Term
| what are 2 ways that classifying periodontal disease can help with communication? |
|
Definition
1. clinical findings can be universally communicated to other ADHPs
2. present info to patients |
|
|
Term
| What are 2 ways that classifying periodontal disease can help with your patient's oral health? |
|
Definition
create individual tx plans
predict tx outcomes |
|
|
Term
| what are two forms of periodontal disease |
|
Definition
1. gingivitis
2. periodontitis |
|
|
Term
| what is a reversible bacterial infection that is confined to the gingiva? |
|
Definition
|
|
Term
| what is bacterial infection of the gingiva, PDL, bone, and cementum that results in irreversible tissue destruction? |
|
Definition
|
|
Term
| who developed the AAP classification and what is it for? |
|
Definition
American Academy of Periodontology
classification of periodontal disease and conditions |
|
|
Term
| what was the previous name for aggressive periodontitis? |
|
Definition
| early onset periodontitis |
|
|
Term
| What are the 2 categories of gingival disease? |
|
Definition
dental plaque induced gingival disease
non-plaque induced gingival disease |
|
|
Term
| what are the 6 main categories of periodontitis? |
|
Definition
1. chronic periodontitis
2. aggressive periodontitis
3. manifestation of systemic disease
4. necrotizing periodontal disease
5. associated with endodontic lesions
6. developmental or acquired deformities or conditions |
|
|
Term
| What is the term for healthy tissue that is free of inflammation and has not been altered by disease or trauma? |
|
Definition
|
|
Term
| What color is health gingiva? |
|
Definition
|
|
Term
| Is gingiva color impacted by the color of skin? |
|
Definition
| yes. Lighter skinned people have paler pink gingiva |
|
|
Term
| does stippling always indicate health? |
|
Definition
|
|
Term
| What is the location of the margin in gingival health? |
|
Definition
| slightly coronal to the CEJ |
|
|
Term
| can chronic gingivitis be resolved with professional care? |
|
Definition
|
|
Term
| Does chronic gingivitis ever progress to periodontitis? |
|
Definition
|
|
Term
| what color is the gingiva in acute gingivitis? |
|
Definition
| bright red due to increased bloodflow |
|
|
Term
| What color is the gingiva in chronic gingivitis? |
|
Definition
| tissue bluish red and purple-red |
|
|
Term
| What is the term for papilla that appear to have been scooped out leaving a concave depression in the IP space |
|
Definition
|
|
Term
| What is the most important early indicator of gingival disease? |
|
Definition
|
|
Term
| what is the term for the effect inflammation has on the pocket wall that causes bleeding? |
|
Definition
|
|
Term
| What is the term for a condition that is occurring in all or most of the mouth? |
|
Definition
|
|
Term
| what is the term for a condition that is confined to the tissue of a single tooth or group of teeth? |
|
Definition
|
|
Term
| What is the term for inflammation confined to the papilla |
|
Definition
|
|
Term
| what is the term for inflammation confined to the margin and papilla |
|
Definition
|
|
Term
| what is the term for inflammation throughout the gingival margin, papilla, and attached gingiva which extends to the mucogingival junction? |
|
Definition
|
|
Term
| what are the two classes of gingival diseases? |
|
Definition
plaque induced gingival disease
non-plaque induced gingivitis |
|
|
Term
| What are the 4 categories of plaque induced gingival disease? |
|
Definition
plaque induced gingivitis
gingival disease from systemic factors
gingival disease from medications
gingival disease from malnutrition |
|
|
Term
| what are the 7 categories of non-plaque induced gingival lesions? |
|
Definition
Disease of bacterial origin
Disease of viral origin
Disease of fungal origin
Disease of genetic origin
Disease of genetic origin
Disease of systemic conditions
Traumatic lesions
foreign body reaction |
|
|
Term
| What is the most common form of periodontal disease? |
|
Definition
| gingivitis associated with dental plaque only |
|
|
Term
| What kind of patient would you have gingivitis on a reduced but stable periodontium? |
|
Definition
| successfully treated periodontitis patients who develop gingivitis |
|
|
Term
| If a treated periodontitis patient develops gingivitis, do they have periodontitis again? |
|
Definition
| no. Not until they have more bone loss |
|
|
Term
| for gingivitis on a reduced but stable periodontium, do you still have the signs of plaque-induced gingivitis? |
|
Definition
|
|
Term
| what are the three categories of gingival disease with modifying factors? |
|
Definition
