Oral Health Wk. 4

gingivitis

inflammation of the gingival tissue only. Bone loss is not present

periodontitis

inflammation of the periodontium. Bone loss is present

gingival sulcus

Base of sulcus is coronal to junctional epithelium

Healthy

gingival pocket

formed by gingival enlargement without apical migration of junctional epithelium

supra-bony

periodontal pocket

Apical migration of junctional epithelium along cementum

Base of pocket can be supra or intra-bony

systemic diseases

Research show an association between periodontal infection and many:

amplify

Periodontal disease does not cause systemic disease, it can ___ the condition

chronic

What type of infection is periodontal disease considered

microorganisms in dental biofilm

Primary etiologic agent of periodontal disease

biofilm

causes an inflammatory response that over reacts and causes tissue destruction

g-anaerobic species, motile rods, and spirochetes

3 type of microorganisms that cause periodontal disease

iatrogenic cause

factors created by professional during treatment

tooth irregularities, maloclusion, and defective restorations

3 dental factors predisposing perio disease

recession, enlargement, size, pockets, and mouth breathing

gingival factors predisposing perio disease

personal self care and diet

other factors predisposing perio disease

biofilm

Accumulation of ____ at the cervical tooth surface near gingival margin initiate an inflammatory reaction and immune system response

initial, early, established, advanced

Four stages in the development of periodontal infection:

inflammatory response

2–4 days of biofilm accumulation

Fluid fills space in connective tissue=edema

initial lesion

Inflammatory Response

Clinical appearance: earliest phase no clinical evidence, slight marginal redness and edema

early lesion

Increased inflammatory response: 7-14 days with thicker biofilm

Clinical appearance: gingivitis apparent: redness and edema

yes

Is gingivitis reversible

established lesion

Increase of fluids into tissues and sulcus, pocket epithelium becomes ulcerated

Marginal redness, inflammation, BOP, and spongy gingiva

advanced lesion

Supragingival biofilm goes sub resulting in apical migration of junctional epithelium

Clinical appearance: pocket formation, mobility, recession, and bone loss

established

What is the last stage of a lesion where it is still considered reversable

pink to coral pink

Healthy clinical recognition of color

red, blue, white

Disease clinical recognition color

tight fit and no enlargement

Healthy Clinical Recognition Size

enlargement, edema, fibrotic

Disease Clinical Recognition Size

flat and follows curve smoothly

Healthy marginal gingiva

anterior pointed and posterior pyramidal

Healthy interdental papilla

McCall’s festoon

gingiva appears as a life saver around the tooth

Stillman’s cleft

localized recession in a V shape, slit like

stipple

a normal textured pattern on the gums that looks like an orange peel

Found on healthy attached gingiva and interdental papilla

spongy, fibrotic, and loss of stippling

Consistency and Texture of diseased gingiva

hyperkeratinization

a thickening of the outer protective layer of the gum tissue similar to leather

healthy

No BOP

No exudate expressed on pressure

diseased

Spontaneous bleeding

BOP

White/yellow pus visible on digital pressure

periodontitis

Inflammation of the periodontal tissues, and loss of connective tissue attachment to the tooth characterized by bone resorption that usually progresses slowly and horizontally.

destruction

Rate of _______ varies due to the virulence of bacteria and the host response

change in color

Acts like a roadmap to gingivitis, there is either biofilm or calculus in these areas

interdental papilla

What should we be looking at when trying to find a color change

clinical attachment loss

Adding the probing depth and amount of recession to get the true health of patient

gingivitis and periodontitis

Both of these are considered a form of periodontal disease

missing teeth, implants, and untreatable teeth

What 3 things must be identified before filling out probe chart on dentrix

yellow

On dentrix, what highlighted color shows the facial of teeth

blue

On dentrix, what highlighted color shows the lingual of teeth

patient chart→ select tooth→ missing tooth button→ Ex

Identify missing teeth on dentrix

patient chart→ select tooth→ conditions→ untreatable→ complete

Identify untreatable teeth on dentrix

trash can icon

What do we press when made a mistake on an untreatable tooth or bring back a missing tooth

middle gingival margin box

Where is recession charted on dentrix

once you reach the midline

When do we go back to mark if there was any BOP

recession

Measured from the gingival margin to the CEJ using a probe

CAL

The best indicator of periodontal disease

Increase in this number = disease progression

CAL

probing depth + recession measurement

furcation

The loss of attachment between the roots

furcation

This can only appear and be measured on bicuspids and tricuspids

nabers

the best probe to detect a furcation

4

How many classes of furcations are there?

class 1

Early/incipient, probe penetrates furca no more that 1 mm

class 2

Moderate, probe penetrates more than 1 mm but not completely through

class 3

Severe, probe will pass completely through furcation, gingiva covers furcation

class 4

furcation is clearly visible clinically due to loss of attachment and recession

probe and mirror

2 things that can be used when checking mobility

finger pads

What can’t be used when checking for mobility because they will get a false sensation of movement

class 1

slight mobility up to 1mm horizontal displacement

class 2

moderate mobility greater than 1mm of horizontal displacement

class 3

severe mobility greater than 1mm of facial/lingual direction and vertical displacement

risk assessment

the process of evaluating the potential risks that may be involved in the progression of a disease

risk factors

characteristic or exposure that significantly increases the risk for onset &/or progression of a specific disease

modifiable risk factors

Smoking, Diabetes, Oral hygiene, Dental care, Hormones, Stress, Medications

non-modifiable risk factors

History of periodontitis, Age, Gender, Race, Genetics

SRP

The more risk factors a patient has the more aggressively they are treated using:

short recall appointment

What does SRP stand for