, gingivitis, glossitis, minor oral injuries and inflammation of the nasal mucosa (Blumenthal et al 2000). These uses can be based on the pharmacological activity of its chemical components. In an open-label, single-blind, RCT of 420 patients, the non-steroidal anti-inflammatory drug, benzydamine hydrochloride, was found to be more effective than sage in relieving postoperative pain when used as a mouthwash after tonsillectomy in children and adults (Lalicevic & Djordjevic 2004).
Disease of the teeth presents as pain, mobility or swelling although some conditions are detected as incidental findings at radiographic examination. Caries and periodontal disease are painless until advanced destruction of tissue has occurred. A draining sinus opening onto mucosa or facial skin may accompany dental abscesses but others may present with soft tissue swelling of the face and other signs of spreading infection. Gingival bleeding is often the only sign of chronic marginal periodontal disease until increased tooth mobility or the drainage of pus from between gingiva and tooth occur. Developmental cysts, odontogenic hamartomas and neoplasms are often painless but may present with bony swelling, facial asymmetry or a failure of teeth to erupt. Discolouration of teeth, rapid wear or abnormal morphology are features of the hereditary developmental tooth disorders such as dentinogenesis imperfecta or amelogenesis imperfecta usually all the teeth will be affected.
As numerous therapeutic drugs and devices are being investigated for their potential benefit in the treatment of periodontal disease, these cell cultures are also being used in the assessment of cell responses and biocompatibility. These developments are of particular interest in relation to tissue engineering. The potential for the cells to differentiate toward an osteoblastic phenotype allows investigation of materials that may be used to There has also been considerable research effort toward the discrimination of cells between the PDL and those from the more superficial gingival connective tissues. This research has been driven by clinical studies suggesting important differences between cells derived from these tissues in leading to the regeneration of the periodontal attachment apparatus. However, differences between these cell types have not yet been clearly defined. Finally, given the unique anatomic role of the periodontium as a protection against local oral bacteria,...
Fiber in the diet, and lack of exercise, is more common, leading to increased use of laxatives, Periodontal disease, hemorrhoids, and diverticulosis (inflammation of the walls of the colon) may compound the digestive problems of older adults. Contributing to these functional changes are declines in stomach acid and intestinal secretions, an increase in body fat, changes in the liver and gall bladder, loss of teeth, and a 50 decline in taste buds.
There has been considerable interest that low grade infections may result in chronic activation of the immune system and that this may predispose to a variety of chronic disease states, including insulin resistance and atherosclerosis. Organisms that have attracted attention include those that cause dental and gum disease, Helicobacter pylori, Chlamydia pneumoniae, and viral infections including cytomegalovirus. A genetic component has also been recognized with polymorphisms in the genes or promoters for many of the cytokines accounting for variation in expression between individuals. For example, the common -174G C polymorphism in the gene for interleukin-6 (IL-6) has recently been linked with longevity as the distribution of genotypes in the very elderly and appears to be different from that of the general population (Hurme et al., 2005). The biological processes involved are obviously very complex, and no single genetic abnormality is going to account for the
Bilberry is used to relieve the symptoms of mild diarrhoea and improve poor night vision, sensitivity to glare, photophobia, peptic ulcers, varicose veins, venous insufficiency and haemorrhoids when taken internally. It is also used as a mouthwash, gargle or paint for mild inflammation of the mouth or throat, such as gingivitis or pharyngitis.
Dental problems are an extremely prevalent and troubling but often-neglected problem for many homeless people. Common conditions include advanced caries, periodontal disease, and ill-fitting or missing dentures. These problems may be related to poverty, lack of access to dental care, and substance use, rather than homelessness per se. In a study comparing homeless and domiciled veterans in Veterans Affairs rehabilitation programs for substance abusers, the two groups had similarly poor oral health (Gibson, et al., 2003).
Vitality testing, using the cooling effect of evaporation of ethyl chloride or small electric currents, can assess the health of the pulpal tissues. Tenderness to percussion (TTP) indicates involvement of periodontal tissues. Probing the junction between tooth and gum can assess the depth and extent of periodontal destruction, the presence of bleeding signifying active inflammation. Mobility is assessed in terms of buccolingual and vertical movement and is due to destruction of periodontal support, perhaps as a result of periodontal disease or because of an adjacent cyst or tumour.
FIGURE 1 Linear gingival erythema Source Courtesy of the International AIDS SocietyUSA From Refs 3 4
Also known as HIV gingivitis, a fiery red linear discoloration of the gingival margin can be seen in HIV disease, even without significant plaque formation (Fig. 1). Patients complain of spontaneous bleeding or are asymptomatic. Referral to an HIV dental specialist is recommended and usually involves debridement, local care, and systemic antibiotics. Necrotizing ulcerative periodontitis and stomatitis. Rarely encountered in the asymptomatic HIV-infected individual, this form of periodontal disease occurs in up to 50 of AIDS patients (11). Halitosis is a common complaint, along with severe pain and bleeding. On exam, gingival necrosis of the tips of the interdental papillae with formation of ulcers is found (Fig. 2).
