2024 HEALTHY MOUTH (5).pptx

THE HEALTHY MOUTH DEPT: ORAL MEDICINE AND PERIODONTOLOGY S SIMONS 2024  OBJECTIVES  Recognize and describe oral tissues in health and disease  Important to differentiate between a healthy and diseased gingiva- be able to describe features of the...

THE HEALTHY MOUTH DEPT: ORAL MEDICINE AND PERIODONTOLOGY S SIMONS 2024  OBJECTIVES  Recognize and describe oral tissues in health and disease  Important to differentiate between a healthy and diseased gingiva- be able to describe features of the Oral cavity BUCCAL MUCOSA  Examine Buccal mucosa and opening of Stenson's duct –route for flow of saliva into the mouth  BUCCAL MUCOSA & LEUKOEDEMA  Filmy opalescence or diffuse whiteness  Folded wrinkled appearance  Pigmentation may be included in leukoedema  Buccal mucosa commonly affected.  May be associated with smoking (including dagga)  Less white when cheek is stretched THE HARD PALATE  Palatine rugae folds of the mucosa of the hard palate  Incisive papilla (behind the maxillary incisors) ▪ Use index finger to gently palpate tissue covering hard palate  Note for any lesions  TORI (TORUS PALITINUS)  Common benign outgrowths of bone from the maxilla  Usually bilateral (mandible)  May be single shaped or multilocular  Appears in 20 to 35% of population DOR SUM SUR FACE OF TONGUE  Check the colour, papilla, presence or lack of coating (The ideal tongue coating consists of a thin, white film on the surface), it indicates that the stomach and digestive system is healthy and functioning  Taste buds on the tongue sit on raised protrusions called papillae - located on dorsum surface of tongue- VENTRAL SUR FACE OF TONGUE  Check ventral surface of the tongue  Visually examine the floor of the mouth, the lingual frenum and the salivary ducts LATERAL SUR FACES OF THE TONGUE  Ask patient to extend the tongue and relax it  Use gauze to grasp the tip of the tongue and pull forward  Check dorsum, ventral and lateral surfaces  Observe for any ulcerations o the tongue EXAMINATION OF LIPS  Gently retract lips with thumb and index finger  Inspect colour, observe for ulcerations, blisters  Gently palpate to detect lumps/ abnormalities  Examine mucosa and frenum of upper and lower lips  Check texture, colour, commissures of the lips..  Note for any blisters, ulcers, lump formation, dryness and cracking of corners of mouth  LINEA ALBA  Appears as a white line beginning at the corners of the oral cavity extending posteriorly at the level of the occlusal plane  Often found bilaterally-cannot be rubbed off  Thickened epithelial changes –due to frictional activity of the teeth  FORDYCE GRANULES  Flat or elevated yellow grains  Asymptomatic – derived from sebaceous glands beneath the mucosa  1-3 mm in dimension  Most common on the buccal mucosa and region of the lips  Clinical Features of a healthy gingiva  Healthy gingiva is usually described as "coral pink" in color  The shade of pink depends on number and size of blood vessels  No bleeding Healthy gingiva can be pigmented – pigmented areas range from light brown to black depends on skin complexion  Tissue contour size and shape  In health -the interdental papillae usually fits to make a sharp point as they approach the area where the teeth come together and make contact.  The gingival margin meets the tooth- with a tapered knife edged papilla  Diastema –no contact between adjacent teeth –flat papilla Tissue consistency and texture in health  Gingiva is firmly attached to crown of tooth  Tissue is resilient (elastic) when gentle pressure is applied to the gingiva-  The gingiva is firm dimpled -resembles skin of an orange peel  This dimpled appearance is called – stippling  healthy tissue may or may not exhibit stippling differs from individual to individual Gingivitis is a non-destructive disease that causes inflammation of the gums. Gingivitis is reversible with good oral hygiene; however, without treatment, gingivitis can progress to periodontitis, in which the inflammation of the gums results in tissue destruction and bone resorption around the teeth Tissue color in gingivitis:  Gingiva is red swollen,tender and bleeds easily  Increased blood flow to the gingiva-causes tissue to appear bright red  Increased fluid causes enlargement of the tissues  Change in color from coral pink to a more reddish color  Change in form from a nice sharp, tapered form into a rounded, swollen, less tapered form  Loss of stippling – shiny, red appearance -bleeds on probing-spontaneous bleeding Types of changes In appearance of the papillae  Enlarged gingiva/ papillae- gingival enlargement is an increase in the size of the gingiva  It is a common feature of gingival disease.  Gingival enlargement can be caused by a number of factors, including inflammatory conditions /and the side effects of certain medications. Bulbous Gingiva  The shape of the papillae varies considerably depending on the: -shape of the teeth - their alignment in the arch - the location and size of the area of the proximal contact.  Interdental papillae appear too large for the space:  Enlarged interproximal papillae May become chronic and firm with long standing inflammation Blunted Papillae  A papillae that is flat –does not fill the interproximal space Cratered papillae  Appears to be scooped out associated with necrotizing gingivitis.  PERIODONTITIS Periodontitis is the inflammation of the gums and supporting structures of the teeth.  Inflammation, bleeding on probing  Spongy marginal gingiva  Alveolar bone loss-only –assessed with probing-and with the aid of a radiograph  Mobility of teeth  Gingival recession References: JS. Nield-Gehrig and DE. Willman. 2011. Foundations of Periodontics for the Dental Hygienist. Third edition. Wolters Kluver. THANK YOU FOR LISTENING