Gingival Recession and Its Impact
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Questions and Answers

What is the primary definition of gingival recession?

  • An increase in gum tissue around teeth
  • Formation of gum pockets around teeth
  • Edema of the gingival tissue due to inflammation
  • The displacement of the gingival margin apical to the cemento-enamel junction (correct)
  • Which of the following is a mechanical factor that can cause gingival recession?

  • Hormonal changes
  • Gingivitis
  • Iatrogenic damage (correct)
  • Systemic diseases
  • How does toothbrush trauma relate to gingival recession?

  • It typically results from non-aggressive brushing techniques.
  • It usually leads to reduced gum tissue exposure.
  • It only occurs with soft-bristled toothbrushes.
  • Improper oral hygiene aids can exacerbate the condition. (correct)
  • In which aspect of the teeth is gingival recession often localized?

    <p>Labial/buccal aspect of teeth (B)</p> Signup and view all the answers

    Which of the following is NOT a common cause of gingival recession?

    <p>Developmental genetic factors (D)</p> Signup and view all the answers

    To monitor gingival recession, which of the following measures is essential among dental professionals?

    <p>Measurement of the gingival margin position relative to cemento-enamel junction (D)</p> Signup and view all the answers

    What is a common complication associated with gingival recession?

    <p>Exposure of root surfaces leading to sensitivity (C)</p> Signup and view all the answers

    What is the purpose of holding the probe parallel to the long axis of the tooth during periodontal measurements?

    <p>To avoid recession measurement errors (D)</p> Signup and view all the answers

    How is Loss of Attachment (LOA) measured?

    <p>By combining recession and probing depth values (C)</p> Signup and view all the answers

    What should be the initial action taken if recession is noted in a patient?

    <p>Identify the cause of the recession first (C)</p> Signup and view all the answers

    What does clinical loss of attachment (CLOA) also refer to?

    <p>Clinical attachment loss (CAL) (C)</p> Signup and view all the answers

    Which classification system is commonly used for marginal tissue recession?

    <p>Miller’s Classification (A)</p> Signup and view all the answers

    What can a marked frenal attachment cause?

    <p>Localized periodontal issues (D)</p> Signup and view all the answers

    What is a significant iatrogenic risk during the treatment of periodontal disease?

    <p>Recession of gingival tissues (D)</p> Signup and view all the answers

    Which of the following is NOT an aetiological factor behind recession?

    <p>High sugar diet (D)</p> Signup and view all the answers

    What characteristic describes the gingival tissue in a thin gingival biotype?

    <p>Delicate and translucent (D)</p> Signup and view all the answers

    The apical migration of the gingival margin is indicative of which condition?

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

    What potential complication arises from having poor marginal fit of dental restorations?

    <p>Increased recession risk (C)</p> Signup and view all the answers

    Which of the following factors is associated with an increased risk of recession?

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

    What is a common appearance of gingival tissue in individuals with a thick biotype?

    <p>Thicker and less translucent (D)</p> Signup and view all the answers

    What is the primary concern regarding gingival recession after periodontal treatment?

    <p>Potential for root exposure (B)</p> Signup and view all the answers

    What can be a consequence of food stagnation in the mouth?

    <p>Uncomfortable sensations for the patient (A)</p> Signup and view all the answers

    Which factor can contribute to mechanical damage in the context of recession?

    <p>Brush trauma (D)</p> Signup and view all the answers

    What is an important recommendation for managing plaque stagnation?

    <p>Use appropriate oral hygiene aids (B)</p> Signup and view all the answers

    What should patients be educated about regarding trauma from foreign bodies?

    <p>It can lead to periodontal disease (A)</p> Signup and view all the answers

    What type of teeth movement might be considered iatrogenic?

    <p>Orthodontic tooth movement (D)</p> Signup and view all the answers

    How should the process of measuring recession be approached?

    <p>It requires systematic documentation (D)</p> Signup and view all the answers

    What is one of the significant risks associated with smoking in relation to dental health?

