Gingival Health and Defence Mechanisms
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Questions and Answers

What is the primary cell type responsible for the initial defense against bacterial plaque in the gingival tissues?

  • Lymphocytes
  • Macrophages
  • Polymorphonuclear neutrophils (correct)
  • Mast cells
  • What is the main function of crevicular (gingival) fluid?

  • To flush away bacteria from the gingival crevice (correct)
  • To lubricate the teeth and gums
  • To provide nutrients to the gingival tissues
  • To help in the formation of plaque
  • What is the role of saliva in maintaining oral health?

  • To lubricate the teeth and gums
  • To protect the teeth from enamel erosion
  • To flush away bacteria from the oral cavity (correct)
  • To help in digestion
  • What is the main characteristic that distinguishes gingivitis from periodontitis?

    <p>The loss of connective tissue attachment (D)</p> Signup and view all the answers

    What is the primary etiological factor in the pathogenesis of both dental caries and periodontal disease?

    <p>Bacterial plaque (A)</p> Signup and view all the answers

    What is the main reason why the formation of pockets in periodontitis facilitates the growth of anaerobic microorganisms?

    <p>The absence of oxygen in the pocket (D)</p> Signup and view all the answers

    What is the key factor that determines the resolution of gingivitis?

    <p>The removal of plaque (A)</p> Signup and view all the answers

    Which of these is NOT a feature of periodontitis?

    <p>Increased thickness of the gingival tissues (A)</p> Signup and view all the answers

    What is the direct consequence of the apical migration of the junctional epithelium in periodontitis?

    <p>Formation of periodontal pockets (A)</p> Signup and view all the answers

    What is the normal depth of the gingival sulcus?

    <p>0.5 mm - 1.0 mm (D)</p> Signup and view all the answers

    What is the primary cause of gingivitis?

    <p>Accumulation of bacterial plaque near the gingival margin (A)</p> Signup and view all the answers

    What is the correct definition of dental calculus?

    <p>A hard, calcified deposit on teeth that can be removed with professional cleaning (B)</p> Signup and view all the answers

    What is the primary difference between gingivitis and periodontitis?

    <p>Gingivitis is a mild form of gum disease, while periodontitis is a more severe form that affects the supporting structures of the teeth. (C)</p> Signup and view all the answers

    Which of the following is NOT a common symptom of gingivitis?

    <p>Tooth sensitivity to cold (A)</p> Signup and view all the answers

    Which of the following conditions would be considered a contraindication for tooth extraction?

    <p>Active cardiovascular disease in the acute stage (B)</p> Signup and view all the answers

    What is the primary reason for using antifungal medications alongside antibiotics for HIV-positive patients?

    <p>To combat opportunistic infections that may thrive in the presence of antibiotics (C)</p> Signup and view all the answers

    Which of the following is NOT considered a possible complication following tooth extraction?

    <p>Loss of taste sensation in the tongue (A)</p> Signup and view all the answers

    What is the main reason for extracting a tooth that has undergone root canal therapy?

    <p>The tooth is infected and cannot be saved with root canal therapy. (D)</p> Signup and view all the answers

    Which of the following is NOT a reason for tooth extraction?

    <p>A tooth that is causing misalignment in the bite but can be treated with orthodontics. (A)</p> Signup and view all the answers

    Which of the following is a common oral hygiene recommendation for preventing gingivitis?

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

    Flashcards

    Normal gingiva

    Healthy gum tissue that is pink, firm, and stippled with papillae.

    Free gingival

    The part of the gum not attached to the tooth, including interdental papillae.

    Attached gingiva

    Gingiva firmly bound to the underlying teeth and bone, measuring 3mm-4mm.

    Alveolar mucosa

    Loosely attached gum tissue that refracts from the bone.

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    Defence mechanisms of oral cavity

    Includes saliva, crevicular fluid, leukocytes, and microorganisms that protect gums.

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    Saliva role

    Flushing action that helps remove bacteria and maintains oral health.

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    Crevicular fluid

    Fluid that percolates through gum tissues, aiding in bacterial flushing.

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    Polymorphonuclear neutrophils (PMNs)

    First line of defense in gingival tissue against bacteria.

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    Gingivitis development

    Related to plaque accumulation and inflammation; reversible if plaque is removed.

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    Periodontitis features

    Inflammatory disease causing attachment loss, pocket formation, and bone loss.

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    Dental Plaque

    A bacterial layer on teeth hard to see initially.

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    Dental Calculus

    Hard, calcified deposits on teeth classified as supra or sub gingival.

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    Gingivitis

    An inflammatory lesion in the marginal gingiva due to plaque buildup.

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    Periodontal Disease

    Disease affecting the supporting structures of teeth including ligaments and bone.

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    Acute Gingivitis

    Sudden onset gum inflammation with symptoms like redness and bleeding.