1. systemic factors
2. medications
3. malnutrition |
|
|
Term
| In gingival disease modified by systemic factors, what initiates the disease process? |
|
Definition
|
|
Term
| in gingival disease modified by systemic factors, what modifies the disease process once disease is initiated? |
|
Definition
|
|
Term
| what are 5 modifying factors associated with endocrine and sex hormones? |
|
Definition
puberty
menstrual cycle
oral contraceptives
pregnancy gingivitis
pyogenic granuloma |
|
|
Term
| what are 3 modifying factors associated with systemic disease? |
|
Definition
diabetes
leukemia
blood dyscrasias |
|
|
Term
| during what trimesters is pregnancy associated gingivitis usually occuring? |
|
Definition
|
|
Term
| where are pyogenic granuloma's more common? |
|
Definition
| maxilla on the gingival papillae |
|
|
Term
| when does a pyogenic granuloma go away? |
|
Definition
| after giving birth (when hormone levels have gone down) |
|
|
Term
| Is a pregnancy tumor painful? Does it bleed? |
|
Definition
| It is not painful and bleeds if disturbed |
|
|
Term
| what are the 3 medications most commonly associated with gingival enlargement? |
|
Definition
1. anticonvulsants
2. calcium channel blocker
3. immunosuppressants |
|
|
Term
| what are the 2 classes of gingival disease modified by medications |
|
Definition
drug-influenced gingivitis
drug-influenced gingival enlargement |
|
|
Term
| is plaque accumulation necessary for initiation of gingival enlargement from medications? |
|
Definition
|
|
Term
| what role does plaque play in medication induced gingival enlargement? |
|
Definition
|
|
Term
| will plaque control eliminate gingival overgrowth? |
|
Definition
|
|
Term
| how many months does it take to see gingival enlargement from medications? |
|
Definition
| 3 months of taking the medication |
|
|
Term
| what population is gingival enlargement from medications most common in? |
|
Definition
|
|
Term
| where is gingival enlargement most commonly seen? |
|
Definition
| interdental papilla of the anterior sextants |
|
|
Term
| what 3 groups are most at risk for vitamin deficiencies? |
|
Definition
|
|
Term
| what is ascorbic acid-deficiency gingivitis? |
|
Definition
| inflammatory response to plaque aggravated by chronically low vitamin C (ascorbic acid) |
|
|
Term
| what are 4 characteristics of ascorbic-deficiency acid gingivitis? |
|
Definition
bright red gingiva
swollen (papilla)
ulcerated
bleeds easily |
|
|
Term
| what is the term for plaque induced gingivitis that occurs in gingival tissues surrounding a dental implant |
|
Definition
|
|
Term
| what is usually the first clinical sign of leukemia? |
|
Definition
|
|
Term
| what is blood dyscrasias? |
|
Definition
| abnormal function or number of blood cells |
|
|
Term
| what is the role of Vitamin A in gingival health? |
|
Definition
| maintains a healthy sulcular epithelium |
|
|
Term
| what is the role of Vitamin B in gingival health? |
|
Definition
| maintains health mucosal tissues |
|
|
Term
| is there usually attachment loss with gingival enlargement? |
|
Definition
|
|
Term
| what are two common drugs associated with gingival overgrowth? |
|
Definition
|
|
Term
| what are the two most commonly seen nonplaque induced gingivitis forms seen? |
|
Definition
primary herpetic gingivostomatitis
allergic reactions |
|
|
Term
| what is the term for the initial infection of herpes simplex characterized by redness and multiple vesicles and form painful ulcers? |
|
Definition
| primary herpetic gingivostomatitis |
|
|
Term
| primary herpetic gingivostomatitis is most common in what age group? |
|
Definition
| young children (younger than 10) |
|
|
Term
| how long does primary herpetic gingivostomatitis take to regress? |
|
Definition
|
|
Term
| what is a clinical consideration for primary herpetic gingivostomatitis |
|
Definition
| ulcers are painful and make eating and drinking difficult (watch for dehydration) |
|
|
Term
| What are some systemic symptoms of primary herpetic gingivostomatitis? |
|
Definition
headache
swollen lymph nodes
sore throat
low fever (not above 101) |
|
|
Term
| what is the gingival appearance for primary herpetic gingivostomatitis |
|
Definition
fiery red marginal gingiva
swollen papilla that bleed easily
yellow ulcers surrounded by red halo (gingiva, buccal and labial mucosa, palate, tongue, lips) |
|
|
Term
| what is an infection of the soft tissue surrounding the crown of a partially erupted tooth? |
|
Definition
|
|
Term
| Where is pericoronitis most common |
|
Definition
|
|
Term
| What care recommendations can be made for a patient with primary herpetic gingivostomatitis |
