Gingival Overgrowth Study Guide
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Questions and Answers

What does cellular hypotrophy refer to?

  • A change in cell shape
  • An increase in the number of cells
  • A decrease in the size of individual cells
  • An increase in the size of individual cells (correct)

Which of the following terms is matched incorrectly with its meaning?

  • Contiguous - randomly distributed (correct)
  • Papillary - characterized by projections
  • Diffuse - spread out
  • Discrete - separate and distinct

Which term best describes localized growth of tissue?

  • Proliferative
  • Discrete (correct)
  • Diffuse
  • Papillary

What is a key characteristic of proliferation in tissue?

<p>Increased cell division (B)</p> Signup and view all the answers

Which of the following statements about the gingiva is true?

<p>Proliferation and intensification can occur in the gingiva. (B)</p> Signup and view all the answers

What medication alternative might be sought for individuals who experience adverse effects from Ramipril?

<p>Captopril (A), Lisinopril (B)</p> Signup and view all the answers

Which of the following is true regarding dental plaque?

<p>Plaque can be categorized as either supra gingival or sub gingival. (A)</p> Signup and view all the answers

Which of the following statements about plaque is NOT correct?

<p>Plaque is always beneficial to dental health. (D)</p> Signup and view all the answers

What is the potential consequence of leaving plaque unmanaged on tooth surfaces?

<p>Development of cavities (B)</p> Signup and view all the answers

Which best describes the role of plaque on teeth?

<p>It can hinder oral health if not properly cleaned. (B)</p> Signup and view all the answers

Which grade indicates that enlargement is confined to the interdental papillae?

<p>Grade 0 (A)</p> Signup and view all the answers

What can be inferred about Grade 3 enlargement?

<p>It covers three-quarters or more of the crown. (C)</p> Signup and view all the answers

Which descriptor is NOT relevant for contemporaneous notes for a patient with DIGO?

<p>Type of medication prescribed (A)</p> Signup and view all the answers

What does the presence of nodules indicate in patients with DIGO?

<p>It may indicate localized enlargement. (C)</p> Signup and view all the answers

Which grade would best describe enlargement that involves papilla and gingival margins?

<p>Grade 2 (B)</p> Signup and view all the answers

What characteristic is typical of Grade 1 enlargement?

<p>Enlargement confined to specific areas. (D)</p> Signup and view all the answers

In the context of DIGO due to Amlodipine, which descriptor would be important to note?

<p>Underlying causative factor if known (D)</p> Signup and view all the answers

Which descriptor would most likely indicate chronic enhancement in a patient with DIGO?

<p>How long present (D)</p> Signup and view all the answers

What is the definition of cellular hyperplasia?

<p>An increase in the number of individual cells. (C)</p> Signup and view all the answers

Which of the following drug groups is commonly associated with drug-induced gingival overgrowth?

<p>Calcium Channel Blockers (B)</p> Signup and view all the answers

Which medical condition is treated with the drug Amlodipine?

<p>Hypertension (B)</p> Signup and view all the answers

What differentiates gingival hyperplasia from gingival overgrowth?

<p>Overgrowth occurs due to systemic conditions, while hyperplasia occurs due to local irritants. (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic of gingival overgrowth?

<p>Permanent tissue loss (D)</p> Signup and view all the answers

Which of the following anti-convulsants is associated with gingival overgrowth?

<p>Phenytoin (C)</p> Signup and view all the answers

What is the primary reason for the classification of gingival overgrowth?

<p>To identify the cause of the overgrowth (C)</p> Signup and view all the answers

Which of the following conditions is related to the use of Tacrolimus?

<p>Crohn's disease (C)</p> Signup and view all the answers

How is gingival overgrowth often scored in clinical settings?

<p>Using a specific scoring guide for gingival enlargement (C)</p> Signup and view all the answers

Which of the following drugs belongs to the calcium channel blocker group?

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

Which medical condition is commonly treated with Nifedipine?

<p>Hypertension (C)</p> Signup and view all the answers

What might cause an overgrowth of the gums?

<p>Prolonged inflammation from bacterial infection (A)</p> Signup and view all the answers

What is a common feature of gingival enlargement?

