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what are 10 things that you look for in a clinical exam?
- gingival infection
- perio infections
- gingival tissue changes
- bleeding, exudate
- mucogingival involvement
- probe depths
- furcation involvement
- dental biofilm
- tooth mobility
- radiographic evidence
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what are the signs and symptoms during the early stages of gingival and perio infections
- gingivitis
- inflammation
- bleeding on probing
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what are subjective signs and symptoms of gingival and perio infections
- patient report
- bleed when brushing
- blood on pillow
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what are advanced signs and symptoms of gingival and perio infections?
- hot
- mobility
- gum recession
- odors
- bad taste
- tenderness
- discomfort when eating
- food caught between teeth
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what is the color shape and texture of clinically normal gingiva
- color-pink (varies by complexion)
- shape-knife edge
- texture-stippling, firm, minimal probing with no bleeding
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what are 3 causes for tissue change?
- disease
- biofilm products
- systemic-pregnancy
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what are the descriptive terms for the severity?
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what are the descriptive terms for the distribution?
- localized
- generalized
- marginal
- papillary
- difuse
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what would be the descriptive term to describe a single or a few teeth?
localized
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what is the descriptive term to describe all or most of the teeth
generalized
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what is the descriptive term to describe something confined to the free or marginal gingiva
marginal
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what is the descriptive term used to describe just the papillary gingiva not the free
papillary
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what is the descriptive term for spread out and affects the gingival margin, attached gingiva, interdental and can go onto the alveolar mucosa?
diffuse
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is diffuse usually generalized or localized
generalized
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what are the early marked changes of the tissue?
- redness
- enlargement
- spongy
- deep pockets
- mobility
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are early marked tissue changes easy to detect or hard?
easy
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what type of early tissue changes are harder to detect
subtle changes, localized or of a lesser degree of severity
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why is it good to recognize tissue changes early?
- prevents neglect
- the treatment is less comoplicated
- higher success
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what does the color of diseased tissue look like for chronic inflammation and acute inflammation?
- chronic inflammation-dark red, bluish red, magenta, deep blue
- acute inflammation-bright red, loose stippling
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how is the size of the free gingiva, papillae, col and attached gingiva affected by disease?
- free gingiva and papillae-enlarged
- col-deepens
- attached gingiva-decreases in amount as the pocket deepens
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how is the shape of the free gingiva and papillae affected by disease
- free gingiva-rounded or rolled
- papillae-blunted, flattened, bulbous or cratered
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what is a festoon?
an enlargement of the marginal gingiva with the formation of a lifesaver like gingival prominence
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what are clefts?
localized recession may be V shaped
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what are floss clefts?
cleft created by incorredt floss positioning
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what is the consistency of healthy gingiva?
firm when palpated
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what is the consistency of gingiva with disease?
- soft spongy
- firm hard-fibrotic
- retraction of margin away from tooth
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how is diseased hard tissue different than healthy hard tissue?
diseased is fibrotic and is more like scar tissue
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what happens with the surface texture of diseased gingiva?
- inflammatory changes-loss of stippling, smooth and shiny surface
- hyperkeratosis-leathery, hard or nodular surface
- chronic disease-hard fibrotic tissue but normal coloring and deep tissue
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what is the actual position of gingiva? what is the apparent position of the gingiva?
- actual position-level of the attached periodontal tissue (not directly visible but can be determined by probing)
- apparent position- level of the gingival margin or crest of the free gingiva that is seen by direct observation
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what is the healthy position of the gingiva?
apparent position of the gingival margin is normally level with the enamel contour
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what are two changes in gingival tissue position with disease?
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what happens to the gingival position with enlargement?
the gingival margin may be high on the enamel, partly or nearly covering the anatomic crown
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what happens with the gingival position with recession (actual recession, visible recession, localized recession and measurement)
- actual recession-position of the attachment level, from cementoenamel junction to the attachment
- visible recession-exposed root surface, gingival margin to the cementoenamel junction
- localized recession-narrow or wide, shallow or deep. The root surface is denuded may extend to or through the mucogingival junction
- measurement- both actual and visible recession can be measured, the total recession is actual and visible added together
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what type of recession is measured from the cementoenamel junction to the attachment?
actual recession
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what type of recession is measured from the gingival margin to the cemetoenamel junction?
actual recession
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what is the actual and visible recession added together?
total recession
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t/f with healthy gingiva bleeding on probing is normal
False-BE GENTLE no BOP!
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with diseased tissue what happens with probing?
bleeding occurs-ulcerated pocket wall bleeds readily on gentle probing
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t/f there won't be any exudate with healthy gingiva?
true
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with diseased tissue there is an ______ in exudate and sulcular fluids
increase
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in young children how will their "healthy" tissue look?
- state of flux
- pink, rounded, less fibrous
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in young children what are some diseased states?
- gingivitis-reversible
- periodontitis-early onset
- ortho
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