Management of plaque-induced gingivitis

Question 1

Describe what gingivitis is (5 points)

Answer 1

• Plaque-induced gingival inflammation confined to the gingival tissues
• Highly prevalent
• Largely painless
• Completely reversible
• Common condition

Question 2

What are the signs and symptoms of gingivitis? (5)

Answer 2

Erythema (redness)
Odema (swelling)
Absence of stippling on attached gingiva
Bleeding on probing 
Bleeding on brushing

Question 3

What are the key signs of periodontitis? (3)

Answer 3

Pocket formation
Gingival recession (receding gums)
Tooth mobility/tooth drifting

Question 4

How is periodontitis described? (3)

Answer 4

Irreversible destruction to supporting tissues of teeth
Apical migration of junctional epithelium
Alveolar bone loss

Question 5

What is done to help manage plaque-induced gingivitis? (4)

Answer 5

• Supragingival scaling to remove plaque/calculus
• Eliminate/modify local plaque retentive factors e.g. mispositioned teeth, overhangs, crowns/bridges, ortho appliances
• Deliver OHI (with action by patient)
• Smoking cessation advice (with action by patient)

Question 6

How do you deal with retentive factors when trying to manage plaque-induced gingivitis? (3)

Answer 6

1. Explain and point where the local plaque retentive factors are to the patient (e.g. a crown)
2. Provide instruction on how to adequately clean this
3. Eliminate or modify the local factors e.g. remove overhangs for restorations

Question 7

How do you outline plaque control management to your patient? (3)

Answer 7

Deliver OHI succinctly
Demonstrate to the pt and get them to show you
Review their plaque control at subsequent visits

Question 8

What must you say when giving smoking cessation? (3)`

Answer 8

That it is the main risk for periodontitis
Inform pt of risks of smoking and benefits of cessation
Offer cessation advice (NHS services etc)

Question 9

What are the steps in managing plaque-induced gingivitis? (6)

Answer 9

1. Explain the risk of untreated gingivitis
2. Reinforce plaque control
3. Smoking cessation
4. Remove supragingival plaque and calculus
5. Remove local retentive factors
6. Review