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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
what are the signs and symptoms during the early stages of gingival and perio infections
- bleeding on probing
what are subjective signs and symptoms of gingival and perio infections
- patient report
- bleed when brushing
- blood on pillow
what are advanced signs and symptoms of gingival and perio infections?
- gum recession
- bad taste
- discomfort when eating
- food caught between teeth
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
what are 3 causes for tissue change?
- biofilm products
what are the descriptive terms for the severity?
what are the descriptive terms for the distribution?
what would be the descriptive term to describe a single or a few teeth?
what is the descriptive term to describe all or most of the teeth
what is the descriptive term to describe something confined to the free or marginal gingiva
what is the descriptive term used to describe just the papillary gingiva not the free
what is the descriptive term for spread out and affects the gingival margin, attached gingiva, interdental and can go onto the alveolar mucosa?
is diffuse usually generalized or localized
what are the early marked changes of the tissue?
- deep pockets
are early marked tissue changes easy to detect or hard?
what type of early tissue changes are harder to detect
subtle changes, localized or of a lesser degree of severity
why is it good to recognize tissue changes early?
- prevents neglect
- the treatment is less comoplicated
- higher success
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
how is the size of the free gingiva, papillae, col and attached gingiva affected by disease?
- free gingiva and papillae-enlarged
- attached gingiva-decreases in amount as the pocket deepens
how is the shape of the free gingiva and papillae affected by disease
- free gingiva-rounded or rolled
- papillae-blunted, flattened, bulbous or cratered
what is a festoon?
an enlargement of the marginal gingiva with the formation of a lifesaver like gingival prominence
what are clefts?
localized recession may be V shaped
what are floss clefts?
cleft created by incorredt floss positioning
what is the consistency of healthy gingiva?
firm when palpated
what is the consistency of gingiva with disease?
- soft spongy
- firm hard-fibrotic
- retraction of margin away from tooth
how is diseased hard tissue different than healthy hard tissue?
diseased is fibrotic and is more like scar tissue
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
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
what is the healthy position of the gingiva?
apparent position of the gingival margin is normally level with the enamel contour
what are two changes in gingival tissue position with disease?
what happens to the gingival position with enlargement?
the gingival margin may be high on the enamel, partly or nearly covering the anatomic crown
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
what type of recession is measured from the cementoenamel junction to the attachment?
what type of recession is measured from the gingival margin to the cemetoenamel junction?
what is the actual and visible recession added together?
t/f with healthy gingiva bleeding on probing is normal
False-BE GENTLE no BOP!
with diseased tissue what happens with probing?
bleeding occurs-ulcerated pocket wall bleeds readily on gentle probing
t/f there won't be any exudate with healthy gingiva?
with diseased tissue there is an ______ in exudate and sulcular fluids
in young children how will their "healthy" tissue look?
- state of flux
- pink, rounded, less fibrous
in young children what are some diseased states?
- periodontitis-early onset