    <p>Increased risk of recession (D)</p> Signup and view all the answers

    What is a common misconception regarding the role of gingival biotype in recession?

    <p>It varies in influence on different individuals (D)</p> Signup and view all the answers

    Which of the following is NOT considered a traumatic factor in recession?

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

    What aspect should be closely monitored to halt the progression of recession?

    <p>Maintain an effective oral hygiene routine (B)</p> Signup and view all the answers

    Which of the following is a consequence of smoking on periodontal health?

    <p>Increased susceptibility to periodontal disease (C)</p> Signup and view all the answers

    What can poor marginal fit of restorations lead to?

    <p>Plaque stagnation and gingival recession (B)</p> Signup and view all the answers

    Which tooth movement can cause gingival recession, especially in individuals with a thin biotype?

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

    What is one potential effect of gingival recession on a patient?

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

    What aesthetic issue can arise from gingival recession?

    <p>Black triangles between teeth (C)</p> Signup and view all the answers

    What can exposure of the dentine root surface cause?

    <p>Root caries risk (A)</p> Signup and view all the answers

    What dental condition can result from dentine hypersensitivity?

    <p>Decreased chewing efficiency (B)</p> Signup and view all the answers

    What impact does gingival recession have on oral hygiene?

    <p>Increased plaque stagnation (C)</p> Signup and view all the answers

    What factor makes exposed dentine more prone to caries?

    <p>Lower mineral content compared to enamel (B)</p> Signup and view all the answers

    Which of the following statements about orthodontic treatment is true?

    <p>Rapid tooth movement can increase risk of gingival recession (C)</p> Signup and view all the answers

    Flashcards

    Gingival Recession

    Displacement of gum tissue, exposing tooth root.

    Mechanical Factors (Recession)

    Causes of gum recession related to physical forces.

    Trauma from Toothbrush

    Recession due to harsh or improper brushing.

    Traumatic Incisal Rel.

    Recession caused by excessive biting pressure.

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    Iatrogenic Damage

    Recession from dental procedures.

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    Abnormal Frenum Attachment

    Recession due to tight frenum pulling on gum tissue.

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    Localized Recession

    Recession limited to a specific tooth surface.

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    Frenal Pull

    A tight frenum (tissue connecting lip/tongue to gum) can pull on the gum, causing recession.

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    Recession Impact

    Frenal pull can lead to gum recession, making oral hygiene difficult, causing localized periodontal issues, and potentially more recession.

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    Iatrogenic Risk

    Successful periodontal treatment can sometimes cause recession, so patients should be warned of this risk.

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    Inflammatory Factors

    Things that cause inflammation, like periodontal disease, smoking, or poor restorations can cause recession.

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    Gingival Biotype

    The type of gum tissue you have (thin or thick) can affect how prone you are to recession.

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    Thin Biotype

    Thin gingival biotype is delicate, translucent, and has a small zone of attached gingiva, making it more susceptible to recession.

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    Periodontal Disease & Recession

    Periodontal disease can lead to recession because it causes the gum margin to move apically (towards the tooth root).

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    Orthodontic Movement & Recession

    Moving teeth with braces can sometimes cause recession, especially if the movement is excessive or if the gum tissue is thin.

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    Recession Measurement

    Distance from the Cement Enamel Junction (CEJ) to the gingival margin.

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    Loss of Attachment (LOA)

    Combination of recession and probing depth.

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    Miller's Classification

    A system for categorizing the severity of gingival recession, based on the extent and location of the recession.

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    Probing Depth

    The distance from the gingival margin to the bottom of the periodontal pocket.

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    Parallel Probe Placement

    The probing instrument should be held parallel to the long axis of the tooth during measurements.

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    Smoking & Periodontal Disease

    Smoking significantly increases the risk of developing periodontal disease. This is because smoking weakens the immune system, reducing the body's ability to fight off bacteria that cause gum disease.

