Dental Plaque Induced Gingivitis Flashcards
What are the four dental plaque induced gingival diseases?
- Gingivitis associated with dental plaque only
- Gingival disease modified by systemic factors
- Gingival disease modified by medication
- Gingival disease modified by malnutrition
What is peri-mucositis?
inflammation limited to the mucosa around an implant
Characteristics common to ALL gingival diseases:
- Signs & Symptoms ________ to the gingiva
- Presence of _______
- Clinical signs of _______
- No _______ or symptoms associated with _____
- ________ of the disease by removal of etiology
- Possible role as _______ to attachment loss
- limited
- plaque
- inflammation
- attachment loss, or stable/reduced periodontium
- reversibility
- precursor
Common clinical changes associated with gingivitis include (5 items)?
color texture/edema bleeding exudate plaque
True or False: There is a sulcular temperature increase associated with plaque-induced gingivitis.
true
Describe the color differences between normal, inflamed, and severely inflamed, gingiva.
Normal: coral-pink
Inflamed: red (inc. vascularization, dec. epithelial keratin)
Severe: red and cyanotic (vasc. prolifer & lack of oxygen)
Why does bleeding on probing occur with increased inflammation?
- Dilation and Engorgement of capillaries
- Thinning/ulceration of the sulcular epithelium
What is spontaneous bleeding?
bleeding that occurs in acute or severe disease that may be related to systemic health problems
Healthy gingiva is ____ and _____; whereas, inflamed gingiva appears ______, ______, and ______
firm and resilient
soft, swollen, friable
How does gingival consistency change in the case of several gingival disease?
it becomes necrotic and flakes or sloughs off, grayish coloring
Inflammation is associated with increased extracellular fluid and ______, degeneration of _______, and thinning of _____.
exudate
connective tissue
epithelium
Chronic inflammation can induce ____ and _____ proliferation which appears firm and leathery.
FIBROSIS and epithelial proliferation
How does surface texture look when tissue is inflamed?
Healthy gingiva is dull (matte) with stippling
Inflamed gingiva is smooth and shiny
Severely inflamed is firm and nodular
Describe the shape of the gingival margin and how it changes from health to disease.
Health: scalloped and following the CEJ
Inflamed: knife-edged or loose with “Stillman’s clefts” or “McCall’s festoons”
What is needed in order to differentiate between periodontitis and gingivitis on a reduced periodontium?
Previous documentation
______ _______ is a chronic inflammatory response characterized by exudate and proliferative features such as deep red lesions, shine, expansion in size, and bleeding tendency.
Gingival Enlargement
In the case of gingival enlargement, an increase in what two cells/fibers would be associated with the increased fibrosis?
fibroblasts
collagen fibers
What is the primary etiologic factor associated with plaque-induced gingivits? Secondary etiologic factors?
primary: bacterial plaque (must have)
secondary: local factors (make it worse)
What are some examples of secondary etiologic factors?
calculus
marginal deficiencies
malocclusion
tooth or root anomalies
Gingivitis associated with local contributing factors include tooth abnormalities such as ______ and _______.
enamel pearls
cemental tears
In health, the biologic width is between ___ and ___mm and includes the depth of the ____, the ______ attachment, and the _____ _____ attachment
2 and 3 mm sulcus epithelial connective tissue (aka: from the gingival margin to the alveolar crest)
True or False: Periodontitis starts with gingivitis but gingivitis does not always progress to periodontitis.
True
True or False: Return of inflammation to sites that were previously treated for periodontitis is common.
True
What is recurrent periodontitis?
recurrent inflammation that does not cause further attachment loss but the inflammation returns to gingival tissues in previously treated areas
True or False: Endocrine disorders can cause gingival disease.
False: it makes it worse but you must have dental plaque to cause disease
What are three circumstances in which the endocrine system is involved with gingivitis?
puberty
menstrual cycle
pregnancy
True or False: pregnancy associated gingivitis usually occurs during the first trimester and is modulated by increased hormones.
False: SECOND trimester
Localized host response mediated by high levels of estrogen or testosterone is characteristic of _______.
Puberty associated gingivitis
True or False: Clinically detectable changes seem to be associated with the menstrual cycle and gingivitis.
False: not clinically detectable… however, increased GCF have been recorded up to 20%
What is a pyogenic granuloma and how is it associated with pregnancy?
a highly vascularized mass of granulation tissue that usually appears during the second or third trimester; appears as a pedunculated mass on gingival tissue
Which vitamin deficiencies are associated with gingival disease?
Vitamin C (scurrrrvyyy)
Vitamin A
Vitamin B2
Vitamin B12
If a small child shows up with spontaneously bleeding gingiva, what should be done and why?
Send the child to get blood work
Systemic diseases such as Diabetes, Leukemia, blood dysplasias, cyclic neutropenia, acute myeloid leukemia, and thrombocytopenia can influence the gums
What are the three commonly used drug types that are associated with gingival overgrowth?
- Anticonvulsants
- Immunosuppressants
- Calcium Channel Blocking Agents
What could occur if a patient is taking Phenytoin (anticonvulsant), Cyclosporin (immunosuppressant), or Nifedipine (calcium channel blocker)?
Gingival Overgrowth**
What is the main sign that a patient may have NUG and not just gingival irritation/swelling?
PAIN of the interdental papilla…most issues don’t cause pain
How is NUG often resolved?
systemic antibiotic
What are the predisposing factors for NUG?
- Systemic disease
- Abnormal white blood cell function
- AIDS
What is lost in patients with NUG?
papilla
Which disease is often associated or confused with NUG?
Primary Herpatic Gingivostomatitis (PHS)
What is the difference in etiology between NUG and PHS?
NUG = bacteria PHS = Herpes simplex virus
What is the difference in duration between NUG and PHS?
NUG = 1-2 days if treated PHS = 1-2 weeks
What is the difference in contagiousness between NUG and PHS?
NUG = not PHS = YESSSSS
Ulceration and necrotic tissue, with yellowish white plaque would indicate _____; whereas, multiple vesicle bursts that leave small, round, fibrin-covered ulcers would indicate ______.
NUG
PHS
