Session 4: Periodontal Health Effects of Aging

Question 1

Describe the clinical appearance and histological characteristics of each of the 4 periodontal structures in health (gingiva, periodontal ligament, cementum and alveolar bone)

Answer 1

– Gingiva- serves to protect underlying supporting structures of teeth
– Cementum- provides attachment to PDL, protects underlying dentin and formative capacity
– Periodontal Ligament-
supporting, sensory, nutritive, formative and resorptive functions
– Bone- form bony sockets to support and protect roots of teeth

Question 2

Gingiva

Answer 2

Part of the mucosa that surrounds the cervical portion of the teeth and the alveolar processes of the jaws
– Composed of thin outer layer of epithelium and underlying connective tissue
– Ends coronal (above) the cemento-enamel junction (CEJ) of each and attaches with special type of
epithelial tissue known as the junctional epithelium

Question 3

Periodontal Ligament

Question 4

Cementum

Question 5

Alveolar Bone

Question 6

Describe the composition of the periodontal structures

Question 7

Identify and describe the 4 anatomical areas of the gingiva

Answer 7

4 anatomical areas:
– Free gingiva: Surrounds the tooth in a cuff-like manner. Unattached portion
– Attached gingiva: allows tissue to withstand mechanical forces and prevents free gingiva from
being pulled away from tooth when tension is applied to alveolar mucosa
– Interdental gingiva: Prevents food from becoming packed between teeth during mastication
– Gingival sulcus: Space between the free gingiva and tooth surface

Question 8

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

Answer 8

Colour Contour Consistency
________________________________________________________________________
Gingival margin: Interdental papilla:
________________________________________________________________________
Pink Knife-edge margins (flat Pyramidal Firm (resilient)
and closely adapted)
________________________________________________________________________
Pigmented Bulbous Bulbous Spongy
(edematous, soft)
_________________________________________________________________________
Erythematous Receded (shrunk away Blunted Retractable (flaccid)
from CEJ)
__________________________________________________________________________
Cyanotic Rolled Cratered (NG diseases) Shiny
___________________________________________________________________________
Scalloped Fibrotic (appears firm
and snug to the tooth)
___________________________________________________________________________

Question 9

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

Answer 9

– 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

Question 10

List the common misconceptions of aging

Answer 10

– Tooth loss is an inevitable part of the normal aging process
– Most teeth are lost as people became ‘long in the tooth’ because of advancing periodontal disease
– All adults are susceptible to severe periodontal disease
– Dental caries is not a common oral disease in older patients and occurs mainly in the young
– Salivary flow is decreased in all older adults