|
Definition
encourage fluid intake
recommend listerine to prevent secondard infection
if fever above 102, patient may be septic and require antibiotics |
|
|
Term
| What dosage of penicillin should be given for primary herpetic gingivostomatitis in a patient with a fever above 102? |
|
Definition
| 500mg, 4 tabs daily, 2 hours after meals for 7-10 days |
|
|
Term
| allergic reactions to toothpaste and mouthwash are usually reactions to what part of the product? |
|
Definition
|
|
Term
| who is most likely to have a reaction to mouthwash and toothpaste? |
|
Definition
| patients who also suffer from hay fever, allergic skin rashes, or asthma |
|
|
Term
| what are the clinical signs for reaction to toothpaste/mouthwash |
|
Definition
fiery red, ulcerated gingiva
tissue sloughing (buccal and labial mucosa)
cheilitis |
|
|
Term
| what can be done to confirm a diagnosis of allergic reaction to toothpaste? |
|
Definition
|
|
Term
| what gingival disease is characterized by a red band limited to the free gingiva (immunosupressed individuals). |
|
Definition
|
|
Term
| gingival diseases of fungal origin are common in what 2 groups? |
|
Definition
immunocompromised patients
patients taking inhaled steroid Rx for resp issues |
|
|
Term
| what are the 3 main classes of periodontitis? |
|
Definition
chronic periodontitis
aggressive periodontitis
less common types of periodontitis |
|
|
Term
| what is the most common form of periodontitis? |
|
Definition
|
|
Term
| what is the historical term for chronic periodontitis? |
|
Definition
|
|
Term
| why is the term "adult periodontitis" inaccurate? |
|
Definition
| can occur in individuals of any age |
|
|
Term
| what are the signs and symptoms of chronic periodontitis? |
|
Definition
tissue enlargement/swelling
redness
bad taste/bad breath
gingival bleeding
periodontal pocketing
bone loss
tooth mobility
suppuration
subgingival calculus |
|
|
Term
| what is a possible explanation for why people with chronic periodontits wait to seek care or delay care recommendations once a diagnosis has been determined? |
|
Definition
| Chronic perio usually doesn't cause any pain which means patients don't feel care is urgent |
|
|
Term
| what are the 2 possible gingival appearances of chronic perio? |
|
Definition
bright red/purple gingiva
pale-pink normal looking/fibrotic appearance (almost looks like gingival health) |
|
|
Term
| Is tissue appearance a reliable indicator of the presence or severity of periodontitis? |
|
Definition
|
|
Term
| what is the rate of progression of chronic periodontitis? |
|
Definition
| slow to moderate rate with bursts of rapid progression |
|
|
Term
| What age is chronic periodontitis commonly detected? |
|
Definition
|
|
Term
| what is the term for periodontitis in the tissues surrounding a dental implant |
|
Definition
|
|
Term
| Is presence of bacteria alone sufficient for the progression to chronic periodontitis? |
|
Definition
|
|
Term
| what is the term for the degree or amount of periodontal destruction and is characterized by the number of sites that have experiences tissue destruction? |
|
Definition
|
|
Term
| what is the term for the seriousness of the disease determined by the rate of disease progressions over time and the response of the tissues to treatment? |
|
Definition
|
|
Term
| what are the two subgroups of severity of chronic periodontitis? |
|
Definition
slight to moderate tissue destruction
advanced tissue destruction |
|
|
Term
| what is the change or advancement of periodontal destruction? |
|
Definition
|
|
Term
| what are the two subgroups of chronic periodontitis extent? |
|
Definition
localized chronic periodontitis
generalized chronic periodontitis |
|
|
Term
| what form of chronic periodontits is present in individuals with 30% or less of sites in the mouth that have experienced attachment loss and bone loss? |
|
Definition
| localized chronic periodontitis |
|
|
Term
| what form of chronic periodontitis is present in individuals with 30% or more of the sites of the mouth that have experienced attachment loss and bone loss |
|
Definition
| generalized chronic periodontitis |
|
|
Term
| what is the most currently accepted theory regarding the rate of disease progression in chronic periodontitis? |
|
Definition
| not continuous. short bursts during where there is breakdown of the PDL and alveolar bone destruction |
|
|
Term
| what are 6 components of initial care for chronic periodontitis? |
|
Definition
1. MD consult is systemic risk factors present
2. patient ed re plaque control
3. smoking cessation counseling
4. debridement of tooth surfaces
