Periodontal disease and treatment

Alveolar bone

Spongy bone that holds the teeth in the jaws.

Gingivae

Soft tissue covering the bone that is pink, firm and stippled (textured, dimple appearance)

Periodontal ligament

Fibrous tissue that connects the cementum to bone and allows bounce.

Cementum

Protective covering of dentine below the gum that attaches to the periodontal ligament.

Pellicle formulation

Protein film from saliva that forms on enamel and allows bacterial attachment.

Toxins/acid production

Bacteria metabolises sugars causing demineralisation and inflammation.

Calcification of soft plaque

Mineral deposits hardens plaque that has been sat on the teeth for hours and forms calculus.

Gingivitis

Swelling of the gingivae caused by plaque accumulating around teeth and soft tissues, irritating the gingivae and causing redness, swelling and bleeding.

How is gingivitis reversed?

By effectively brushing and removing plaque.

How is calculus removed?

Calculus can only be removed by dental instruments such as a scaler.

False pockets

A swollen area of the gingivae that measures deep on a BPE probe, but does not involve any bone damage or lost tooth attachment.

True pockets

A pathologically deepened space between the tooth and the gum that occurs when bacteria destroy the tissue and bone supporting the tooth.

Supra-gingival calculus

Calculus that builds up above the gumline and is yellow in colour.

Sub-gingival calculus

Calculus that builds up below the gum line and is black or brown in colour.

What instruments are used for subgingival debridement?

1. Curette

2. Periodontal hoe

3. Ultrasonic scaler

What instruments are used for supragingival debridement?

1. Sickle scaler

2. Jacquette scaler

3. Push scaler

What are the signs/symptoms of inflammation?

1. Redness

2. Swelling

3. Pain

4. Heat

5. Loss of function

Periodontal disease

A chronic, irreversible bacterial infection that damages the soft tissue and supporting structures of the teeth.

What does ANUG stand for?

Acute Necrotising Ulcerative Gingivitis

What are the signs and symptoms of ANUG?

1. Acute gingivitis

2. Inflammation

3. Puss

4. Halitosis (persistent bad breath)

How is ANUG treated?

Antibiotic Metronidazole

Who does ANUG usually affect?

Teenagers or students with poor diets or high stress levels.

What issues will a patient have when halitosis is a problem?

• Bleeding on brushing

• Red, swollen gingivae

• Puss oozing from pockets

• Occasional pain

• Loose teeth