а) Gingivitis

Gingivitis is inflammation of the gums and is characterized by the presence of tissue fluid (exudate), tissue damage (alteration), and proliferation. Gingivitis can be primary, occurring due to local factors (infectious, thermal, chemical, etc.), or secondary, when it is a sign of a systemic disease.

Catarrhal gingivitis develops under the influence of dental plaque, tartar, sharp edges of broken crowns or roots, improperly made fillings, and dentures. Symptomatic catarrhal gingivitis may arise from various blood, infectious, allergic, or other systemic conditions. Gum inflammation can be acute or chronic. Acute inflammation presents with mild itching, pain upon touching the gingival papillae, bleeding, and increased salivation. Chronic inflammation shows milder symptoms.

Purulent gingivitis is less common and usually occurs as a bacterial complication, characterized by swelling, redness, ulceration, abscesses, and enlargement of regional lymph nodes. Ulcerative gingivitis is also common and has an infectious origin. Acute ulcerative gingivitis begins with nocturnal neuralgic pain and the appearance of ulcers. The gingival papillae become necrotic and covered with gray-yellow deposits. Body temperature rises, and patients feel fatigued. Symptomatic ulcerative gingivitis progresses chronically, with recurrences, and most often develops during viral illnesses. Hypertrophic gingivitis mainly occurs in young individuals, pregnant women, or patients with epilepsy. It presents as gum swelling, gradually forming small, smooth, soft nodules that bleed easily. In later stages, the nodules become firmer and no longer bleed. Treatment of gingivitis begins with the removal of local irritants, especially tartar. In cases of catarrhal gingivitis, antiseptics, vitamins, appropriate mouth rinses, and toothpastes are applied. Purulent and ulcerative gingivitis require specialized dental treatment, including anesthesia, tartar removal, medicated treatment of the ulcers, dressings, and the use of antibacterial and antifungal agents.

б) Periodontitis (Periodontal Disease)

Periodontitis is a common disease affecting the supporting structures of the teeth. The pathological changes involve a tissue complex, including the gingival papilla, gingival margin (marginal periodontium), alveolar bone, tooth cementum, and the tooth itself. The most frequent causes of periodontitis are prolonged traumatic factors, such as heavy tartar buildup, improperly made fillings, crowns, bridges, and other prostheses, disturbances in tooth contacts, malpositioned teeth, and similar conditions. These situations create the possibility for the periodontium to be traumatized by food trapped in the interdental spaces. Localized periodontitis affects individual teeth. Changes in the supporting tissues are unilateral or limited to the area affected by the factor. Often, the effect of the local factor is combined with the traumatic action of tartar. The gums recede, exposing the root, sometimes even to the apex. The inflamed gingiva is sunken due to loss of the underlying bone, and the gingival margin is thickened. Tartar and overgrown granulation tissue can be found in the gingival pocket. X-rays show unilateral or bilateral involvement of the interdental bone septa with simultaneous formation of a bone pocket, while other teeth remain unchanged.

Generalized periodontitis is a serious problem in dental practice and can occur at any age. It presents with reddened gingival papillae, which often bleed, and exposed tooth roots. In more advanced stages, the gums may discharge pus with an unpleasant odor, teeth become unstable, and chewing is difficult. A fan-shaped spacing of teeth may be observed. Treatment of periodontitis is performed by a dentist.

в) Dental Calculus (Tartar)

Dental calculus is mineralized dental plaque. Dental plaque is a soft, amorphous deposit on the tooth surfaces. When plaque is present in small amounts at the early stages of formation, it is colorless and invisible to the naked eye. Tartar is rare in children and more common in adults. By itself, it is not pathogenic, but its rough surface provides an ideal environment for the retention of pathogenic microorganisms. Its porous structure acts as a reservoir for toxic bacterial products that are harmful to the surrounding gingival tissues. For this reason, methods for its removal have been sought since ancient times. According to its location, tartar is classified as:

Supragingival tartar is observed on the clinical crown of the teeth, around the gingival margin. Its color varies from light yellow to dark brown, appearing darker in smokers or when present for a long time. It has a softer consistency and is easier to remove than subgingival tartar.

Subgingival tartar is difficult to detect even during a clinical examination. It is located deep within the gingival pocket, has a serum origin, and is quite difficult to remove. Its dark color may be visible through the thin gingival margin. Regular removal of tartar by a dentist and preventing plaque buildup through effective brushing ensures healthy teeth, fresh breath, and a charming smile.