chronic gingivitis Flashcards
What’s the best and earliest sign of gingivitis?
Bleeding on probing is considered the BEST and EARLIEST sign of gingivitis.More OBJECTIVE than visual changes.
Why does inflamed tissue bleed?
Epithelium is ulcerated.* Blood vessels are engorged. Healthy gingiva does NOT bleed!
What can gingival bleeding be influenced by?
- Bleeding disorders such as vascular/platelet abnormalities, Hemophilia.
- oral contraceptives, pregnancy
- Excessive use of drugs such as – Salicylates, Thrombolytics.
- Smoking - they are saying that with smokers, even if the gingiva is inflamed there will be less bleeding, so don’t rely on probing as much or bleeding as much with them.
THERE CAN ALSO BE LOCALIZED BLEEDING. SITES THAT ARE UNHEALTHY BUT OTHER SITES ARE HEALTHY.
What is the color like for chronic gingivitis?
From PINK to RED.
Usually begins near the margins of the papilla and spread to involve the rest of the tissues.
what can the color of the gingiva be influenced by?
Thickness of epithelium.
- Keratinization.
- Infl/ Vascularity.
- Pigmentation.
- Subgingival deposits.
and
Systemic diseases such as
Addison’s [ incr.pigmentation]
Albrights’ syndrome [brown spots]
Diabetes, Anemia, Leukemia, Polycythemia.
What is the surface texture of the gingiva in chronic gingivitis like? What can influence the surface texture?
Stippling lost. Att.gingiva is smooth, shiny.
Surface texture may be influenced by;
- DRUGS [Fibrous/nodular]
- Hyper keratosis [Leathery] - like from smoking. Smoker’s keratosis.
Why is it important to be systematic while looking at the gingiva?
Otherwise you will miss small tissue changes.
What is the consistency of chronic gingivitis gingiva?
Soft, spongy, edematous.
Loss of marginal fit.
May pit on pressure. (like if you push your mirror handle in to it)
Has a ‘juicy (don’t use this term in exams!) appearance.
What are some indications of healthy gingiva?
Sulcus is less than 3mm. Bone is rounded and about 1 to 2 mm from CEJ. No rete pegs in the sulcular epithelium.
What are some indications of unhealthy gingiva? and what makes it not periodontitis?
there becomes a pocket. there are rete pegs in the sulcular epithelium.
the junctional epithelium is still at the CEJ and not below it. Also the bone has not moved apically as compared to before when it was healthy.
you can get blunting or cratering of the papilla.
What is the contour in chronic gingivits gingiva?
PAPILLA: Bulbous, Blunted or Cratered
MARGINS: Rolled or rounded [McCall’s Festoons] it looks like a rolled towel at the gingival margin, Clefts [Stillman’s clefts] looks like you cut a little V shaped valley on the buccal surface and these can widen, Recession.
What’s the difference between a symptom and a sign?
A sign is something physical that you can see and you can elicit.
A symptom is something taht the patient tells you. E.g. “my gums were bleeding when I was brushign my teeth”
Why do tissue swell[BECOME BULBOUS] when inflamed?
Increase in Edema. - permeability of the blood vessels increases and so you have an increased number of cells and fluids in the tissue.
Increase in the # of cells.
Increase in the # new blood vessels.
How can you tell if it’s mild gingivitis?
If you are probing you don’t see bleeding immediately, it is delayed. If it bleeds immediately it is moderate or advanced.
What do you havei n patients with chronic gingivitis?
Gingival pocket: A pathological deepening of the gingival sulcus not accompanied by the apical migration of the epithelial attachment.
Usually, there is hardly any pain in chronic gingivitis!
