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Gingival Color Changes Quiz
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Gingival Color Changes Quiz

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Questions and Answers

Which factor was found to exert a strong, chronic, dose-dependent suppressive effect on gingival bleeding with probing?

  • Anatomic and developmental tooth variations
  • Mouth breathing
  • Orthodontic treatment
  • Current cigarette smoking (correct)

    • What is the most common cause of abnormal gingival bleeding on probing?

  • Hormonal replacement therapy
  • Chronic inflammation (correct)
  • Frenum pull
  • Vitamin C deficiency

    • Which systemic disorder may lead to excessive and difficult to control gingival hemorrhage?

  • Thrombocytopenic purpura (correct)
  • Christmas disease
  • Vitamin K deficiency
  • Leukemia

    • What condition is reported to affect gingival bleeding in women?

    <p>Fluctuating estrogen and progesterone levels</p> Signup and view all the answers

    Which medications have been found to cause gingival enlargement and secondarily cause gingival bleeding?

    <p>Aspirin and antihypertensive calcium channel blockers</p> Signup and view all the answers

    What changes in the gingiva are considered as an important clinical sign of gingival disease?

    <p>&quot;Bluish red&quot; color</p> Signup and view all the answers

    What color change is associated with acute necrotizing ulcerative gingivitis?

    <p>Marginal</p> Signup and view all the answers

    What color change is associated with herpetic gingivostomatitis?

    <p>Diffuse</p> Signup and view all the answers

    What color change can occur with severe acute inflammation?

    <p>Red to dull, whitish gray</p> Signup and view all the answers

    What systemic disease may cause blue-gray pigmentation of the oral mucosa?

    <p>Addison’s disease</p> Signup and view all the answers

    What factor can cause hyperkeratosis of the gingiva and a significant increase in melanin pigmentation of the oral mucosa?

    <p>Tobacco</p> Signup and view all the answers

    What has been used more recently to ablate cells that produce melanin pigment in gingival depigmentation?

    <p>Laser techniques</p> Signup and view all the answers

    What is the primary etiological factor that causes gingivitis?

    <p>Plaque</p> Signup and view all the answers

    Which of the following is a characteristic feature of chronic gingivitis?

    <p>Painless unless complicated by acute exacerbations</p> Signup and view all the answers

    What type of gingivitis affects the entire mouth?

    <p>Generalized gingivitis</p> Signup and view all the answers

    What is the significance of gingival bleeding on probing?

    <p>It appears earlier than a change in color or other visual signs of inflammation</p> Signup and view all the answers

    What is the value of probing pocket depth measurements for the assessment of gingivitis severity?

    <p>They are of limited value for the assessment of gingivitis severity</p> Signup and view all the answers

    What does the absence of gingival bleeding on probing imply?

    <p>Low risk of future clinical attachment loss</p> Signup and view all the answers

    What is the primary cause of the development of an inflammatory process around gingival tissue?

    <p>Accumulation of microbial biofilm on clean tooth surfaces</p> Signup and view all the answers

    According to the text, what percentage of adolescents in the United States have overt gingivitis and signs of gingival bleeding?

    <p>More than 82%</p> Signup and view all the answers

    What is the main factor that causes the persistence of local inflammation around gingival tissues?

    <p>Presence of microbial biofilm adjacent to the gingival tissues</p> Signup and view all the answers

    What did experimental gingivitis studies provide the first empiric evidence for?

    <p>The link between microbial biofilm and development of gingival inflammation</p> Signup and view all the answers

    What did research show regarding the resolution of inflammation around gingival tissues?

    <p>It may resolve after meticulous removal of the microbial biofilm</p> Signup and view all the answers

    What do epidemiologic studies indicate about the prevalence of gingivitis?

    <p>It is evident worldwide</p> Signup and view all the answers

    What is the effect of toothbrushing on the consistency of the gingiva?

    <p>All of the above</p> Signup and view all the answers

    What is a common feature of chronic inflammation in patients with chronic inflammation according to the text?

    <p>All of the above</p> Signup and view all the answers

    What is the primary cause of traumatic gingival lesions?

    <p>All of the above</p> Signup and view all the answers

    What is the difference between the actual and apparent positions of the gingiva?

    <p>The actual position is the level of the coronal end of the epithelial attachment on the tooth, whereas the apparent position is the level of the crest of the gingival margin</p> Signup and view all the answers

    What effect do standard oral hygiene procedures have on gingival health according to the text?