<p>Brawny or firm consistency of the tissue (C)</p> Signup and view all the answers

Which drug is commonly associated with gingival overgrowth in patients with epilepsy?

<p>Phenytoin (C)</p> Signup and view all the answers

What is a characteristic of generalized gingival conditions?

<p>Involving the gingivae throughout the mouth (A)</p> Signup and view all the answers

Which option best describes discrete gingival enlargement?

<p>An isolated enlargement such as an abscess (C)</p> Signup and view all the answers

What type of cleaning method is emphasized for interdental areas?

<p>Interdental cleaning with floss and brushes (A)</p> Signup and view all the answers

Which instruction is vital for patients with plaque control issues?

<p>Attending regular hygienist appointments (C)</p> Signup and view all the answers

What is one impact of having dental issues like DIGO on a patient?

<p>Increased caries development (B)</p> Signup and view all the answers

Which of the following are among the compromising factors that can arise from DIGO?

<p>Delayed tooth eruption (B)</p> Signup and view all the answers

What role do disclosing tablets play in oral hygiene?

<p>They help identify plaque accumulation (D)</p> Signup and view all the answers

Which option is not a method to improve plaque control?

<p>Ignoring dental hygiene practices (B)</p> Signup and view all the answers

What complication is associated with increased periodontitis from DIGO?

<p>Greater likelihood of tooth loss (B)</p> Signup and view all the answers

Which of the following statements about speech is true regarding DIGO?

<p>It can lead to speech impairment. (D)</p> Signup and view all the answers

What is a potential social effect of DIGO on patients?

<p>Lowered self-esteem (B)</p> Signup and view all the answers

How can medication changes affect a patient with DIGO?

<p>They may worsen gingival health. (A)</p> Signup and view all the answers

What is one of the goals of using a manual or electric toothbrush?

<p>To reduce plaque buildup (D)</p> Signup and view all the answers

Which is not a recommendation for improving dental health in patients with plaque issues?

<p>Avoiding dental professional visits (D)</p> Signup and view all the answers

Flashcards

Cellular Hypertrophy

An increase in the size of individual cells

Cellular Hyperplasia

An increase in the number of cells in a tissue or organ

Cellular Differentiation

The process of cells maturing into their full size and function

Discrete

A term used to describe individual, distinct features or structures

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Diffuse

A term used to describe something spread out or widespread, not concentrated in one area

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Grade 0 (DIGO)

Enlargement is confined to the interdental papillae.

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Grade 1 (DIGO)

Enlargement involves papilla and gingival margins.

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Grade 3 (DIGO)

Enlargement covers three quarters or more of the tooth crown.

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Grade 2 (DIGO)

Enlargement covers three quarters or more of the tooth crown.

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DIGO caused by Amlodipine

A patient presents with gingival enlargement specifically caused by taking the medication Amlodipine.

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Shape (DIGO Documentation)

The shape of the gingival enlargement.

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Generalised/Localised (DIGO Documentation)

Whether the enlargement is generalised or localised.

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Nodules (DIGO Documentation)

Any nodularity present in the gingival enlargement.

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Hyperplastic gingival overgrowth

A type of gingival enlargement caused by an increase in the number of cells, such as in inflammation or hormonal fluctuations.

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Hypertrophic gingival overgrowth

A type of gingival enlargement caused by an increase in the size of cells due to increased demands upon the tissue.

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Fibrotic gingival overgrowth

A type of gingival enlargement caused by increased blood vessels and fibroblasts responding to stimuli such as inflammation or medication.

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Classification of gingival overgrowth

A classification of gingival overgrowth based on the underlying cause, including inflammatory, drug-induced, and hormonal.

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Inflammatory gingival overgrowth

Gingival enlargement resulting from inflammation, often triggered by plaque and calculus buildup.

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Drug-induced gingival overgrowth

Gingival enlargement resulting from the use of certain medications, primarily calcium channel blockers, anti-convulsants, and immunosuppressants.

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Hormonal gingival overgrowth

Gingival enlargement associated with hormonal fluctuations, particularly during pregnancy or puberty.