5. antimicrobial agents
6. removal/control of local factors causing inflammation |
|
|
Term
| some are some systemic risk factors for chronic periodontitis that may warrant MD referral for evaluation? |
|
Definition
smoking
poorly controlled diabetes
systemic diseases
stress
systemic medications (dilantin) |
|
|
Term
| what is the next step following initial care for chronic periodontitis? |
|
Definition
| re-examination to determine response to therapy after resolution and tissue repair |
|
|
Term
| what are 4 treatment goals for patients with chronic periodontitis? |
|
Definition
1. control bacterial plaque
2. eliminate contributing risk factors to perio
3. arrest disease progression
4, prevent recurrence of periodontitis |
|
|
Term
| what are 4 desired outcomes following periodontal therapy for patients with chronic periodontitis? |
|
Definition
1. reduction in inflammation
2. reduction in biofilm
3. reduction in probing depths
4. prevention of further attachment loss |
|
|
Term
| what are the two forms of chronic periodontitis characterized by their lack of response to periodontal therapy? |
|
Definition
recurrent periodontitis
refractory periodontitis |
|
|
Term
| what form of chronic periodontitis forms when signs and symptoms reappear after tx because the disease was not adequately treated or the patient did not practice proper self care? |
|
Definition
| recurrent chronic periodontitis |
|
|
Term
| what form of chronic periodontitis form when additional attachment loss is present despite repeated professional therapy and a patient who practices appropriate self care and recall frequency |
|
Definition
| refractory chronic periodontitis |
|
|
Term
| what is the term for chronic periodontitis that does not respond to periodontal therapy? |
|
Definition
| refractory chronic periodontitis |
|
|
Term
| what form of periodontitis is characterized by rapid destruction of the PDL, bone structure, high risk of tooth loss, and lack of response to peridontal therapy |
|
Definition
|
|
Term
| what is the historical term for aggressive periodontitis? |
|
Definition
|
|
Term
| what are 5 characteristics of aggressive periodontitis? |
|
Definition
1. rapid destruction of PDL and supporting bone
2. high risk for tooth loss
3. poor response to perio therapy
4. no obvious signs/symptoms of systemic disease
5. lack of clinical signs of disease (normal looking gingiva with increased probing depths) |
|
|
Term
| do patient's with aggressive periodontitis present with low or high levels of plaque? |
|
Definition
| low presence characterized by exaggerated response to the minimal plaque |
|
|
Term
| what are 6 recommended components of a care plan for an aggressive periodontitis patient? |
|
Definition
1. smoking cessation
2. education on plaque control
3. debridement of tooth surfaces
4. antimicrobial therapy
5. control of contributing factors causing inflammation
6. surgical debridement of soft tissues |
|
|
Term
| If control of aggressive periodontitis isn't possible, what is a reasonable treatment goal? |
|
Definition
| slow the progression of disease |
|
|
Term
| what are the 3 desired outcomes for patients with aggressive periodontitis? |
|
Definition
1. reduction of gingival inflammation
2. reduction in plaque levels
3. prevention of further attachment and bone loss |
|
|
Term
| what are the 2 forms of aggressive periodontitis? |
|
Definition
localized aggressive periodontitis
generalized aggressive periodontitis |
|
|
Term
| what is the historical terminology for localized aggressive periodontitis? |
|
Definition
| localized juvenile periodontitis |
|
|
Term
| what are the 5 features of localized aggressive periodontitis (LAP)? |
|
Definition
1. onset around puberty
2. rapid tissue destruction- 1st molar and incisors
3. Actinobacillus Actinmycetemcomitans (Aa)
4. abnormal neutrophil function
5. more common in females |
|
|
Term
| what are 4 features of generalized aggressive periodontitis? |
|
Definition
1. occurs in people under 30 years
2. rapid tissue destruction around all teeth
3. A. actinomycetemcomitans and Porphyromonas gingivalis
4. abnormal neutrophil function |
|
|
Term
| what is the primary bacteria associated with localized aggressive periodontitis? |
|
Definition
| Actinobacillus Actinmycetemcomitans (Aa) |
|
|
Term
| what are the 2 primary bacteria associated with generalized aggressive periodontitis? |
|
Definition
| A. actinomycetemcomitans and Porphyromonas gingivalis |
|
|
Term
| what is the historical term for generalized aggressive periodontitis (GAP)? |
|
Definition
| generalized juvenile periodontitis (GJP) |
