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 patient’s discomfort until the dentist can provide emergency treatment.
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 TISSUES
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.
MARGINAL GINGIVITIS
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.
Symptoms
A patient with acute gingivitis may complain of the following:
Sore or swollen gums
Bleeding gums
Signs
Upon examination for gingivitis, you may observe:
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 affected area
Treatment
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 solution.
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 factors.
Symptoms
A patient may present the following symptoms when NUG is present:
The same symptoms as that of marginal gingivitis
A bad taste in the mouth
Pain when eating or brushing
Excessive bleeding
Signs
Upon examination for acute gingivitis, you may observe the following signs of NUG:
Same as those of marginal gingivitis, but more severe.
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.Continue Reading