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Papillary gingival overgrowth

Gingival enlargement that primarily affects the interdental papilla, the tissue between teeth.

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Marginal gingival overgrowth

Gingival enlargement involving the marginal gingiva, the area surrounding the teeth.

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Generalized gingival overgrowth

Gingival enlargement affecting all parts of the gingiva, including the papillary, marginal, and attached gingiva.

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Scoring guide for gingival overgrowth

A system used to assess the severity of gingival overgrowth based on the extent and prominence of the enlargement.

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Calcium channel blockers

A class of medications that relax blood vessels and lower blood pressure, often associated with gingival overgrowth.

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Anticonvulsants

A class of medications used to treat seizures and epilepsy, also associated with gingival overgrowth.

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What is plaque?

Plaque is a sticky film that builds up on teeth, composed of bacteria and their byproducts. It can be found above the gum line (supragingival) or below (subgingival).

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What to do if Ramipril causes side effects?

If someone experiences side effects from the medication Ramipril, it's important to seek alternative medications that don't cause similar issues. The BNF (British National Formulary) is a great resource for finding such alternatives.

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Is plaque beneficial to teeth?

Plaque is NOT a protective film and is harmful to teeth. It contributes to tooth decay and gum disease. It is NOT harmless and should be removed regularly.

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How does plaque lead to cavities?

Plaque formation is a major factor in the development of dental cavities. Bacteria in plaque feed on sugars, producing acids that erode tooth enamel.

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What is plaque made of?

Plaque is formed by bacteria and their waste products. It's NOT just a mineralized film. This waste includes acids that damage enamel and can lead to cavities.

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What is Generalized Drug-Induced Gingival Overgrowth (DIGO)?

Generalized Drug-Induced Gingival Overgrowth affects the gingivae throughout the mouth.

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What is Localized Drug-Induced Gingival Overgrowth (DIGO)?

Localized Drug-Induced Gingival Overgrowth only affects a specific area of the gingiva, such as an abscess.

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What is Papillary Drug-Induced Gingival Overgrowth (DIGO)?

Papillary Drug-Induced Gingival Overgrowth affects the interdental papillae, the area between the teeth.

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What is Diffuse Drug-Induced Gingival Overgrowth (DIGO)?

Diffuse Drug-Induced Gingival Overgrowth affects the gingival margins, attached gingivae, and interdental papillae.

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Why is plaque control important for patients with DIGO?

Plaque control is crucial for patients with DIGO to help prevent complications.

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What are the methods for plaque control in patients with DIGO?

Regular brushing and flossing are effective methods to remove plaque.

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What is a single tufted brush, and why it is useful in DIGO?

Single tufted brushes target specific areas of the mouth, like around orthodontic appliances, where regular brushes may not reach.

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What is interdental cleaning, and why is it important in DIGO?

Interdental cleaning removes plaque between the teeth, where brushing cannot reach.

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How can disclosing tablets be used for plaque control in DIGO?

Disclosing tablets help visualize plaque, making it easier to remove.

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How can regular hygienist appointments help with DIGO?

Regular dental checkups allow for professional cleaning and assessment.

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What are the aesthetic and functional effects of DIGO?

DIGO can affect speech, aesthetics, and eating.

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What are the oral health implications of DIGO?

DIGO can lead to increased risk of caries and periodontitis.

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How can DIGO affect tooth development?

DIGO can delay tooth eruption and prolong the retention of primary teeth.

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What are some other potential effects of DIGO?

DIGO can lead to diastemas (gaps between teeth), difficulty with mouth breathing, and xerostomia (dry mouth).

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How can DIGO affect mental health?

DIGO can negatively impact self-esteem, leading to social anxiety and reduced self-confidence.

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Study Notes

Gingival Overgrowth

  • Gingival overgrowth is a condition involving enlargement of the gums.
  • Differentiating overgrowth from hyperplasia is crucial.
  • Pathological processes contribute to gingival enlargement.
  • Classifications of gingival overgrowth exist.
  • Locations and distribution of gingival overgrowth vary.
  • Scoring guides help assess gingival overgrowth severity.
  • Drug-induced gingival overgrowth is associated with specific drug groups.

