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ENTAMOEBA GINGIVALIS
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Entamoeba gingivalis was discovered in 1849
It is the first amoeba in humans to have been described.
It is single celled (eukaryotic)
It is free living, globally distributed.
Taxonomic classification.
KINGDOM
SUBKINGDOM
Animalia
Protozoa
PHYLUM
SUBPHYLUM
CLASS
Sarcomastigophora
Sarcodina
Archamoebiae
ORDER
GENUS
SPECIES
Amoebida
Entamoeba
gingivalis
FEATURES OF E. GINGIVALIS.
• They assume any shape.
• The trophozoite is about 10-20µm, actively motile with
multiple pseudopodia.
• Has only the trophozoite found and the cystic stage being
apparently absent.
• They crawl along surfaces using pseudopodia.
• They are believed to have evolved from flagillates as a result
of loosing flagela.
• Contain cellular debris.
Cont…
• Cytoplasm contains food vacuoles with ingested
bacteria, leucocytes, and epithelial cells. Presence of
ingested leucocytes and their nuclear fragments is
diagnostic as no other amoeba ingests these cells
• The nucleus is round with a delicate central
karyosome and nuclear membrane lined with coarse
chromatin granules.
GENERAL INFORMATION.
• The amoeba lives in the gingival tissues and is abundant in
unhygienic mouths.
• A temperature-resistant species of amoeba found in the
mouth of humans and other mammals. As a causal agent of
gingivitis.
• It is a commensal and is not considered to cause any disease.
• It is transmitted by direct oral contact through droplets of
saliva or fomites. Also by sharing eating utensils.
Cont…
• E . gingival has also been found in bronchial washings
from cases of pulmonary suppuration and in sputum,
where it can be mistaken for E. histolytica from lung
abscess.
• The amoeba has been reported in vaginal and
cervical smears of women using intrauterine devices
and disappear spontaneously with the removal of
these devices.
• Similar amoeba have been observed in the mouth of
dogs, cats, and monkeys.
GINGIVITIS.
• Gingivitis, painless inflammation or degeneration of the gum
tissue, or gingiva, considered the first stage of gum disease.
• Healthy gums are firm and uniformly pink, with the gum
tissue evenly filling the spaces in between the teeth.
• In gingivitis, the gum tissue between the teeth becomes
swollen and uneven; the tissue at the gum line (where the
teeth meet the gums) becomes darker; and gums bleed easily.
In advanced cases, the mouth will develop a noticeably
unpleasant odor.
Cont…
• Gingivitis can begin at puberty but most often appears in
adults, generally as a result of poor dental hygiene.
• According to the American Dental Association, some form of
gum disease affects three out of four adults over age 35.
• People who have certain medical conditions, including
diabetes mellitus and acquired immunodeficiency syndrome
(AIDS), are more prone to develop this disorder.
• Hormonal changes, such as those occurring during pregnancy,
can also make a person more susceptible to gingivitis.
Pathogenesis of gingivitis.
• 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.
Cont…
• 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.
Cont…
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.
TREATMENT.
• 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.
DENTAL ADVICE.
• Brushing with a very soft nylon brush twice a day for two to
three minutes each session.
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Daily flossing is also important, using the correct technique
that includes cleaning the root surfaces of the teeth just
below the gum line.
• Finally, regular visits to the dentist for checkups and
professional cleaning are essential.
REFERENCES.
• CK Jayaram Paniker, text book medical parasitology, 6th
edition, Jaypee brothers medical publisher, New Delhi, 2007.
• Kumar, Abbas, Fausto.Robin and Carton Pathologic basis of
disease, 7th edition. Saunders, The Curtis center, 170 S
Independence Mall W 300E, Philadelphia, Pennsylvania
19106, 2004.