STUDY - Technical - New Dacian's Medicine
Gum
swelling (Classical / Allopathic Medicine)
Gum swelling may
result from one of two mechanisms: enlarged existing gum cells
(hypertrophy) or an increase in their number (hyperplasia).
This common sign may involve one or many papillae - the
triangular bits of gum between adjacent teeth. Occasionally,
the gums swell markedly, obscuring the teeth altogether.
Usually, the swelling is most prominent on the labia and
bucca.
Gum swelling
usually results from the effects of phenytoin; less commonly,
from nutritional deficiency and certain systemic disorders.
Physiologic gum swelling and bleeding may occur during the
first and second trimesters of pregnancy when hormonal changes
make the gums highly vascular; even slight irritation causes
swelling and gives the papillae a characteristic raspberry hue
(pregnancy epulis). Irritating dentures may also cause
swelling associated with red, soft, movable masses on the
gums.
HISTORY:
Ask the patient to fully describe the swelling. Has he had it before? Is it painful?
Ask the patient when the swelling began and about aggravating or alleviating factors.
Review the patient's medical history, focusing on major illnesses, bleeding disorders, and, if the patient is female, pregnancies.
Check the patient's dental history. Ask him if he wears dentures. If he does, ask if they're new.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake and tobacco use.
Ask the patient about his normal diet to evaluate his nutritional status. Ask about his intake of citrus fruits and vegetables.
Ask the patient to fully describe the swelling. Has he had it before? Is it painful?
Ask the patient when the swelling began and about aggravating or alleviating factors.
Review the patient's medical history, focusing on major illnesses, bleeding disorders, and, if the patient is female, pregnancies.
Check the patient's dental history. Ask him if he wears dentures. If he does, ask if they're new.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake and tobacco use.
Ask the patient about his normal diet to evaluate his nutritional status. Ask about his intake of citrus fruits and vegetables.
PHYSICAL
ASSESSMENT:
Inspect the patient's mouth and note the color and texture of the gums. Note ulcers, lesions, masses, lumps, or debris-filled pockets around the teeth.
Inspect the patient's teeth for discoloration, obvious decay, and looseness.
Inspect the patient's mouth and note the color and texture of the gums. Note ulcers, lesions, masses, lumps, or debris-filled pockets around the teeth.
Inspect the patient's teeth for discoloration, obvious decay, and looseness.
SPECIAL
CONSIDERATIONS:
When performing mouth care, avoid using lemon-glycerin swabs, which can irritate the gums.
When performing mouth care, avoid using lemon-glycerin swabs, which can irritate the gums.
PEDIATRIC
POINTERS:
Gum swelling in children commonly results from nutritional deficiency.
Gum swelling may accompany phenytoin therapy; drug-induced gum swelling is more common in children than in adults. Fortunately, this dramatic swelling is usually painless and limited to one or two papillae.
Gum swelling may result from idiopathic fibrous hyperplasia and from inflammatory gum hyperplasia, which is especially common in pubertal girls.
Gum swelling in children commonly results from nutritional deficiency.
Gum swelling may accompany phenytoin therapy; drug-induced gum swelling is more common in children than in adults. Fortunately, this dramatic swelling is usually painless and limited to one or two papillae.
Gum swelling may result from idiopathic fibrous hyperplasia and from inflammatory gum hyperplasia, which is especially common in pubertal girls.
AGING ISSUES:
Always ask an elderly patient if he wears dentures. If he does and they are the cause of the gum inflammation, he may require a new set.
Ask the patient when he last visited the dentist.
Always ask an elderly patient if he wears dentures. If he does and they are the cause of the gum inflammation, he may require a new set.
Ask the patient when he last visited the dentist.
PATIENT
COUNSELING:
To prevent further swelling, teach the patient the basics of good nutrition. Advise him to eat foods high in vitamin C, such as fresh fruits and vegetables, daily. Encourage him to avoid gum irritants, such as commercial mouthwashes, alcohol, and tobacco. Advise him to see a periodontist at least once every 6 months.
To prevent further swelling, teach the patient the basics of good nutrition. Advise him to eat foods high in vitamin C, such as fresh fruits and vegetables, daily. Encourage him to avoid gum irritants, such as commercial mouthwashes, alcohol, and tobacco. Advise him to see a periodontist at least once every 6 months.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)