G32* in Acute and
Chronic Gingivitis associated with
Painful Teeth
Miss KIRTI P. SHAH, B. D. s. (Bom.)
By
Hony. Dental Surgeon
People's
Ruparel People’s Mobile Clinic & Shantaben Zaverichand Mehta
Clinic,
Gingivitis is
simple in outlook but serious in consequences, as it may be the beginning to
the ultimate loss of teeth. It is very often associated with painful teeth or
bleeding gums. The patient rarely consults a General Practitioner and much less
a Dental Surgeon for the maintenance of oral hygiene. There is a notion among
the people that a Dental Surgeon is to be consulted only to pull out a tooth
or make a denture. The important role of a Dental Surgeon in the maintenance of
oral hygiene which helps in preventing premature loss of teeth is
unfortunately not appreciated in our country. The message of oral hygiene must . be carried to the people and this responsibility rests
greatly on us, the Dental Surgeons. Unless
this is done, there cannot be worth-while progress in the prevention of dental
diseases in our country.
Selection
of the Drug G32 : G32 (Alarsin) has been described as
having antiseptic, anti inflammatory, astringent, styptic, anodyne, deodorant,
aromatic, cooling and healing properties. it is said to give fragrant smell
and a sense of freshness in the mouth, while
it cleans the teeth also. This
prompted me to give a regular clinical trial to this drug, as it meets the
requirements for treating most of the common ailments of gums and teeth that we
get in our every day dental practice. Another reason to try G32 was that as it
is a local application, it has an advantage over mouth washes now routinely
used.
Also, now-a-days
people are preferring more and more of Ayurvedic medicines and medical and
allied professions are taking increased interest towards Ayurveda,
our national heritage which has stood the test of time since centuries.
MATERIALS AND METHODS
The criterion of
selection of cases for clinical trial of G 32 in gingivitis was that it must be
associated with pain atleast in one tooth. Gingivitis
was either acute or chronic, localised
or generalised, bleeding or not.
50
consecutive cases that were treated by me during 1976 were put on trial with
G32. Those patients who discontinued in the middle of the study and also those
who could not be followed up, were left out of this
study. Normally, patients were advised to use the drug for a period of 8 days.
But in those who did not get relief in 8 days, the drug was continued to a
maximum period of 30 days which was fixed as the period of the trial. No other
drug was used during G 32 trial. Also brushing of teeth was not advised during the trial period
as G32 is said to clean the teeth also.
Age Groups :
40% of
the patients were between 20-30 years and 36% were between 31-40 years.
On the
whole, 76% of the patients were between 20-40 years. Among the patients, 34
were males and 16 were females. Details of the Age Groups are given in Table 1
TABLE 1 Showing Age Groups
|
Age
Group |
M |
F |
Total |
% |
|
18
Yrs. |
0 |
2 |
2 |
4% |
|
20-30
Yrs. |
14 |
6 |
20 |
40% |
|
31-40
Yrs. |
12 |
6 |
18 |
36% |
|
41-50
Yrs. |
8 |
2 |
10 |
20% |
|
Total |
34 |
16 |
50 |
100% |
Smoking & Chewing habits :
8% of patients had smoking habit,
12% had pan chewing habit and 8°,io had pan
-I- tobacco chewing habit. Majority of my patients, that
is 72% had no habits mentioned above. However, the percen
- tages of these habits are not taken as a general
pattern, because these vary with different socioeconomic groups and other
unknown factors. Details of smoking and chewing habits are given in Table 2.
|
TABLE 2 Showing Smoking & Chewing
Habits |
||||
|
Habit |
M |
F |
Total |
% |
|
Smoking |
4 |
0 |
4 |
8% |
|
|
|
|
|
|
|
Pan
Chewing |
4 |
2 |
6 |
12% |
|
Pan +Tobacco Chewing |
|
|
|
|
|
4 |
0 |
4 |
8;0 |
|
|
No
Habits |
22 |
14 |
36 |
72% |
|
|
|
|
|
|
|
Total |
34 |
16 |
50 |
100% |
Teeth
cleaning habits : 56% of the patients were using tooth
paste with tooth brush and 44% were using tooth powder with finger.
There
was always a changing pattern in the use of brands of tooth paste. While the
users of tooth powder preferred black tooth powder of various brands.
In 10 patients, it
was observed that brushing was correctly done by vertical and rotatory stroking of the tooth-brush by previous advice of
a Dental Surgeon. Even in these patients, unfortunately, gingivitis could not
be prevented. This emphasises the necessity for
constant observation and prompt treatment of gingivitis so that it may not
lead to periodontitis and loss of teeth.
