Gingivitis

Gingivitis, painless inflammation or degeneration of the gum tissue, or gingiva, considered the first stage of gum disease. The gum tissue between the teeth becomes swollen and uneven; the tissue at the gum line becomes darker; and gums bleed easily. In advanced cases, the mouth will develop a noticeably unpleasant odor.

Gingivitis is caused by the buildup of plaque, a film of bacteria that sticks to the teeth at the gum line. Toxins released from the bacteria irritate the gums, causing the gums to swell and bleed. This enables the bacteria to penetrate just below the gum line into an area known as the gingival sulcus. Warm, moist, and protected from the tongue and the chewing movement of the teeth, the gingival sulcus provides the perfect environment for bacteria to breed. Moreover, the delicate tissues of the sulcus are particularly vulnerable to the strong toxins produced by the bacteria. As the bacteria grow and continue to release toxins, they create a solid pocket of plaque beneath the gum line. This bacteria-filled pocket causes the gums to become more inflamed, which weakens the tissue, allowing even more plaque to be trapped in the expanding pocket.

Left untreated, gingivitis progresses to the next stage of gum disease known as periodontitis. In periodontitis, the inflammation from plaque not only damages the gums but also destroys the bones and ligaments that support the teeth. Eventually, the gums detach from the teeth and the teeth may begin to fall out.

The first step in treating gingivitis is scaling—a thorough professional cleaning of the teeth to remove any plaque. This is particularly important because plaque can harden into a mineral form called calculus or tartar, which can be removed only by professional instruments. In addition, dental structures that can interfere with plaque removal, such as broken fillings or bridges, may be fixed during regular dental cleanings. Most important, the patient will be instructed in proper home care, including regular brushing and effective flossing.

Spasm

Spasm, involuntary and abnormal violent contraction of muscles or muscle tissue. Tonic spasm, or cramp, is characterized by an unusually prolonged and strong muscular contraction, with relaxation taking place slowly. The extreme example of tonic spasm is tetanus, in which the spasms are so violent and so enduring that they may paralyze breathing. In the other form of spasm, called clonic spasm, contractions of the affected muscles take place repeatedly, forcibly, and in quick succession, with equally sudden and frequent relaxations. The most typical examples of clonic spasm are epilepsy and convulsive hysteria.

The medicines used to counteract spasmodic muscular activity are termed antispasmodics. These are used in certain surgical procedures because they block transmission of nervous impulses to the muscles. Derivatives of hemlock and some 50 other plants have a relaxing effect on muscles.

Emphysema

Emphysema, progressive respiratory disease characterized by coughing, shortness of breath, and wheezing, developing into extreme difficulty in breathing, and sometimes resulting in disability and death. Although the exact cause is unknown, bronchial spasm, infection, irritation, or a combination of the three seem to be contributory. The highest degree of occurrence is among heavy cigarette smokers, especially those exposed to polluted air. Children who suffer from bronchitis or asthma are also susceptible.

In the course of the disease the passages leading to the air sacs of the lungs become narrowed. Air is trapped in the sacs, and the tissues of the lungs lose their natural elasticity and undergo destructive changes. Symptoms akin to the common cold or asthmatic wheezing may result. As the disease progresses the volume of residual air trapped in the lungs increases, and the volume of each breath decreases. The lungs increase in size, and in severe cases the patient develops a characteristic “barrel chest.” The lungs become unable to supply enough oxygen to the body tissues. This reduction in oxygen intake causes the heart to pump faster; consequently, the heart becomes strained. Excessive carbon dioxide in the blood gives the patient a bluish skin color.

Elephantiasis

Elephantiasis, disease of the lymphatic system, characterized by an enormous enlargement of the infected area. The hardened skin of this area resembles the hide of an elephant. The disease is usually the result of blockage of the lymphatic system by threadlike filarial worms, usually Wuchereria bancrofti. The parts of the body most frequently affected are the limbs and the genitals. The disease is treated with the antifilarial drug diethylcarbamazine (Hetrazan) and with surgery.

Dysentery

Dysentery, acute or chronic disease of the large intestine of humans, characterized by frequent passage of small, watery stools, often containing blood and mucus, accompanied by severe abdominal cramps. Ulceration of the walls of the intestine may occur. Although many severe cases of diarrhea have been called dysentery, the word properly refers to a disease caused by either a specific amoeba, Entamoeba histolytica, or a bacillus that infects the colon.

Amoebic dysentery, caused by the parasite Entamoeba histolytica, is endemic in many tropical countries, but is attributable more to unsanitary conditions than to heat. It is most commonly spread by water or contaminated, uncooked food or from carriers. Flies may carry the cysts to spread the amoeba from the feces of infected persons to food. Various drugs, including metronidazole, ementine, and iodine-containing preparations, have been useful in treating severe cases of the disease.

Bacillary dysentery is caused by certain nonmotile bacteria of the genus Shigella. This dysentery is usually self-limiting and rarely manifests the more severe organ involvements characteristic of amoebic dysentery. Bacillary dysentery is spread by contaminated water, milk, and food. Feces from active cases and those from healthy carriers as well contain immense numbers of the disease-producing bacteria. Flies carry the bacteria on their feet or in their saliva and feces and deposit them on food; ants are also believed to spread the disease. Proper replacement of fluid is important in treating. Sulfonamides, tetracycline, and streptomycin were effective in curing acute cases until drug-resistant strains emerged. Chloramphenicol is sometimes used to treat these strains. Quinolones such as norfloxacin and ciprofloxacin are also effective against Shigella infection.