    <p>Faulty toothbrushing technique may cause significant injury</p> Signup and view all the answers

    What are Stillman’s clefts and McCall festoons associated with?

    <p>Traumatic occlusion</p> Signup and view all the answers

    What term is frequently used but is considered a misnomer for necrotizing ulcerative gingivitis?

    <p>ANUG</p> Signup and view all the answers

    What is the term for a microbial disease of the gingiva in the context of an impaired host response?

    <p>Necrotizing ulcerative gingivitis</p> Signup and view all the answers

    What happens to necrotizing ulcerative gingivitis (NUG) without treatment?

    <p>It undergoes a diminution in severity</p> Signup and view all the answers

    What type of lesions are characteristic of necrotizing ulcerative gingivitis?

    <p>Punched-out, craterlike depressions</p> Signup and view all the answers

    Involvement of which tissues can occur in necrotizing ulcerative gingivitis, especially in patients with long-standing disease or severe immunosuppression?

    <p>Periodontal attachment apparatus</p> Signup and view all the answers

    What are characteristic clinical signs of necrotizing ulcerative gingivitis?

    <p>Fetid odor and increased salivation</p> Signup and view all the answers

    What is a common feature of the mild and moderate stages of necrotizing ulcerative gingivitis?

    <p>High fever and rapid pulse rate</p> Signup and view all the answers

    What may occur if necrotizing ulcerative gingivitis (NUG) is left untreated?

    <p>Progressive destruction of the periodontium and gingival recession</p> Signup and view all the answers

    What technique has been used to study the relationship of bacteria to the characteristic lesion of NUG?

    <p>Light and electron microscopy</p> Signup and view all the answers

    What was found between the necrotic and living tissue in necrotizing ulcerative gingivitis lesions?

    <p>Enormous numbers of bacteria, leukocytes, and fibrin only</p> Signup and view all the answers

    What did experimental gingivitis studies provide the first empiric evidence for?

    <p>The accumulation of microbial biofilm on clean tooth surfaces results in the development of an inflammatory process around gingival tissue.</p> Signup and view all the answers

    What percentage of adolescents in the United States have overt gingivitis and signs of gingival bleeding, according to epidemiologic studies?

    <p>More than 82%</p> Signup and view all the answers

    What is the primary cause of the development of an inflammatory process around gingival tissue?

    <p>The accumulation of microbial biofilm on clean tooth surfaces</p> Signup and view all the answers

    What systemic disorder may lead to excessive and difficult to control gingival hemorrhage?

    <p>Systemic disorder may lead to excessive and difficult to control gingival hemorrhage.</p> Signup and view all the answers

    What is the significance of gingival bleeding on probing?

    <p>A common feature of chronic inflammation in patients with chronic inflammation.</p> Signup and view all the answers

    What was found between the necrotic and living tissue in necrotizing ulcerative gingivitis lesions?

    <p>The presence of a characteristic lesion of NUG.</p> Signup and view all the answers

    What are some systemic diseases that may cause color changes in the oral mucosa?

    <p>Addison’s disease, Peutz-Jeghers syndrome, Albright’s syndrome, von Recklinghausen’s disease, jaundice, hemochromatosis, diabetes, pregnancy, anemia, polycythemia, leukemia</p> Signup and view all the answers

    What are the endogenous oral pigmentations caused by?

    <p>Melanin, bilirubin, iron</p> Signup and view all the answers

    What are the exogenous factors capable of producing color changes in the gingiva?

    <p>Atmospheric irritants, such as coal and metal dust, coloring agents in food or lozenges, tobacco, amalgam</p> Signup and view all the answers

    What are the methods traditionally used for gingival depigmentation?

    <p>Nonsurgical and surgical procedures, including chemical, cryosurgical, and electrosurgical techniques</p> Signup and view all the answers

    What changes in the consistency of the gingiva occur in patients with chronic gingivitis?

    <p>Edematous and reparative changes coexist, determining the consistency of the gingiva</p> Signup and view all the answers

    What may be found in the gingiva and varies with regard to size, location, shape, and structure?

    <p>Calcified masses</p> Signup and view all the answers

    What are the effects of toothbrushing on the consistency of the gingiva?

    <p>Promoting keratinization of the oral epithelium, enhancing capillary gingival circulation, and thickening alveolar bone.</p> Signup and view all the answers

    What is the biologic significance of gingival stippling?