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    Tooth Extraction

    The process of removing a tooth from its socket.

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    Contraindications to Tooth Extraction

    Conditions that require careful management before tooth removal.

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    Complications of Dental Extraction

    Potential problems following tooth removal like fractures and infections.

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    Periodontitis

    Chronic inflammation of the supporting structures of teeth, often from untreated gingivitis.

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    Oral Hygiene

    Practices to maintain oral health and control plaque.

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    Study Notes

    Normal Gum Characteristics

    • Healthy gums are pink, firm, and stippled, with well-defined papillae and gingival crevices.
    • The gingival sulcus should be shallow and without exudates.
    • Parts of normal gingiva include:
      • Free gingiva (interdental papillae)
      • Attached gingiva (3.0 mm – 4.00 mm, stippled surface)
      • Alveolar mucosa (loosely attached to bone, refracting away from it)

    Oral Cavity Defence Mechanisms

    • Junctional epithelium is part of the defence, but offers limited protection against underlying connective tissue damage when plaque is present.
    • Defence mechanisms include:
      • Saliva (flushing action removes bacteria)
      • Crevicular fluid (flushing action reduces bacterial colonization, increased production with inflammation)
      • Polymorphonuclear leukocytes (PMNs, first line of defence, vital to prevent/treat gingivitis, pocket formation, and periodontal disease progression)

    Development of Gingivitis

    • Related to plaque accumulation and inflammation
    • Resolves with plaque removal

    Periodontitis

    • Inflammatory disease of periodontal tissues
    • Features include:
      • Loss of connective tissue attachment to the root surface
      • Cementum exposure
      • Apical migration of junctional epithelium (gingival recession/pocket formation)
      • Alveolar bone loss
      • Increased tooth mobility
      • Plaque colonization on root surfaces and necrotic cementum
      • Pocket environment facilitates anaerobic microorganism growth

    Plaque

    • Major etiological factor in dental caries and periodontal disease
    • Bacterial aggregation on teeth and other solid structures
    • Difficult to identify with the naked eye unless thick enough to appear yellowish at the gingival margin

    Calculus

    • Hard, calcified deposit on teeth
    • Classified by location relative to the marginal gingiva (supra or sub gingival)

    Gingivitis

    • Inflammatory lesion of marginal gingiva
    • Caused by bacterial plaque accumulation
    • Clinical features:
      • Redness
      • Bleeding
      • Gum oedema
      • Gum tenderness

    Oral Hygiene and Treatment

    • Plaque control, oral hygiene, and measures like oraldine mouthwash are crucial treatments for gingivitis.
    • Antibiotics may also be administered.

    Periodontum

    • Supporting apparatus of the teeth, including gums, alveolar bone, gingiva tissues, ligaments, blood vessels, periodontal space, root, and cementum.
    • Periods of oral health are essential for the maintenance of a healthy periodontum.

    Periodontal Disease Classification

    • Gingivitis:
      • Acute
      • Chronic
      • Juvenile
      • Rapidly progressive
      • Chronic (adult)
      • Refractory
    • Periodontitis:
      • Acute
      • Chronic (Apical, marginal)
    • Dystrophic conditions:
      • Hyperplastic
      • Atrophic
      • Degenerative

    Severe Marginal Periodontal Diseases

    • Signs of severe diseases
    • Impacted, mal-erupted, misplaced, or extra teeth
    • Fractured teeth, root, or loosened teeth
    • Severe cases may require radical surgery or preparation for radiotherapy

    Modification for HIV Patients

    • Use of antibiotics/chemotherapeutics can promote opportunistic microorganisms
    • Alternative measures include: Chlorhexidine mouthwash, Amphotercine lozenges, Nystatine, and combined administration of antibiotics and antifungal drugs.

    Tooth Extraction

    • Removal of a tooth from its socket with instruments.
    • Indications include:
      • Hopelessly diseased teeth
      • Acute/chronic pulpitis, necrosis or gangrene when root canal treatment is impossible
      • Apical periodontitis
      • Retained roots or primary teeth
    • Contraindications are relative and involve a multidisciplinary approach to treatment in regards to systemic conditions.
      • Cardiovascular issues (acute)
      • Liver, kidney, or pancreatic diseases
      • Blood disorders
      • Acute infectious diseases
      • Nervous system conditions
      • Psychological illness (acute phase)
      • Oral cavity diseases
      • Acute febrile illnesses
    • Complications (local):
      • Tooth fracture
      • Jaw fracture
      • Soft tissue damage
      • Maxillary sinus penetration
      • Excessive bleeding
      • Dry socket
      • Root loss in the maxillary sinus

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    Description

    This quiz explores the characteristics of normal gums, highlighting the key components of healthy gingiva and the oral cavity's defence mechanisms. It also covers the development of gingivitis related to plaque accumulation. Test your knowledge on gum health and periodontal disease prevention.

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