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    Poor Marginal Fit of Restorations-Impact

    Poorly fitted dental restorations can lead to gum recession due to plaque buildup and irritation around the restoration. This is because the restoration creates a space where bacteria can thrive, causing inflammation and gum tissue loss.

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    Dentine Hypersensitivity-Cause

    Gum recession exposes the dentine, the layer beneath enamel, causing tooth sensitivity. This is because dentine contains tiny tubules that lead to the nerve of the tooth, making it more sensitive to cold, hot, or sugary foods.

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    Aesthetic Effects of Recession

    Gum recession can affect the appearance of teeth, creating a 'black triangle' between teeth and making the teeth appear longer. This can be a source of concern for some patients.

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    Root Caries-Cause

    Root caries is a type of tooth decay that affects the root of the tooth, which is less mineralized than enamel and more susceptible to decay. This is often caused by the exposure of the root surface due to gum recession.

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    Food Trap & Plaque Stagnation

    Recession can create spaces between the teeth and the gums, leading to food getting trapped and plaque accumulation. This can contribute to further periodontal problems.

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    Confidence & Speaking Issues

    Gum recession can affect a person's confidence due to the aesthetic changes it causes, potentially impacting their speaking ability or comfort in social situations.

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    Comfort & Eating

    Gum recession can lead to discomfort while eating, especially with hot, cold, or acidic foods. This is due to dentin hypersensitivity caused by exposed root surfaces.

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    Critical pH Levels

    The critical pH level for enamel is about 5.5, while for dentine it is around 6.0. This means that the enamel is more resistant to acid attack than dentine, making dentine more prone to decay when exposed due to gum recession.

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    Plaque Stagnation

    The accumulation of plaque, primarily at the gum line, due to inadequate oral hygiene.

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    Food Trapping

    The accumulation of food particles between teeth due to poor oral hygiene practices.

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    Black Triangles

    Dark spaces between teeth, often caused by gum recession or tooth decay.

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    Recession

    The displacement of the gum tissue away from the tooth, exposing more of the tooth's root.

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    Inflammatory Factors (Recession)

    Conditions that cause inflammation in the gums, leading to recession (like periodontal disease, smoking, or poorly fitting restorations).

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    Orthodontic Tooth Movement

    Moving teeth with braces, which can sometimes cause gum recession due to excess force or thin gum tissue.

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    Stabilizing Recession

    Measures taken to halt further gum recession and protect the tooth.

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    Consequences of Recession

    The negative effects of gum recession, such as tooth sensitivity, root decay, and difficulty maintaining oral hygiene.

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    Study Notes

    Gingival Recession

    • Gingival recession is the displacement of the gingival margin apically to the cemento-enamel junction, exposing the root surface.
    • This condition can be localized or generalized.

    Intended Learning Outcomes

    • Explain the multiple etiological factors associated with gingival recession.
    • Recognize the oral health impact of gingival recession on the dental patient.
    • Identify methods for measuring and monitoring gingival recession.
    • Identify various treatment modalities for gingival recession in dental patients.

    Definition

    • Gingival recession involves the gingival margin moving below the cemento-enamel junction (CEJ), exposing the root surface.

    Healthy Gingival Tissues

    • Alveolar mucosa
    • Mucogingival junction
    • Attached gingiva
    • Free gingiva
    • Interdental papilla
    • Stippling
    • Keratinized tissue (KT)

    Clinical Appearance

    • Determine if gingival recession is localized or generalized.

    Recession

    • Recession is often confined to a single tooth surface, typically the labial/buccal aspect.
    • Recession alone does not typically jeopardize periodontal support.
    • The underlying cause of gingival recession should be considered.

    Causative Factors: Mechanical

    • Toothbrush trauma (prolonged aggressive brushing, inappropriate oral hygiene aids)
    • Traumatic incisor relationship (lower incisors impacting the upper incisors)
    • Trauma from foreign bodies (lower lip stud, tongue stud)
    • Abnormal frenum attachment
    • Iatrogenic damage

    Causative Factors: Inflammatory

    • Gingival biotype
    • Periodontal disease
    • Smoking
    • Poor marginal fit of restorations
    • Orthodontic tooth movement

    Gingival Biotype

    • Gingival tissue is often delicate and translucent.
    • The tissue may appear friable with a minimal attached gingiva zone.