    <p>Not known</p> Signup and view all the answers

    What are the sources of traumatic gingival lesions?

    <p>Chemical, physical, or thermal</p> Signup and view all the answers

    What is the difference between the actual and apparent positions of the gingiva?

    <p>The actual position is the level of the coronal end of the epithelial attachment on the tooth, whereas the apparent position is the level of the crest of the gingival margin.</p> Signup and view all the answers

    What is the primary cause of gingival recession?

    <p>Faulty toothbrushing technique or brushing with hard bristles</p> Signup and view all the answers

    What are Stillman’s clefts and McCall festoons associated with?

    <p>Gingival recession</p> Signup and view all the answers

    What are the two earliest signs of gingival inflammation that precede established gingivitis?

    <p>increased gingival crevicular fluid production rate and bleeding from the gingival sulcus on gentle probing</p> Signup and view all the answers

    What is the value of probing pocket depth measurements for the assessment of the extent and severity of gingivitis?

    <p>limited value</p> Signup and view all the answers

    What does the absence of gingival bleeding on probing imply?

    <p>implies a low risk of future clinical attachment loss</p> Signup and view all the answers

    What was found between the necrotic and living tissue in necrotizing ulcerative gingivitis lesions?

    <p>a zone of demarcation</p> Signup and view all the answers

    What did experimental gingivitis studies provide the first empiric evidence for?

    <p>an important role of the host response in the development and degree of gingival inflammation</p> Signup and view all the answers

    What factor was found to exert a strong, chronic, dose-dependent suppressive effect on gingival bleeding with probing?

    <p>smoking</p> Signup and view all the answers

    What is the relationship between persistent gingivitis and periodontal attachment loss, according to the findings?

    <p>Persistent gingivitis can be considered as a risk factor for periodontal attachment loss that may lead to tooth loss.</p> Signup and view all the answers

    What did recent research reveal about gingival bleeding in patients who quit smoking?

    <p>Recent research reveals an increase in gingival bleeding with probing in patients who quit smoking.</p> Signup and view all the answers

    What systemic disorders can lead to excessive and difficult to control gingival hemorrhage?

    <p>Vascular abnormalities (vitamin C deficiency, allergy [e.g., Henoch–Schönlein purpura]), platelet disorders (thrombocytopenic purpura), hypoprothrombinemia (vitamin K deficiency), other coagulation defects (hemophilia, leukemia, Christmas disease), deficient platelet thromboplastic factor as a result of uremia, multiple myeloma, and postrubella purpura.</p> Signup and view all the answers

    What are the effects of hormonal replacement therapy, oral contraceptives, pregnancy, and the menstrual cycle on gingival bleeding?

    <p>They are reported to affect gingival bleeding.</p> Signup and view all the answers

    How does diabetes affect the periodontium?

    <p>In diabetes, marked inflammation affects both the epithelial and connective tissues, leading to various tissue changes and degeneration.</p> Signup and view all the answers

    What adverse effects on the gingiva have been associated with certain medications?

    <p>Anticonvulsants, antihypertensive calcium channel blockers, and immunosuppressant drugs are known to cause gingival enlargement, which secondarily can cause gingival bleeding.</p> Signup and view all the answers

    What is the term used to describe the characteristic lesions of necrotizing ulcerative gingivitis?

    <p>Punched-out, craterlike depressions at the crest of the interdental papillae</p> Signup and view all the answers

    What are the extraoral and systemic signs and symptoms commonly associated with the mild and moderate stages of necrotizing ulcerative gingivitis?

    <p>Local lymphadenopathy and a slight elevation in temperature</p> Signup and view all the answers

    What is the primary cause of the development of an inflammatory process around gingival tissue in necrotizing ulcerative gingivitis?

    <p>A change in living habits, protracted work without adequate rest, poor nutrition, tobacco use, and psychological stress</p> Signup and view all the answers

    What is the microscopic appearance of necrotizing ulcerative gingivitis?

    <p>Nonspecific</p> Signup and view all the answers

    What is the effect of necrotizing ulcerative gingivitis (NUG) if left untreated?

    <p>Progressive destruction of the periodontium and gingival recession, accompanied by an increase in the severity of systemic complications</p> Signup and view all the answers

    What is found in the exudate on the surface of the necrotic lesion in necrotizing ulcerative gingivitis?

    <p>Microorganisms that morphologically resemble cocci, fusiform bacilli, and spirochetes</p> Signup and view all the answers

    What is the impact of systemic reactions in children with necrotizing ulcerative gingivitis?

