Gingivitis Herpetica
The classic clinical picture of gingivitis herpetica is a consequence of infection with type 1 of the herpes simplex virus. It occurs mainly in children between the ages of two and four, but is also observed in adolescents and adults. After an incubation period (=time between infection with the pathogen and the first appearance of symptoms) of 4 to 6 days, fever, fatigue, vomiting, tendency to cramps, severe restlessness and changes in the oral cavity, which are commonly referred to as “mouth rot”, develop in those affected.
Those affected tend to have strong bad breath, increased saliva production and swelling of the lymph nodes in the head and neck area. The gums are severely reddened and numerous blisters are formed. After a short time, the vesicles turn into round depressions and cause pain to the affected person.
The gingiva may also be covered by whitish – yellowish secretions. The viral infection may also be accompanied by an inflammation of the throat and severe coughing, as well as sore throat. First diseases in adulthood are, as so often, more complicated than in early childhood.
The oral mucosal changes in the context of gingivitis herpetica recede within 10 to 14 days with symptomatic treatment. This includes bed rest, antipyretic medication, copious drinking and careful but cautious oral hygiene. The use of an antibiotic is pointless as it has no effect against viruses. In particularly severe cases, the drug Aciclovir is prescribed by the treating physician. After an infection, the affected person is immune for the rest of his or her life against a new illness.
Gingivitis Ulcerosa
Ulcerative gingivitis, also known as acute necrotizing ulcerative gingivitis (ANUG), usually begins abruptly in the area between the teeth. What distinguishes it from other forms of gingivitis is its tissue-destroying character, which is why the interdental papillae almost “melt away” within a few hours.The destroyed tissue is accompanied by secretion coating. It leaves crater-shaped defects of the gums, which show a tendency to affect the rest of the gums or the periodontium and the entire periodontium.
ANUG is accompanied by severe pain, bleeding and increased salivation. The affected persons suffer from bad smelling bad breath and taste a foul taste. The surrounding lymph nodes are swollen and a high fever is another accompanying symptom.
ANUG often develops on top of pre-existing chronic gingivitis and due to a weakened immune system, which is why it originates as a result of diseases of the throat and pharynx. The exact composition of the responsible bacteria is not known today. However, it is clear that the ANUG is not contagious.
Besides a therapeutic cleaning of the oral cavity, an antibiotic is prescribed to fight the bacteria. Also additional rinsing with the active ingredient chlorhexidine can minimize the bacteria to heal the gums. In severe cases, bed rest is appropriate for the affected patients. During the therapy, the affected persons should fall back on soft food and provide for an increased fluid intake.