Introduction

  • This handbook combines lectures and powerpoints on gingival overgrowth.
  • Key concepts covered include: definitions, distinguishing overgrowth from hyperplasia, pathological processes related to enlargement, classifications of gingival overgrowth, locations and distributions, scoring guides, and drug groups commonly implicated in drug-induced gingival overgrowth.
  • Students will use a workbook for self-directed learning.

Learning Outcomes

  • Students will be able to identify clinical features associated with gingival overgrowth.
  • Students will be able to categorize potential causative factors for gingival overgrowth.
  • Students will be able to select appropriate clinical assessment measures of patients with gingival overgrowth.
  • Students will list the classification of gingival overgrowth and the oral areas where it might present.
  • Students will evaluate the impact of gingival overgrowth on oral health and patients’ overall well-being.

Drug Groups and Medical Conditions

  • Calcium Channel Blockers: Associated with medical conditions like hypertension, angina pectoris, vascular disease, cardiac arrhythmia, and coronary artery disease.

    • Specific drugs like amlodipine, felodipine, nicardipine, nifedipine, verapamil, diltiazem, and others are listed.

  • Anticonvulsants: Associated with epilepsy, Parkinson's disease, down's syndrome, essential tremor, and other conditions.

    • Drugs like phenytoin, ethotoin, sodium valproate, phenobarbitone, vigabatrin, primidone, mephenytoin, ethosuximide, and methosuximide are listed.

  • Immunosuppressants: Associated with organ transplants, inflammatory diseases including Crohn's disease, ulcerative colitis, rheumatoid arthritis, and ankylosing spondylitis.

    • Tacrolimus is a notable immunosuppressant.

  • Cardiac Arrhythmias: Also linked to calcium channel blockers in specific cases.

True/False

  • Cellular hyperplasia involves increased cell numbers, not necessarily the cell size. (True)

Complete the Statement

  • Gingival enlargement or overgrowth is the proliferation and intensification of the gingiva

Cellular Hypotrophy Definition

  • Cellular hypotrophy refers to a decrease in cell size, not an increase. (False)

Matching Words to Definitions

  • Diffuse: Involving the entirety of the gingiva throughout the mouth.
  • Discrete: An isolated enlargement, like an abscess.
  • Papillary: Confined to the interdental papillae.
  • Generalised: Involving the gingival margins, attached gingiva, and interdental papillae).

Plaque Control Instructions

  • Five instructions for improving plaque control for patients with Drug-Induced Gingival Overgrowth (DIGO):
    • Tooth brushing (manual or electric, single tufted brushes)
    • Interdental cleaning (floss and brushes)
    • Disclosing tablets
    • Regular hygienist/therapist appointments
    • Consult a doctor (general practitioner) regarding medication adjustments if necessary.

Compromising Factors of DIGO

  • Speech, aesthetics, eating difficulties, increased caries, increased periodontal disease, delayed tooth eruption, retention of primary teeth, diastemas, mouth breathing, xerostomia, low self-esteem, halitosis, lack of confidence, and poor oral hygiene.

Grade Definitions

  • Grade 1: Enlargement involves the papilla and gingival margins.
  • Grade 2: Enlargement is confined to the interdental papillae.
  • Grade 3: Enlargement covers three quarters or more of the tooth crown.
  • Grade 0: No signs of gingival enlargement visible.

Patient Presentation Descriptors

  • When writing notes for patients presenting with DIGO, use these descriptors: shape, nodules, location, generalized or localized, vascular conditions, relevant classifications, scoring guides, duration of presentation, and underlying causative factors.

Medication Alternatives for DIGO

  • Medication alternatives to Amlodipine include Ramipril (check online BNF for others).

Plaque Definition

  • Plaque is an innocuous substance.

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Related Documents

Gingival Overgrowth Workbook Answers PDF

Description

This quiz focuses on gingival overgrowth, covering key aspects such as its definitions, classifications, and the pathological processes involved. Students will learn to differentiate overgrowth from hyperplasia and identify drug-induced causes. Utilize the workbook for self-directed learning to enhance your understanding of this condition.

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