    <p>More severe systemic reactions</p> Signup and view all the answers

    What type of lesions occasionally occur in the soft palate in relation to necrotizing ulcerative gingivitis?

    <p>Isolated spherical lesions</p> Signup and view all the answers

    What type of tissue involvement can occur in necrotizing ulcerative gingivitis, especially in patients with long-standing disease or severe immunosuppression?

    <p>Tissue destruction involving the periodontal attachment apparatus</p> Signup and view all the answers

    What have light and electron microscopy been used to study in relation to necrotizing ulcerative gingivitis?

    <p>The relationship of bacteria to the characteristic lesion of NUG</p> Signup and view all the answers

    Experimental gingivitis studies provided the first empiric evidence that the accumulation of microbial biofilm on clean tooth surfaces results in the development of an inflammatory process around gingival tissue. Research has also shown that the local inflammation will persist as long as the microbial biofilm is present adjacent to the gingival tissues and that the inflammation may resolve subsequent to a meticulous removal of the ______.

    <p>biofilm</p> Signup and view all the answers

    The prevalence of gingivitis is evident worldwide. For example, epidemiologic studies indicate that more than 82% of adolescents in the United States have overt gingivitis and signs of ______.

    <p>gingival bleeding</p> Signup and view all the answers

    What is the term used to describe the characteristic lesions of necrotizing ulcerative gingivitis?

    <p>necrosis</p> Signup and view all the answers

    What may occur if necrotizing ulcerative gingivitis (NUG) is left untreated?

    <p>tissue destruction</p> Signup and view all the answers

    What type of gingivitis affects the entire mouth?

    <p>generalized</p> Signup and view all the answers

    What is the significance of gingival bleeding on probing?

    <p>inflammation</p> Signup and view all the answers

    Longitudinal findings revealed that sites with consistent ______ (gingivval index = 2) had 70% more attachment loss than sites that were noninflamed over a 26-year period in 565 males.

    <p>bleeding</p> Signup and view all the answers

    Thus, persistent gingivitis can be considered as a risk factor for periodontal attach ment loss that may lead to ______.

    <p>tooth loss</p> Signup and view all the answers

    Numerous studies have shown that current cigarette smoking suppresses the gingival inflammatory response, and smoking was found to exert a strong, chronic, dose-dependent suppressive effect on gingival ______ with probing in the Third National Health and Nutrition Examination Survey.

    <p>bleeding</p> Signup and view all the answers

    In addition, recent research reveals an increase in gingival ______ with probing in patients who quit smoking.

    <p>bleeding</p> Signup and view all the answers

    Factors that contribute to plaque retention and that may lead to gingivitis include anatomic and developmental tooth variations, caries, frenum pull, iatrogenic factors, malpositioned teeth, mouth breathing, overhangs, partial dentures, lack of attached gingiva, and ______.

    <p>recession</p> Signup and view all the answers

    Chronic and Recurrent ______. The most common cause of abnormal gingival bleeding on probing is chronic inflammation.

    <p>Bleeding</p> Signup and view all the answers

    A significant percentage of adults also show signs of gingivitis; more than half of the US adult population is estimated to exhibit gingival ______

    <p>bleeding</p> Signup and view all the answers

    In general, clinical features of gingivitis may be characterized by the presence of any of the following clinical signs: redness and sponginess of the gingival tissue, ______ on provocation, changes in contour, and the presence of calculus or plaque with no radiographic evidence of crestal bone loss

    <p>bleeding</p> Signup and view all the answers

    Chronic gingivitis is slow in onset and of long duration. It is ______, unless it is complicated by acute or subacute exacerbations, and it is the type that is most often encountered

    <p>painless</p> Signup and view all the answers

    Localized gingivitis is confined to the gingiva of a single tooth or group of teeth, whereas generalized gingivitis involves the entire ______

    <p>mouth</p> Signup and view all the answers

    Gingival disease in individual cases is described by combining the preceding terms as follows: Localized marginal gingivitis is confined to one or more areas of the ______ gingiva

    <p>marginal</p> Signup and view all the answers

    Gingival bleeding varies with regard to severity, duration, and ease of provocation. Bleeding on probing is easily detected clini cally and therefore is of value for the early diagnosis and prevention of more advanced ______

    <p>gingivitis</p> Signup and view all the answers

    Gingival stippling is restricted to the attached gingiva and predominantly localized to the subpapillary area, but it extends to a variable degree into the ______.

