If drainage does not occur, have the patient rinse
with warm saline solution for 10 minutes every 2
hours. This should help promote drainage.
NOTE: NEVER apply heat to the external
surfaces of the face.
If drainage still does not occur, apply an ice pack
to the affected area. This may reduce the
patients discomfort until the dentist can provide
When drainage is established, give the patient
instructions about home care and notify the
dental officer to see if a prescription for
antibiotics can be called in to the pharmacy.
Instruct the patient to return to the dental
treatment facility (DTF) for definitive treatment
as soon as possible.
DISEASES OF THE PERIODONTAL
Most periodontal diseases result in the gradual
recession of the tissues of the periodontium. If the
disease process is not stopped, it may progress to the
harder, bony tissues of the alveolar ridge and lead to
the loss of teeth.
Gingivitis is an inflammation of the gingival
tissue. Marginal gingivitis is a relatively mild
inflammation of the borders of the gingival tissue.
Sometimes, the inflammation is localized; it may exist
around one, two, or a group of teeth. If the condition is
generalized, then it will exist around all the teeth. The
most frequent cause of marginal gingivitis is the
presence of bacterial plaque buildup due to lack of
adequate oral hygiene.
A patient with acute gingivitis may complain of
Sore or swollen gums
Upon examination for gingivitis, you may
A painful reaction or gingival bleeding when
finger pressure is applied
Red, swollen gingiva with a loss of stippling
Heavy plaque and calculus deposits in the
To treat marginal gingivitis, include the following
in the emergency treatment plan:
Perform the emergency treatment guidelines.
Give the patient oral hygiene instructions; refer
to Dental Technician, Volume 2, NAVEDTRA
12573, chapter 3, Preventive Dentistry.
Have the patient rinse with a warm saline
Gently scale the teeth to remove soft debris and
any obvious supragingival calculus.
NECROTIZING ULCERATIVE GINGIVITIS
Necrotizing ulcerative gingivitis (NUG) is a
severe infection of the gingival tissue, commonly
referred to as trenchmouth. It may result from
untreated marginal gingivitis, poor dietary habits,
smoking or alcohol consumption, a rundown physical
condition of the patient, or a combination of these
A patient may present the following symptoms
when NUG is present:
The same symptoms as that of marginal
A bad taste in the mouth
Pain when eating or brushing
Upon examination for acute gingivitis, you may
observe the following signs of NUG:
Same as those of marginal gingivitis, but more
Heavy plaque and calculus deposits.
Ulceration and cratering of the interdental
papillae. Frequently, so much of the papillae is
lost that the triangular area between the crowns
of the teeth present a punched out appearance.
A gray-white membrane covering the gingiva.
A foul odor from the oral cavity.
Pus oozing from the gingiva.
Areas of gingival recession.