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Periodontology > Gingivitis and gingival disease > Flashcards

Gingivitis and gingival disease Flashcards

1
Q

How can periodontal diseases and conditions be classified in the 2017 classification system?

A

Periodontal health, Gingival disease and conditions
Periodontitis
Other conditions affecting the periodontium
Peri-implant diseases and conditions

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2
Q

Name the 4 periodontal structures

A

Gingivae
PDL
Cementum
Alveolar bone

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3
Q

What type of gingiva sits between the gingival margin and the gingival groove?

A

Free gingiva

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4
Q

Where is the gingival sulcus found. What type of epithelium lines this?

A

Found in the sulcus between tooth and free gingiva.

Lined by sulcular epithelium

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5
Q

What structure demarcated the attachment of attached gingiva to alveolar musocsa?

A

Mucogingival junction

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6
Q

Function of the junctional epithelium?

A

Forms attachment of gingiva to tooh

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7
Q

4 signs of gingival health

A

Gingiva are firm and pink
Stippling may be present
Interdental papillae are pyramidal
Gingival crevice less than or equal to 3mm

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8
Q

How does the body ensure an intact epithelial barrier is maintained?

A

Shedding of epithelial cells - replaced by new cells. Junctional epithelium has a very high turnover rate
Outflow of GCF
Antimicrobial effects of antibodies
Phagocytic functions of neutrophils and macrophages
Complement activity

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9
Q

Signs of periodontal disease?

A 
Plaque around gingival margin
Bleeding
Swelling
Redness
Halitosis 
Papillae more blunt
increased GCF
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10
Q

5 signs of inflammation

A 
Pain
Redness
Swelling
Temperature 
Loss of function
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11
Q

First disease processes involved with gingivitis?

A

Dental plaque related gingivitis

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12
Q

Define dental plaque biofilm

A

Collection of microorganisms, held together within a matrix structure, on a surface or interface

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13
Q

What are early dental plaque biofilm colonisers?

A

Streptococcus

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14
Q

What are the later colonisers of plaque biofilm?

A

Rod shaped (G +ve) e.g. actinomyces

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15
Q

What is the ecological plaque hypothesis?

A

Non specific pathogenic species of bacteria cause disease due to a shift in bacteria population and biofilm balance

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16
Q

How is gingivitis diagnosed?

A

Clinical appearance
BOP
Plaque indices

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17
Q

How is initial examination of the gingiva carried out?

A

BPE - a screening tool

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18
Q

BPE score 0

A

Pockets <3.5mm
No calculus/overhangs
No BOP

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19
Q

BPE score 1

A

Pockets <3.5mm
No calculus/overhang
BOP

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20
Q

BPE score 2

A

Pockets <3.5mm

Supra or sub gingival calculus/overhangs

21
Q

BPE score 3

A

Pockets 3.5-5.5mm

22
Q

BPE score 4

A

Pockets >5.5mm

23
Q

Patient has code 0/1/2 and <10% BOP. What is the diagnosis?

A

Clinical gingival health

24
Q

Patient has code 0/1/2 and 10-30% BOP. What is the diagnosis?

A

Localised gingivitis

25
Q

Patient has code 0/1/2 and more than 30% BOP. What is the diagnosis?

A

Generalised gingivitis

26
Q

What are false pockets?

A

Present when junctional epithelium is still at CEJ but the sulcus is deepened to more than 3mm due to changes in gingival swelling

27
Q

Diagnosis of gingivitis

A

No pocket depths >3mm - BPE code 0/1/2
BOP - amount dictates severity of disease
Redness, swelling, heat
NO bone destruction or breakdown of PDL

28
Q

Consequence of necrotising gingivitis?

A

Sloughing of gingival margin, ulceration, painful

29
Q

Aetiology of necrotising gingivitis?

A 
Poor OH
immunocompromised
Poor diet and general health
Smokers
Stress
30
Q

List 8 local contributing factors of gingivitis

A 
Dental plaque
Supra/subgingival calculus
Suboptimal restoration margins
Tooth anatomical factors
Malocclusion/crowding
Fixed/removable prosthodontics/ortho
Incompetent lips/lack of seal
oral dryness (mouth breathers, xerostomia)
31
Q

List 8 systemic factors that can contribute to gingival disease?

A 
Puberty
Pregnancy
Menstrual cycle
Diabetes
Blood dyscrasia (leukaemia)
Medications - amlodipine
malnutrition (Vit C deficiency)
Smoking - vasoconstriction
32
Q

Why might smokers not notice signs of gingival disease as soon as non-smokers?

A

Causes vasoconstriction so stops bleeding.

Non-smokers will notice more bleeding sooner

33
Q

How is plaque-induced gingivitis managed?

A

OHI
Biofilm destruction - scale, toothbrushing
Removal of retentive features

34
Q

Describe how pregnancy-associated gingivitis occurs?

A

Increased hormone levels increasing vascular permeability into gingival tissues

35
Q

How should pregnant patients be managed?

A

OHI
Recall - every 3 months
identify stage of pregnancy - should get better in 3rd trimester

36
Q

How does hereditary gingival fibrzomatosis present?

A

Gingival overgrowth

37
Q

How can infections of bacterial origin cause gingivitis?

A

Necrotising gingivitis –> fusobacterium, treponema infection
Associated with ulceration and sloughing of gingival margin

38
Q

Name 4 bacterias that can cause gingivitis?

A

Neisseria gonorrhoea
Treponema pallidum
Mycobacterium tuberculosis
Streptococcal gingivitis

39
Q

How can gingivitis occur as a result of viral infections?

A

Hand, foot and mouth disease - cocksackie virus
Primary herpetic gingivostomatits - HSV1 and 2
Chicken pox, shingles - VZV
Human papilloma virus

40
Q

How does hand, foot and mouth disease present?

A

Usually in children
Vesicles that rupture and ulcerate
Similar lesions in mouth, hand and feet

41
Q

How does primary herpetic gingivostomatitis present?

A

Primary infection
Usually in children/pregnant women
Aggressive gingivitis and multiple fluid filled vesicles which burst and leave ulcers

42
Q

How can fungal infections case gingivitis?

A

Oral candidiasis = opportunistic pathogen

43
Q

How does human papilloma virus present in the mouth?

A

Cauliflower like lesion
Usually asymptomatic
Refer to oral surgery to remove

44
Q

How can gingivitis occur in hypersensitivity reactions?

A

Type IV hypersensitivity reaction

45
Q

How can autoimmune diseases cause gingivitis?

A

Lichen planus
Pemphigus vulgaris
Bullous pemphigoid

46
Q

How can pre-malignant neoplasms cause gingivits?

A

Leukoplakia (white patch)
Erythroplakia (red patch)
Refer to oral medicine

47
Q

How can malignant neoplasms cause gingivitis

A

Squamous cell carcinoma
Leukaemia - bleeding, swelling
Lymphoma

48
Q

How can traumatic lesions cause gingivitis?

A

Physical/mechanical - function keratosis - zealous toothbrushing
chemical - etching
Thermal - food/drink

49
Q

How can endocrine/nutritional and metabolic disease cause gingivitis?

A

Diabetes

Vit C deficiency

Periodontology (10 decks)

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