    <p>interdental papilla</p> Signup and view all the answers

    In patients with chronic inflammation, the gingival surface is either smooth and shiny or firm and ______, depending on whether the dominant changes are exudative or fibrotic.

    <p>nodular</p> Signup and view all the answers

    Gingival recession is a common finding. The prevalence, extent, and severity of gingival recession increase with age, and this condition is more prevalent among ______.

    <p>males</p> Signup and view all the answers

    The actual position is the level of the coronal end of the epithelial attachment on the tooth, whereas the apparent position is the level of the crest of the gingival margin. The severity of recession is determined by the actual position of the gingiva and not by its ______ position.

    <p>apparent</p> Signup and view all the answers

    Receded gingiva can be inflamed, but it may be normal except for its ______.

    <p>position</p> Signup and view all the answers

    Standard oral hygiene procedures, whether they involve toothbrushing or flossing, may lead to frequent transient and minimal gingival ______.

    <p>injury</p> Signup and view all the answers

    Necrotizing ulcerative gingivitis (NUG) is a microbial disease of the ______ in the context of an impaired host response.

    <p>gingiva</p> Signup and view all the answers

    NUG can cause tissue destruction that involves the periodontal attachment apparatus, especially in patients with long-standing disease or severe ______.

    <p>immunosuppression</p> Signup and view all the answers

    Necrotizing ulcerative gingivitis (NUG) is characterized by its sudden onset, sometimes after an episode of debilitating disease or acute respiratory tract ______.

    <p>infection</p> Signup and view all the answers

    Characteristic lesions of NUG are punched-out, craterlike depressions at the crest of the interdental papillae that subsequently extend to the marginal ______ and rarely to the attached gingiva and oral mucosa.

    <p>gingiva</p> Signup and view all the answers

    Patients with NUG often complain of a constant radiating, gnawing pain that is intensified by eating spicy or hot foods and ______.

    <p>chewing</p> Signup and view all the answers

    NUG may lead to a progressive destruction of the periodontium as well as gingival recession accompanied by an increase in the severity of systemic ______.

    <p>complications</p> Signup and view all the answers

    Light and electron microscopy have been used to study the relationship of bacteria to the characteristic lesion of ______.

    <p>NUG</p> Signup and view all the answers

    What happens to necrotizing ulcerative gingivitis (NUG) without ______?

    <p>treatment</p> Signup and view all the answers

    Spirochetes and other bacteria invade the underlying living ______.

    <p>tissue</p> Signup and view all the answers

    The clinical course of NUG can vary. If untreated, NUG may lead to a progressive destruction of the periodontium as well as gingival recession accompanied by an increase in the severity of ______ complications.

    <p>systemic</p> Signup and view all the answers

    With acute necrotizing ulcerative gingivitis, the color changes are ______; with herpetic gingivostomatitis, it is ______; and with acute reactions to chemical irritation, it is ______ or diffuse.

    <p>marginal, diffuse, patchlike</p> Signup and view all the answers

    Initially, there is an increase in ______. If the condition does not worsen, this is the only color change until the gingiva reverts to normal.

    <p>erythema</p> Signup and view all the answers

    Heavy metals (i.e., bismuth, arsenic, mercury, lead, and silver) that are absorbed systemically may discolor the gingiva and other areas of the oral mucosa. These changes are rare, but they should still be ruled out in suspected cases. Metals typically produce a ______ or bluish line in the gingiva that follows the contour of the margin.

    <p>black</p> Signup and view all the answers

    Pigmentation from systemically absorbed metals results from the perivascular precipitation of metallic sulfides in the subepithelial connective tissue. Gingival pigmentation is not a result of systemic toxicity. It occurs only in areas of inflammation in which the increased permeability of irritated blood vessels permits the seepage of the metal into the surrounding tissue. In addition to inflamed gingiva, mucosal areas that are irritated by biting or abnormal chewing habits are common sites of ______.

    <p>pigmentation</p> Signup and view all the answers

    Systemic diseases may cause color changes in the oral mucosa, including the gingiva. In general, these abnormal pigmentations are nonspecific, and they should stimulate further diagnostic efforts or referral to the appropriate ______.

    <p>specialist</p> Signup and view all the answers

    Several endocrine and metabolic disturbances, including diabetes and pregnancy, may result in ______ changes.

    <p>color</p> Signup and view all the answers

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