Gingiva condition in puberty period:
Puberty is a condition which is often
showed some exaggerated responses to the gingival tissues when it relates with
plaque. Pronounced type of inflammation, discoloration as bluish red type, presence
of edema, and gingival enlargement may occur due to the availability of all the
local factors. These local factors have the ability to create mild response to
gingival tissue.
As adulthood approaches, the
severity condition of the gingival tissue slowly diminishes, even at the time
of local factors availability. For the complete regeneration of normal or
healthy gingiva requires eradication of all the essential local factors. The
dominance along with the severity of all gingival diseases is usually being
increased in the period of puberty. Even though, gingivitis is not the
predominant pathological condition during puberty. Through following good oral
hygiene technique, this sort of pathological condition can be removed.
Menopausal gingivostomatitis (Senile
atrophic gingivitis):
The usual rhythmical imbalances
hormones occur during menopause where the female cycles are ended as estradiol
ceases to be the major circulating estrogen. So that female can develop
gingivostomatitis. This occurs during menopause or post menopausal periods.
The gingiva and other parts of the
oral mucosa appear as dry and shiny. It varies in color where it ranges from
abnormal type of paleness to redness. Apart from the color changes, bleeding
also occurs with great ease.
Microscopically gingiva exhibits
atrophy of the germinal and prickle cell layers of the epithelium and sometimes
areas of ulceration.
Patient often complaints both dry
and burning type of sensation that usually feels in every portion of the oral
cavity. It has also been associated with greater sensitivity that may occur due
to the thermal changes. Apart from the extreme level of sensitivity, patient
may also experience abnormal types of sensations such as sour, peppery, salty.
Patient will partial prosthesis will face difficulty due to these reasons.
Signs and symptoms are quite similar
with chronic desquamative ginigivits. And it usually gets similar after
ovariectomy or sterilization by radiation in the treatment of malignant
neoplasm.
Hormonal Contraceptive and its
affects over the Gingiva:
Hormonal contraceptives usually aggravates
several types of gingiva tissue related responses due to the presence of local
factors in such a way that is quite similar to the condition that has been seen
in pregnancy. And if it has been taken for more than 1 and half years, the
periodontal destruction level will increase.
Pregnancy induced gingivitis:
During pregnancy, estrogen and
progesterone hormones’ level get higher and these increased levels of hormones
induces inflammatory condition of the gingiva and eventually causes gingivitis.
Etiology of gingival tissue related responses
to elevated level of estrogen and progesterone hormones during the time of pregnancy
is given here:
a)Sub lingual plaque composition:-
-Increase in anaerobic: aerobic
ratio.
-Availability of substantial amount
of Prevotella intermedia (It also acts as the substitutes of sex hormone for
the growth factor of Vit – k).
- Bacteroides melaninogenicus will
be available at higher concentration.
- Porphyromonas gingivalis will be
found at an extensive portion.
b)Maternal Immuno-response:-
- Cell-mediated immunity will be in
decreased level.
- The function of neutrophil will be
reduced, which in follow chemotaxis will be almost impaired.
- Reduced in the level of T-cell response
along with the antibody.
- Difference between CD4 and CD8
cell will be reduced where the T-suppressor cyto-toxic cell and peripheral
T-helper cell will be in decreased mood.
-Cyto-toxicty has been used against
the function of macrophages, and for the diminishing immune response,
cyto-toxic cell will create affect of B-cel.
-Decrease substantial amount of
CD4+, CD3+ and CD19+ cells that usually presents peripheral at the time of
pregnancy in the peripheral blood.
-Stimulates the production level of
prostaglandin.
c)Sex hormone concentration:-
1.Estrogen =>
-Increase proliferation of cells in all types of blood vessels.
- Keratinization will be decreased,
while the epithelial glycogen will be uplifted.
-Specific types of receptors will be
established in the tissues of gingiva.
2. Progesterone =>
-Increase vascular dilation and thus
increase permeability (resulting in edema and accumulation inflammatory cells).
-Increase proliferative activity of
capillaries that are being new formed, and these are basically presented in
gingival tissue. There will also increase any type of bleeding tendency.
-Collagen production rate and
pattern will be changed.
- Folate’s metabolic activity will
be broken down. Folate deficiency has the ability to initiate any repaid of
tisshe.
-Specific types of receptors are
usually being found in the tissues of gingiva.
-Decrease plasminogen activator
type-2 and this usually increases proteolytic activity of tissues.
d)Estrogen hormone and Progesterone
hormone:-
-Through increasing level of
fluidity, it can affect the connective tissues ground substance.
-Concentration level of saliva
increases and fluid where there will be increased level of serum
concentrations.