Periodontal disease and dental plaque are clearly identified risk factors for the development of nursing-home acquired aspiration pneumonia. Recent studies have focused on the relationship between oral hygiene, colonization of dental plaques, and subsequent risk of pneumonia (El-Solh et al., 2003 El-Solh et al., 2004). A high plaque index and or evidence of periodontal disease has been associated with presence of anaerobic bacteria in broncho-alveolar lavage (BAL) samples (Imsand et al., 2002). In a study of 49 older patients from chronic long-term facilities requiring intensive care for a lower respiratory tract infection (LRTI), El-Solh et al. (2004) assessed dental status (plaque index, culture of dental plaques) upon admission to the ICU BAL was performed in 14 subjects. The study showed a high rate of colonization of dental plaque by aerobic bacteria (S. aureus 45 P. aeruginosa 13 other GNB 42 ). Furthermore, pathogens recovered from BAL matched the micro-organisms recovered from...
NUG generally responds to initial therapy of debridement, antimicrobial oral rinses, and antibiotic therapy (37). When the process heals, the altered gingival anatomy resulting from tissue loss through necrosis creates anatomic forms that predispose to recurrence of NUG and to the development of chronic periodontitis. NUG may progress from gingival soft-tissue involvement to produce loss of periodontal attachment (necrotizing ulcerative periodontitis) and may extend to involve the adjacent oral soft tissues (necrotizing ulcerative stomatitis). Extension of the infectious process through the soft tissues to the facial skin is termed Noma (cancrum oris).
Primary herpetic gingivostomatitis represents the primary infection of the HSV in an individual without prior exposure to the virus, and is accompanied by constitutional symptoms of fever, malaise, and cervical lymphadenopathy. Symptomatic primary infection usually occurs in childhood and is frequently accompanied by painful gingivitis with red, swollen gingiva (Fig. 1). The lesions may affect any mucosal surface, including Both primary herpes simplex and erythema multiforme (EM) exhibit a sudden onset of disease. The lip lesions of primary herpetic gingivostomatitis may bear a resemblance to the crusted lip lesions of EM (Fig. 4). Exfoliative cytology may be useful to differentiate the two by demonstrating the characteristic viral cytopathic effect produced as the epitheliotropic herpes virus replicates within the keratinocytes. Viral culture may also be useful. Lesions of herpangina, caused by the Coxsackie virus, may clinically resemble oral herpes virus infections but typically...
The PDL is an anatomically unique tissue providing functional support for the teeth in the alveolar bone. Although the characterization of the cells derived from this tissue has not provided an absolute marker, the anatomic characteristics do allow for the selection of explant materials specifically from these tissues. The high levels of destructive periodontal disease within the population, leading to the degradation of this tissue, have generated interest in the characterization of cells derived from these tissues.
Most infections in patients with severe neutropenia are caused by either aerobic Gram-negative bacilli, particularly Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, or Gram-positive cocci, particularly Staphylococcus aureus and a-hemolytic streptococci (2). In recent years, infections by S. aureus, including methicillin-resistant and vancomycin-resistant species, have been increasing (13). Infections by anaerobic organisms are relatively uncommon, although the microaerophilic organisms of the mouth contribute to gingivitis and mucositis in patients with neutropenia. For unclear reasons, clostridial infections, including bac-teremias, occur in patients with various forms of chronic neutropenia however, clostridial blood stream infections occur infrequently in patients with chemotherapy-induced neutropenia. Clostridia difficile, however, is an important cause of diarrhea, abdominal pain, and fever in all patients with neutropenia, particularly after exposure to...
Around 40 of people with dental phobia have other clinically significant psychological problems such as depression or anxiety (Roy-Byrne etal., 1994). Furthermore, those people have a higher degree of impairment than those with no comorbidity. This is not surprising because more than a third of patients, unselected for dental phobia, are in continual pain when they decide to visit dentists (Green et al, 1997). Those with a phobia of treatment would probably be in more pain because of greater dental disease (Berggren, 1993). Most patients who are too fearful to tolerate dentistry are afraid of experiencing pain that they believe can occur without warning during treatment and they are afraid that they lack control over this (DeJongh et al., 1995 Lindsay & Jackson, 1993). Cognitive interventions would have to address those expectations.
CMV disease in HIV is usually reactivation of a latent, previously acquired infection in patients with CD4 count of less than 100 cells mm3 (19) The typical primary CMV infection, presenting with a mononucleosis-like syndrome characterized by fever, pharyngitis, lymphadenopathy, and malaise, is not usually encountered in the setting of HIV infection. In the pre-HAART era, CMV reactivation disease could be asymptomatic or cause fever and constitutional symptoms or end organ disease, occurring in 40 of AIDS patients. The most common organ involved is the retina, in 85 of cases, with the GI tract accounting for another 10 . In the HAART era, incidence of new CMV-reactivation disease has decreased dramatically and is usually seen with CD4 counts less than 50 cells mm3. Oral and esophageal ulcers are the most common upper GI tract manifestation, CMV being the second most common cause of esophagitis after Candida, with HSV being the third. Necrotizing gingivitis and...
The vast majority of teeth are removed because of dental caries or periodontal disease and are not submitted for histological examination unless there are unusual clinical or radiological findings. Teeth adjacent to cystic lesions are removed either as part of the treatment for the lesion (e.g., the unerupted tooth associated with a dentigerous cyst) or because they cannot be restored to useful function (e.g., a tooth whose roots have been extensively resorbed by a keratocyst). Where a primary neoplastic lesion is suspected, teeth may be removed to provide access to underlying lesional tissue via the socket. Teeth may be submitted whole or as fragments deeply buried unerupted teeth are most likely to be divided by the surgeon prior to removal.
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