In the recognition of normal gingiva, gingival infections, and deeper periodontal involvement, it is necessary to know the_____________of the disease
extent
___________infections are confined to the gingiva, whereas______________infections include all parts of the periodontium, namely the gingiva, periodontal ligament, bone, and cementum
gingival
periodontal
What are 8 markers that show signs and effects of inflammation during a clinical examination of the gingiva and periodontium?
gingival tissue changes
bleeding and exudate
mucogingival involvement
probing depths; pocket formation
furcation involvement
dental biofilm and calculus present
mobility of teeth
radiographic evidence
Name 5 specific gingival tissue changes
color
size
shape
surface texture
position
Why is it that patients may or may not have specific symptoms to report because of periodontal infections?
because periodontal infections are insidious in development
Patients with periodontal and/or gingival infections may notice bleeding in the gingiva in what 3 instances?
bleeding while brushing
bleeding with drooling at night
bleeding spontaneously
Name 7 symptoms of advanced periodontal disease
sensitivity to hot and cold
tenderness or discomfort while eating
pain after eating
food retained between teeth
unpleasant mouth odors
chronic bad taste
feeling that teeth are loose
What is radiographic evidence of advanced periodontal disease?
bone loss
What are symptoms that are described by the patient?
subjective symptoms
What are the color shades of clinically normal teeth?
shade of pale, or coral pink (varied by complexion and pigmentation)
Describe clinically normal or healthy gingival margin
knife-edged gingival margin that adapts closely around the tooth
true or false. stippling; firmness; and minimal sulcus depth with no bleeding on probing are signs of clinically normal and healthy gingival tissue
true
What are 3 causes of tissue changes?
disease
biofilm products
systemic changes; including pregnancy (nausea in 1st trimester)
Severity of gingival and periodontal disease is expressed as_________, __________, or___________
slight
moderate
severe
What are 5 terms used to describe the distribution of gingival or periodontal disease?
localized
generalized
marginal
papillary
diffuse
The gingiva is involved only about a single tooth or a specific group of teeth
localized
the gingiva is involved about all or nearly all of the teeth throughout the mouth
generalized
A condition may also be generalized throughout a __________ __________, the maxillary or the mandibular
single arch
a change that is confined to the free or marginal gingiva, specified as either localized or generalized
marginal
a change that involves the papilla but not the rest of the free gingiva around the tooth, it may be localized or generalized
papillary
spread out, dispersed; affects the gingival margin, attached gingiva, and interdental papilla; may extend into alveolar mucosa, it is more frequently localized, rarely generalized
diffuse
name 5 marked changes in infected gingiva or periodontia that are easy to detect even with little experience
moderate to severe redness
enlargement
sponginess
deep pockets
mobility
when tissue changes are subtle, localized about one or a few teeth, and of a lesser degree of severity, more ________ __________ of ________ is necessary
more
skillful
application
Why is it so important to recognize tissue changes early?
because it prevents neglect of conditions that can develop into severe disease
treatment is less complicated
success of treatment and recovery to healthy tissue is predictable
describe healthy gingival tissue seen in a gingival exam.
pale pink; darker in people with darker complexions
describe color changes in chronic diseased gingival tissue.
dark red
bluish red
magenta
deep blue
describe color changes in acute inflammation of gingival tissue
bright red
Describe the size of healthy free gingiva.
flat, not enlarged, fits snugly around the tooth
describe the size of healthy attached gingiva.
width of attachments varies among patients, from 1-9mm5
The width of the attached gingiva is wider in the_________than ____________; broadest zone related to___________, narrowest at the________and__________regions
maxilla
mandible
incisors
canine
premolar
describe tissue size changes in diseased free gingiva and papilla
become enlarged, and the col deepens
describe changes in diseased attached gingiva
decreases in amount as the pocket deepens
describe the shape (form or contour) of healthy free gingiva
follows a curved line around each tooth
the margin is knife-edged or slightly rounded and closely adapted to the tooth
describe the shape (form or contour) of healthy papillae
teeth with a contact area; pointed or slightly rounded papilla with a col area under the contact
spaced teeth; papilla is flat or saddle shaped
describe the shape (form or contour) of diseased free gingiva
rounded or rolled
describe the shape (form or contour) of diseased papillae
blunted, flattened, bulbous, cratered
an enlargement of the marginal gingiva with the formation of a life-saver like gingival prominence, frequently the total gingiva is very narrow, with associated apparent recession
festoon seen in diseased papilla
a localized recession may be 'V' shaped, apostrophe shaped, or form a slit like indentation that may extend several millimeters towards the mucogingival junction or even to or through the junction; seen in the papillae
clefts (stillman's cleft)
a cleft created by incorrect floss positioning appears as a vertical linear or V-shaped fissure in the marginal gingiva. It usually occurs on one side of an interdental papilla, the injury can develop when dental floss is curved repeatedly in an incomplete C around the line angles so the floss is pressed across the gingiva
