G32* in Acute and Chronic Gingivitis associated with Painful Teeth

Miss KIRTI P. SHAH,    B. D. s. (Bom.)

By

Hony. Dental Surgeon People's Mobile Clinic & Shantaben Zaverichand Mehta Clinic,

Ruparel People’s Mobile Clinic & Shantaben Zaverichand Mehta Clinic, Bombay

 

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, Bombay - 400 023, for the supply of G 32 tablets necessary for the trial.

 

 

 

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