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Questions and Answers
What is the usual color description of a healthy gingiva?
What is the usual color description of a healthy gingiva?
Coral pink
What factors influence the color of a healthy gingiva? (select all that apply)
What factors influence the color of a healthy gingiva? (select all that apply)
The alveolar mucosa is usually described as being pale pink.
The alveolar mucosa is usually described as being pale pink.
False
What is the common cause of physiologic pigmentation in black individuals?
What is the common cause of physiologic pigmentation in black individuals?
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How does the shape and size of the interdental area affect the gingival margin?
How does the shape and size of the interdental area affect the gingival margin?
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The height of the interdental gingiva remains consistent regardless of the location of the proximal contact.
The height of the interdental gingiva remains consistent regardless of the location of the proximal contact.
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What is the shape of interdental gingival papillae correlated with?
What is the shape of interdental gingival papillae correlated with?
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The marginal gingiva envelops the teeth in a scalloped outline.
The marginal gingiva envelops the teeth in a scalloped outline.
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The consistency of the gingiva is uniform throughout.
The consistency of the gingiva is uniform throughout.
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What contributes to the firmness of the attached gingiva?
What contributes to the firmness of the attached gingiva?
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The surface texture of the gingiva is smooth and uniform across the entire surface.
The surface texture of the gingiva is smooth and uniform across the entire surface.
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What is stippling a form of?
What is stippling a form of?
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Stippling occurs only on the attached gingiva.
Stippling occurs only on the attached gingiva.
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What is the primary factor that can disrupt the delicate balance of host-bacterial interactions in the oral cavity?
What is the primary factor that can disrupt the delicate balance of host-bacterial interactions in the oral cavity?
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What type of bacteria initially initiate periodontal infection?
What type of bacteria initially initiate periodontal infection?
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The oral cavity is a closed system with limited exchange of nutrients and microbes.
The oral cavity is a closed system with limited exchange of nutrients and microbes.
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What are the mechanisms for removing bacteria from the oral cavity? (select all that apply)
What are the mechanisms for removing bacteria from the oral cavity? (select all that apply)
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A completely plaque-free condition in the oral cavity is unattainable.
A completely plaque-free condition in the oral cavity is unattainable.
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The oral cavity is sterile at birth.
The oral cavity is sterile at birth.
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The oral flora remains relatively constant throughout life.
The oral flora remains relatively constant throughout life.
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The presence of sex hormones can influence the composition of the oral flora.
The presence of sex hormones can influence the composition of the oral flora.
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What is the name of the classical criteria developed by Robert Koch to identify causative agents in human infections?
What is the name of the classical criteria developed by Robert Koch to identify causative agents in human infections?
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Koch's postulates require that the organism be able to produce a similar disease in a susceptible laboratory animal.
Koch's postulates require that the organism be able to produce a similar disease in a susceptible laboratory animal.
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What microorganism is frequently associated with dental caries?
What microorganism is frequently associated with dental caries?
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Who proposed the criteria for identifying periodontal pathogens that are often referred to as Socransky's criteria?
Who proposed the criteria for identifying periodontal pathogens that are often referred to as Socransky's criteria?
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Socransky's criteria require that the suspected periodontal pathogen be eliminated from the site of infection for the disease to resolve.
Socransky's criteria require that the suspected periodontal pathogen be eliminated from the site of infection for the disease to resolve.
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Health-related bacteria in the oral cavity are typically Gram-negative.
Health-related bacteria in the oral cavity are typically Gram-negative.
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Health-related bacterias are often strictly anaerobic.
Health-related bacterias are often strictly anaerobic.
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Which of these bacteria are examples of health-related bacteria? (select all that apply)
Which of these bacteria are examples of health-related bacteria? (select all that apply)
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What is the primary distinguishing feature of disease-related bacteria? (select all that apply)
What is the primary distinguishing feature of disease-related bacteria? (select all that apply)
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Disease-related bacteria are always motile.
Disease-related bacteria are always motile.
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Which of these is an example of a disease-related bacterial species? (select all that apply)
Which of these is an example of a disease-related bacterial species? (select all that apply)
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What is the purpose of the lipopolysaccharide layer in the cell wall of Gram-negative bacteria?
What is the purpose of the lipopolysaccharide layer in the cell wall of Gram-negative bacteria?
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All bacteria residing in the oral cavity contribute to disease.
All bacteria residing in the oral cavity contribute to disease.
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Which types of bacteria can be broadly classified as "orange or red complex" organisms? (select all that apply)
Which types of bacteria can be broadly classified as "orange or red complex" organisms? (select all that apply)
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The study of microorganisms is known as microbiology.
The study of microorganisms is known as microbiology.
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What are the three primary shapes of bacteria?
What are the three primary shapes of bacteria?
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Spirochetes have a spherical shape.
Spirochetes have a spherical shape.
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The Gram staining technique differentiates bacteria based on their oxygen requirements.
The Gram staining technique differentiates bacteria based on their oxygen requirements.
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Gram-positive bacteria have a thick layer of peptidoglycan in their cell walls.
Gram-positive bacteria have a thick layer of peptidoglycan in their cell walls.
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Gram-negative bacteria are typically more resistant to antibiotics compared to Gram-positive bacteria.
Gram-negative bacteria are typically more resistant to antibiotics compared to Gram-positive bacteria.
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Capnophilic microorganisms thrive in environments with low carbon dioxide levels.
Capnophilic microorganisms thrive in environments with low carbon dioxide levels.
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Asaccharolytic microorganisms are able to ferment sugars for energy production.
