UD4 Introduction to periodontal disease

Question 1

What causes Periodontitis/ gingivitis?

Answer 1

plaque

Question 2

What the difference between Periodontitis &

gingivitis

Answer 2

Gingivitis – affects gingiva only, reversible
Periodontitis – affects all structures,
irreversible

Question 3

In good periodontal health,

1) Describe the gingiva
2) Describe the interdental papillae?(the bits of the gum between teeth)
3) How deep is the gingival crevice?

Answer 3

1) pink and firm, stippled (possess a textured surface that is referred to as being stippled)
2) Pyramidal shape
3) less than 3mm

Question 4

1) Describe the appearance of gingiva in gingivitus?
2) What occurs on probing?
3) What else occurs
4) Describe bone

Answer 4

• red (erythema)
• swollen (oedema)
• shiny
• soft
  2) bleeding
  3) Increased gingival crevicular fluid (GCF)flow
  4) no destruction

Question 5

What does periodontitis effect?

Answer 5

All periodontal

structures

Question 6

What are the clinical features of periodontitis?

Answer 6

Pocket formation
 Loss of attachment
 Bleeding on probing
 Alveolar bone destruction
 Gingival recession
 Tooth mobility
 Tooth migration

Question 7

What are the 2 types of plaque, where are they found?

Answer 7

 Supragingival plaque:
located on the clinical crowns of teeth
 Subgingival plaque:
found within the gingival sulcus or
periodontal pocket

Question 8

Define Pathogenesis

Answer 8

the manner of development of a disease.

Question 9

What is the pathogenesis of periodontal disease?

Answer 9

Minor tissue destruction caused by products
produced by plaque bacteria
 Majority of tissue destruction caused by host
response to plaque bacteria

Question 10

What harmful products do plaque bacteria produce?

Answer 10

ammonia, sulphuric acid (toxic)

– collagenase (enzyme which breaks down collagen)

Question 11

How does host response lead to gingival recession?

Answer 11

Plaque bacteria stimulate immune response
– Inflammatory mediators released/immune cells recruited
– Inflammatory mediators initiate/propogate tissue
destruction to make way for more immune cells

Question 12

What are the risk factors for periodontitis:

Answer 12

Plaque retention factors, e.g overhanging
restoration margins
 Smoking
 Systemic Disease, e.g. diabetes
 Stress
 Medications
 Genetics/individual susceptibility

Question 13

1)Periodontitus is..
a) a chronic disease
b) a acute disease
2) It __?_ with age.
3) TRUE OR FALSE
little variation in individual susceptibility
4) What is a common periodontal disease?
5) What is uncommon periodontal disease?

Answer 13

1)a 2) increases
3) False- there is great variation
4) Gingivitis and mild/mod periodontal disease
common, (54% of adults have bleeding on
probing)
5) Severe periodontal disease less common

Question 14

What us the treatment for periodontitis?

Answer 14

Plaque control
Removal plaque etentive factors
Scaling and Root surface debridement (RSD)
Periodontal surgery

Question 15

How do we reduce the amount of plaque in our mouths?

mechanical: 3
chemical: 1

Answer 15

Mechanical: -toothbrushes -interproximal cleaning aids -professional cleaning Chemical: -mouthrinses

Question 16

What is the bass technique?

Answer 16

bristles at 45oto tooth long axis -pressed against gingival margin -short back/forth strokes -bristles go subgingivally

Question 17

How oftern should you brush, and for how long?

Answer 17

AT LEAST:twice per day AT LEAST:3 minutes

Question 18

Which is better power toothbrush or manual?

Answer 18

powerbrush

Question 19

What is scaling and root surface debridement (RSD)?

Answer 19

Mechanical removal of plaque and calculus from the tooth and root surface

Question 20

1) What mouthwash is used for plaque?
2) How does it work?
3) What are the sideeffects
4) How long should you use it for?

Answer 20

1) -anti-plaque agent is Chlorhexidine
2) Binds to bacterial cell walls = Significantly reduces oral microrganisms
3) stains teeth brown
4) use 1 month only

Question 21

Describe periodontal surgery used to regenerate alveolar bone:

Answer 21

1. Open flap surgery can allow access for deep instrumentation
2. Soft tissue surgery, e.g. grafting/recontouring
3. Bony regeneration in periodontal pockets