Details
of teeth cleaning habits are given in Table 3
Table 3 :
Showing Teeth Cleaning Habits
|
|
M |
F |
Total |
0 |
|
Tooth
Paste |
|
|
|
|
|
with
tooth brush |
14 |
14 |
28 |
56% |
|
Tooth
Powder |
|
|
|
|
|
with
finger |
20 |
2 |
22 |
44% |
|
Total |
34 |
16 |
50 |
100% |
Tooth
Pain : 600, , of the patients had pain in the lower right teeth and
56°/o
had pain in the lower left teeth. This shows that lower teeth are more affected
with pain than the upper teeth.
The
least affected with pain were the upper left teeth (only 24%).
The
average number of teeth affected per case was a maximum of 2.1 per case, right
or left, but of lower teeth only. Tooth pain was mild in 24%, moderate in 26%
and severe in 50%of patients;
Table 4 Showing Painful Teeth (50 Cases)
|
|
No. of cases |
°o |
Total No. of teeth affected |
Ave rage per case |
|
Upper
Right |
20 |
40% |
36 |
1.8 |
|
Upper
Left |
12 |
24°a |
24 |
2.0 |
|
Lower
Right |
30 |
60% |
64 |
2.1 |
|
Lower
Left |
28 |
56% |
60 |
2.1 |
Bleeding Gums, Ulcerated Gums
& Severity of Gingivitis : Gingivitis was mild in
24%, moderate in 26% and severe in 50% showing that the majority of patients
come to a Dental Clinic only in a severe condition
Two patients had ulcerated gums
and 21 patients had bleeding gums. Bleeding complaint ranged from 1 month to 3
years.
Some patients had bleeding after
brushing, some on pressing with fingers, some had bleeding in the morning, and
some had bleeding while sucking only.
Many patients with bleeding gums had salty taste in the
month. Salty taste was more common in those & patients where there was bleeding
while sucking, or in those patients where bleeding was present in the early
morning.
Details of duration of the complaint bleeding gums are
given in Table 5.
Table 5 Showing the duration of the complaint of
bleeding gums (21 patients)
Duration No of Cases %
1-6 months 8 38.1%
7-12 months 3 14.3%
1-2 years 4 19.0%
2-3 years 6 28.6%
Directions for the use of G32:
1. Firstly, the patient was asked
to gargle with luke warm
water.
2. Then he or she was asked to
crush two G32 tablets into powder form.
3. This powdered G32 was to be
applied gently to the affected parts and the application was to be spread to
the surrounding tissues.
4. Patient was instructed to wait for 10-15 minutes for the drug to act
5. Finally the patient was advised
to gargle thoroughly with luke-warm water.
G32 application in the above
manner was advised two times a day. Normally the patient was advised to use G32
for 8 days. ). In case there was no relief in 8 days, the drug was continued to
a maximum period of 30 days
Response to G32 was
noticed in all the 50 patients of gingivitis.
Tooth pain was
relieved in all the cases in two days time After using G32 for five days, the
inflammatory condition of the gums was absent or considerably reduced. Bleeding
from gums was either absent or considerably reduced after 8 days of treatment
with G32. Then scaling could be carried out in many cases. Supra-gingival or
sub-gingival scaling was done in 30 patients, out of the total 50 patients.
10 cases who
were using the right technique of vertical and rotatory
stroking of tooth brush who could not get any relief by their correct technique
of brushing, got relief in reducing the inflammation with the use of G32.
On the whole, 50% of patients had
complete relief in 8 days, 30°'° in 15 days and 4% in 30 days; that
is 42 patients out of the total of 50 patients had complete relief from
gingivitis and associated complaints, like tooth pain and bleeding gums. Only 8
patients (16°'.) did not fully respond but showed satisfactory improvement.
Subsequently,
all patients were followed-up for three months, during which period the
patients were advised G32 application, two tablets at a time, twice a day to
maintain oral hygiene. Their gingival condition and oral hygiene were good.
Further follow-up for three more months did not show any relapse.
The details of response to G32
are given in Table 6.
Table 6 : Showing results of G32 treatment
|
|
In 8 days |
% |
In 15 days |
% |
In 30 days |
% |
Total |
% |
|
Complete Relief |
25 |
50% |
15 |
30% |
2 |
4% |
42 |
84% |
|
Satisfactory Relief |
- |
|
- |
- |
8 |
16% |
8 |
16% |
|
Total |
25 |
50% |
15 |
30% |
10 |
20% |
50 |
100% |
CONCLUSION
G32 is
found to be an effective and a safe drug in gingivitis, acute or chronic, localised or generalised, and
even when associated with painful teeth and bleeding gums.
SIDE EFFECTS :
No side effects, local or
systemic, were observed with the use of G32
SUMMARY
50 consecutive patients having
gingivitis, acute or chronic, localised or generalised, associated with painful teeth, were given a
clinical trial with G32 local application. 21 patients had also bleeding gums.
With G32 complete relief was
obtained in 84% of patients within 8 to 30 days. Majority of
the patients getting relief in 8 days only. There was satisfactory
relief in the remaining 16°,0 of patients.
AKNOWLEDGEMENT
I am thankful to Alarsin
Pharmaceuticals,