Asaccharolytic microorganisms are able to ferment sugars for energy production.
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What type of environment is the oral cavity considered?
What type of environment is the oral cavity considered?
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Study Notes
Clinical Criteria of Normal Gingiva
- Healthy gingiva is typically described as coral pink (pale pink).
- Color is due to vascular supply, thickness, keratinization degree of epithelium, and presence of pigment-containing cells.
- Color is correlated with cutaneous pigmentation.
- Alveolar mucosa is red, smooth, and shiny.
- Physiologic pigmentation is common in Black individuals due to melanin, a non-hemoglobin-derived brown pigment.
Form of Gingiva
- Form depends on interdental area shape and size.
- Gingival margin usually terminates against the tooth in a knife-edge fashion.
- Interdental gingiva height varies with proximal contact location.
- Shape of interdental gingival papillae is correlated with teeth and embrasure shape.
- Broad interdental papilla is one type.
- Narrow interdental papilla is another type.
Contour of Gingiva
- Marginal gingiva surrounds the teeth in a collar-like fashion.
- It follows a scalloped outline (festooned) on facial and lingual tooth surfaces.
- Interradicular depressions and prominences correspond with root contours.
- On teeth with noticeable mesiodistal convexity (e.g., maxillary canines) or labial version, normal arc-like contour is emphasized, and gingiva is located more apically.
- On teeth in lingual version, gingiva is horizontal and thickened.
Consistency of Gingiva
- Gingiva is firm and resilient, except for movable free gingiva, which is tightly bound to underlying bone.
- Firmness of attached gingiva is determined by the collagenous nature of lamina propria.
- Gingival fibers also contribute to gingival margin firmness.
Surface Texture of Gingiva
- Gingiva's texture resembles an orange peel; dried gingiva is matte.
- Attached gingiva is stippled; marginal gingiva is not.
- Interdental papilla central portion is typically stippled, but marginal borders are smooth.
- Stippling is a form of adaptive specialization or reinforcement for function.
- It is related to the presence and degree of epithelial keratinization.
Microbiology of Periodontal Diseases
- As many as 500 different bacteria species colonize the oral cavity.
- They affect the delicate balance of host-bacterial interactions; leading to either health or disease.
- Periodontal infection is initiated by specific invasive oral pathogens colonizing dental plaque biofilms on the tooth root surface.
- Local and systemic factors modulate susceptibility to periodontitis.
Oral Microbiota and Oral Cavity
- Oral microbiota generally lives in harmony with the host.
- Disease can occur in special conditions, like reduced host response or increased pathogenicity.
- Most oral bacteria are commensal and beneficial.
- Oral cavity, with its microbiota, is a complex ecological system.
- Teeth and implants within oral cavity provide hard, non-shedding surfaces for bacterial deposits.
Classification of Bacteria
- Bacteria are classified by morphology, cell wall characteristics, oxygen requirements, and metabolism.
- Morphologies: cocci (spherical forms), rods (bacilli), spirochetes (spiral forms)
- Cell wall characteristics: gram-positive and gram-negative.
- Oxygen requirements: aerobes, anaerobes, facultative anaerobes, capnophilic microorganisms
- Metabolism: saccharolytic microorganisms (obtain energy from sugar breakdown), asaccharolytic microorganisms (do not ferment sugars).
Removal of Bacteria
- Oral cavity is an open system with nutrients and microbes.
- Bacteria removal mechanisms include saliva flow, gingival fluid flow, chewing, and epithelial cell desquamation (high turnover rate).
- Some bacteria are retained in pits/fissures, interdental areas, or under dental restorations' edges.
- Bacteria aggregate on tooth surfaces to form plaque.
Acquisition of Oral Flora
- Absolutely plaque-free oral cavity is unrealistic.
- Oral cavity is sterile at birth.
- Microorganisms appear within hours, transmitted from others and capable of adhering to the oral mucosa. Examples include Streptococcus salivarius.
- By 1 year, more complex flora is established, including Staphylococcus, Streptococcus, and Actinomyces species.
- Puberty marks a significant shift in oral flora; many periodontal pathogens become established.
- Shifts may be due to sex hormones; which sometimes replace vitamin K requirements by some bacteria.
Criteria for Identification of Periodontal Pathogens
- Defined by Robert Koch's postulates for establishing causal agent in human infections since 1870.
- Includes isolating from diseased individuals, growing in pure culture, inducing similar disease in susceptible animal models, recovering agent from lesions. Examples include Streptococcus mutans in dental caries.
- Sigmund Socransky's criteria (1992) further detail these criteria and include association with disease (increase in organims at diseased sites), elimination/decrease in sites with disease resolution, host response, capability to cause disease in experimental models, and evidence of virulence factors causing destruction.
Characteristics of Health-Related Bacteria
- Gram-positive.
- Aerobes or facultative anaerobes.
- Generally non-motile.
- Examples: Streptococcus sanguis, Streptococcus mitus, Actinomyces viscosus (yellow or purple complex).
Characteristics of Disease-Related Bacteria
- Predominantly Gram-negative.
- Cell walls have lipopolysaccharide (endotoxin) with significant pathogenic potential.
- Strict anaerobes.
- Non-motile and motile forms exist.
- Examples: Aggregatibacter actinomycetemcomitans, Prevotella intermedia (orange or red complex).
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Description
This quiz explores the clinical characteristics of normal gingiva, including its color, form, and contour. Participants will learn about the factors influencing gingival health and anatomy, with a focus on various types of gingival morphology. Ideal for dental students and professionals seeking to deepen their understanding of periodontal health.