    Periodontal Disease

    • Apical migration of the gingival margin is a sign of periodontal disease.

    Smoking

    • Smoking significantly impacts periodontal health.
    • Smokers are more susceptible to periodontal disease.

    Poor Marginal Fit of Restorations

    • Low-grade irritation from sub-gingival margins can negatively affect the width of the biological gingival tissue.
    • Plaque stagnation is a risk.
    • Gingival recession can occur in susceptible patients.

    Orthodontic Movement

    • Orthodontic tooth movement can lead to gingival recession, especially in rapid orthodontic movement in adults, particularly in patients with thin biotypes.

    Impact of Gingival Recession on the Patient

    • Dentin hypersensitivity
    • Aesthetic concerns
    • Root caries
    • Food traps/plaque stagnation
    • Confidence/speaking difficulties
    • Comfort with eating

    Dentin Hypersensitivity

    • Recession exposes the dentin root surface, potentially causing hypersensitivity in the patient.
    • Hyperaemia of the pulp might occur due to root surface exposure.

    Aesthetic Considerations

    • Recession might lead to poor aesthetics, frequently creating a "black triangle" appearance.

    Root Caries

    • Exposed root surfaces are less mineralized and thus more susceptible to caries compared to enamel.
    • Caries progression speed is faster on exposed root surfaces.

    Plaque Stagnation and Food Trapping

    • Improper oral hygiene can lead to plaque stagnation and problematic food trapping.

    Summary of Causative Factors

    • A diagram illustrating mechanical and inflammatory factors associated with recession. Include detailed descriptions.

    Measuring & Monitoring Recession

    • Recession is measured from the cemento-enamel junction (CEJ) to the gingival margin.
    • A probe held parallel to the tooth's long axis, with clear markings, is used.

    Loss of Attachment (LOA)

    • It's a combination of recession and probing depth.
    • Sometimes expressed as clinical loss of attachment (CLOA) or clinical attachment loss (CAL).

    Recession Management

    • Refer to the diagram, showing a cyclical process of patient management:
      • Refer
      • Inform the patient
      • Monitor
      • Identify the cause
      • Treat as needed
      • Educatie patient
      • Measure and record

    Miller's Classification of Recession

    • Classification system defining different degrees of gingival recession:
      • Class I: Recession does not extend to the mucogingival junction (MGJ)
      • Class II: Recession extends to or beyond the MGJ, but there's no loss of interdental bone or soft tissue.
      • Class III: Recession extends to or beyond the MGJ, with loss of interdental bone or soft tissue coronal to the apical extent of the gingival recession.
      • Class IV: Recession extends to or beyond the MGJ with loss of interdental bone or soft tissue with apical to the extent of the marginal tissue recession.

    Treatment Modalities

    • Periodontal treatment (surgical or non-surgical)
    • Desensitizing agents
    • Gingival veneers
    • Composite restorations
    • Referral for surgical intervention
    • Gingival graft surgery

    Gingival Veneers

    • Removable acrylic facings to improve aesthetics.

    Restorations

    • Composite used to cover sensitive, caries-prone exposed dentine in cervical areas.

    Considerations for Treatment

    • Difficult treatment in some cases
    • Limited compliance

    Monitoring Gingival Recession

    • Regularly measure and monitor recession.
    • Respond to treatment needs.
    • Refer as needed.

    Summary Revision Slide

    • A diagram summarizing all aspects of gingival recession, such as identification, measurement, impact on patients, treatment, and monitoring strategies.

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    Related Documents

    Gingival Recession PDF

    Description

    Explore the essential aspects of gingival recession, including its definitions, etiological factors, and clinical appearances. This quiz will help you recognize the implications of gingival recession on oral health and identify various treatment modalities available for dental patients.

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