Review Flashcards
What differentiates gingivitis vs periodontitis?
CAL
What is the easiest clinical way to know if gingivitis is plaque induced or non-plaque induced?
Plaque induced will go away with prophy
T/F: Diabetes and pregnancy CAUSE periodontitis.
FALSE
Increase risk but do not cause it
What are the characteristics for aggressive periodontitis?
- Younger patients
- Systemically healthy
- Disease progression does not match clinical findings
- Robust antibody response
How do we classify aggressive periodontitis as localized?
1st molar must be involved
Molars and incisors and no more than two other teeth
How do we categorize chronic periodontitis as localized?
30% or less of probe sites are diseased
How do you differentiate between slight, moderate and severe disease?
Slight = 1-2 mm CAL Moderate = 3-4 mm CAL Severe = 5 or more CAL
How do you score the gingival index?
0 = normal 1 = mild inflam, slight color change, NO bleeding 2 = moderate inflam, redness, edema, BoP 3 = severe inflam, SELF REPORTED BLEEDING
If the patient comes in and says their gums bleed when they brush, eat, or sleep what should you expect some of their GI scores would be?
Will have some 3s due to spontaneous bleeding
T/F: You can only give a GI score of 2 if it is bleeding.
FALSE
Bleeding always will give a score of 2.
But if inflammation is bad enough without bleeding can still give score of 2
T/F: The Gingival Index is very subjective.
True
Doctors can have different scores
What are the scores for the plaque index?
0 = no plaque 1 = plaque seen by swiping probe along the margin 2 = moderate amounts of visible plaque 3 = visible plaque seen in abundance
T/F: Disclosing agents are used to do the Loe and Silness plaque index.
FALSE
It is a non-disclosed index
What are the dimensions of the PSR probe?
Ball = 1/2 mm Clear = 3 mm Color = 2 mm
TOTAL = 5.5 mm
What are the PSR codes?
0 = colored area visible, no plaque/defective margins, no BoP 1 = colored area visible, no plaque, yes BoP 2 = colored area visible, yes plaque, yes/no BoP 3 = colored area partially visible, yes/no plaque, yes/no BoP 4 = colored area not visible, yes/no plaque, yes/no BoP
Why do we do PSR?
Understand patient needs
Can only use it once on a patient
Can not use during maintenance
T/F: With PSR you record the average of each sextant.
FALSE
GI = averages per sextant PSR = worst code is put down per sextant
T/F: If one sextant is recorded as a three in PSR, the patient needs full mouth perio evaluation.
FALSE
3 on one sextant = perio eval that sextant
4 on one sextant or 3 on two sextants = full mouth perio eval
Who can get PSR eval?
Adults only during the first visit
T/F: BoP is always immediately seen upon probing.
False
Takes 30 secs - 1 minute
What is the O’Leary Index?
Uses disclosing rinse and look for stained surfaces
Calculated in percentage
Only counts presence/absence
What is a sensitive test?
You will diagnose the disease when they have it
What is a specific test?
You will know when the patient does not have disease
Will only pick up disease when it is definitely there
What is predictive value positive?
The probability of disease in a subject with a positive test
T/F: Viral infections are self-limiting.
True
Will heal with/without treatment
What will HSV ulcers often be mistaken for and how do you differentiate?
Apthous (stress) ulcers
Apthous are not on keratinized mucosa but HSV are
How does recurrent HSV often present?
Herpes labialis
Zoster ulcers are normally found where? What is specific about these lesions?
Tongue, palatal, gingiva
Unilateral with skin lesion on other side of the body
What causes thrush?
Candida albicans
T/F: Thrush is pleomorphic.
True
Comes in many different forms
T/F: Everyone carries candida in their mouths.
True
Only bad when it goes into overdrive
What can predispose patients to thrush?
- Heavy antibiotic use
- Immunosuppression
- Malnutrition
- HIV
- Diabetes
What are the two types of candidosis presentation?
Pseudomembranous (white)
Erythematous candidosis (red gums)
Burning tongue = shiny mass on the tongue
T/F: Culture can be a great way to diagnose oral fungal infection.
FALSE
Can be misleading because we all have some candidiasis
What are the characteristic skin lesions for lichen planus?
Wickham striae
T/F: Lichen planus is an autoimmune disease.
True
What is the major concern with lichen planus?
May become malignant
What is the classic histopathologic presentation of lichen planus?
Band-like accumulation of lymphocytes
What will be seen in immunofluorescence of Lichen planus?
IgM, C3, C4, C5 in basement membrane
What is the major characteristic of pemphigoid?
Detachment of epithelium from connective tissue
T/F: Pemphigoid is an autoantibody reaction.
True
T/F: Pemphigoid can cause eye problems.
True
What is the classic characterization of pemphigus?
Formation of intraepithelial bullae in the spinus cell layer
Which disease causes Acantholysis?
Pemphigus
Acantholysis is the formation of the intraepithelial bullae
T/F: There will be bleeding in patients with pemphigus.
FALSE
Pemphigoid = bleeding Pemphigus = no bleeding
Where do you expect to see NUG?
Marginal gingiva esp in the interdental papillae
What can predispose patients to NUG?
Smoking and stress
When would you give antibiotics to a patient with NUG?
Only if they have other systemic conditions
Periapical cemental dysplasia is a ___________ process of periodontal _______ tissue.
Reactive; hard
What are some characteristics of periapical cemental dysplasia?
- Tooth is vital
2. No symptoms
What is primary TFO?
Excessive force on normal periodontium
What is secondary TFO?
Normal or excessive force on weakened periodontium
What are the three models for chronic periodontitis progression?
- Continuous - slow and constant
- Random burst - short periods of destruction with periods of rest
- Asynchronous multiple burst - destruction during defined periods of life
What are the two major risk factors for chronic periodontitis?
Smoking and diabetes
T/F: Risk factors can be modified.
True
