Periodontal Health

Question 1

Identify 4 anatomical areas of gingiva

Answer 1

1. Free gingiva
2. Attached gingiva
3. Interdental gingiva
4. Gingival sulcus

Question 2

Describe free gingiva

Answer 2

• Fits closely to tooth but not directly attached to the tooth
• Contours the teeth forming a scalloped (wavy) outline around them
* Serves as the soft tissue wall of the gingival sulcus
* The unattached portion of the gingiva surrounding the tooth near the CEJ

Question 3

Describe attached gingiva.

Mention the mucogingival junction.

Answer 3

• Mucogingival junction: clinically visible boundary where attached gingiva meets alveolar mucosa
  There is a shallow depression which separates the free gingiva from attached gingiva
• Connected tightly to the cementum
• Located between the free gingiva and the alveolar mucosa
• Colour may be pale pink or pigmented (in dark-skinned individuals)
• May exhibit dimpled appearance (stippling)

Question 4

Describe interdental gingiva.

Mention the col.

Answer 4

• Gingiva that fills interdental gaps between 2 adjacent teeth
• Col: A valley-like area lies directly below the contact area of 2 adjacent teeth
* No col exists when adjacent teeth are not in contact or recession is present
* Interdental gingiva consists of 2 interdental papillae (one on facial aspect, one on lingual or palatal)

Question 5

Describe gingival sulcus, and mention the GCF

Answer 5

• The space between the free gingiva and tooth surface
* Base of sulcus is formed by junctional epithelium

• Gingival crevicular fluid (GCF) or gingival sulcular fluid seeps into sulcular space from underlying connective tissue
○ little to no fluid is found in healthy sulcus
○ GCF flow increases with tooth brushing, mastication or other stimulation
* flow increases in presence of dental plaque biofilm and with inflammation

Question 6

Identify and demonstrate the ability to describe the clinical characteristics of healthy gingiva (gingival descriptors) (8)

Answer 6

• Colour: pink; may be pigmented but is uniform in colour
• Size: fits snugly around tooth, no unusual bumps/ swelling
• Consistency: resilient
• Texture: normal or stippled

• Gingival Margin:
○ Scalloped outline
○ Located near or 1-2 mm above CEJ

• Bleeding / Exudate: none
• Interdental Papillae: firm; occupy interdental spaces apical to contact areas
• Sulcus depth: 1- 3mm

Question 7

Identify and demonstrate the ability to describe the histological characteristics of healthy periodontium

Answer 7

• Junction epithelium: is firmly attached to by hemidesmosomes to the enamel slightly coronal to the CEJ
• Periodontal Ligament fibres: intact bundles that extend between boney walls of tooth socket to cementum of the root
• Alveolar Bone: intact
* Gingival fibres: intact