|
|
Term
| what are the 6 less uncommon types of periodontal disease? |
|
Definition
1. periodontitis as the result of systemic disease
2. necrotizing periodontal disease
3. abscesses of the periodontium
4. periodontitis associated with endodontic lesions
5. developmental/acquired deformities/conditions
6. occlusal trauma |
|
|
Term
| what are 3 systemic conditions that can affect the periodontium? |
|
Definition
1. poorly controlled diabetes
2. Down syndrome
3. acquired immunodeficiency syndrome |
|
|
Term
| what are 5 systemic conditions associated with periodontitis in young children |
|
Definition
1. leukocyte adherence deficiency
2. congenital primary immunodeficiency
3. hypophophatasia
4. chronic neutrophil defects
5. cyclic neutropenia |
|
|
Term
| what is the historical term for periodontitis associated with immune dysfunction? |
|
Definition
| generalized prepubertal periodontitis |
|
|
Term
| what is the broad term for infections of the periodontal tissues that involve tissue necrosis? |
|
Definition
| necrotizing periodontal diseases |
|
|
Term
| what are the two forms of necrotizing periodontal diseases |
|
Definition
NUG- necrotizing ulcerative gingivitis
NUP- necrotizing ulcerative periodontitis |
|
|
Term
| NUG is primary located to which gingival tissues? |
|
Definition
| interdental and marginal gingiva |
|
|
Term
| what is the appearance of interdental papilla in NUG |
|
Definition
| partial loss/ punched out appearance |
|
|
Term
| how long does it take to see tissue destruction in NUP? |
|
Definition
| rapidly progressing periodontal attachment loss (days) |
|
|
Term
| what are 8 symptoms of NUG |
|
Definition
sudden onset
pain
fiery red bleeding gingiva
cratered papilla
gray pseudomembrane
excessive salivation
fetid breath odor
fever/swollen lymph nodes |
|
|
Term
| in addition to the symptoms of NUG, what additional traits are seen in NUP |
|
Definition
rapid gingival recession
rapid, irregular bone loss |
|
|
Term
| what are three alternative historical names for NPD |
|
Definition
trench mouth
Vincent's infection
acute ulcerative necrotizing gingivitis (ANUG) |
|
|
Term
| what causes the bad breath seen in NUG and NUP |
|
Definition
| materia alba, sloughed tissue, blood, saliva-- patient stops brushing due to pain |
|
|
Term
| what is a gray membrane that covers areas a necrosis? |
|
Definition
|
|
Term
| what is a pseudomembrane made of? |
|
Definition
necrotic tissue cells
fibrin
leukocytes
bacteria |
|
|
Term
| what are two systemic symptoms of NUG/NUP |
|
Definition
fever and malaise
swollen lymph nodes |
|
|
Term
| what 3 microorganisms are associated with NPD |
|
Definition
fusiform bacteria
Provotella intermedia
spirochetes |
|
|
Term
| what are 9 predisposing risk factors for NPD |
|
Definition
smoking/alcohol use
stress
poor nutrition
fatigue
immune dysfunction or suppression
pre-existing gingivitis or tissue trauma
poor oral health care
systemic disease
caucasian background |
|
|
Term
| NUG is most commonly observed in what population |
|
Definition
| between 15-25 years (usually students and military persons under stress) |
|
|
Term
| NUP is most commonly observed in what population |
|
Definition
| individuals with systemic conditions (HIV, malnutrition, immunosuppression |
|
|
Term
| What are 5 components of NPD treatment |
|
Definition
1. irrigation
2. debridement of tissues and tooth surfaces
3. self-care instruction
4. pain control
5. antibiotic therapy for systemic management |
|
|
Term
| what is secondary occlusal trauma? |
|
Definition
| injury from excessive occlusal forces on an already unhealthy periodontium |
|
|
Term
| what are 5 clinical indicators of occlusal trauma? |
|
Definition
tooth mobility
fremitis
tooth migration
tooth fracture
thermal sensitivity on chewing or percussion |
|
|
Term
| what is vibration felt when palpating a tooth as the patient taps the teeth together |
|
Definition
|
|
Term
| what are 3 radiographic indicators of secondary occlusal trauama? |
|
Definition
widened PDL space
bone loss
root resporption |
|
|
Term
| What are some warning signs of chronic periodontitis that you should have your patient watch for? |
|
Definition
bleeding during brushing
bad taste in the mouth
sensitive/loose teeth
pus |
|
|
Term
| what are 3 characteristics to disease sites not responding successfully to therapy? |
|
Definition
inflammation
increasing attachment loss
high plaque levels |
|
|
Term
| what type of bone loss is seen in individuals with localized aggressive periodontitis (LAP_ |
|
Definition
|
|
Term
| what is the distribution of teeth impacted for GAP? |
|
Definition
| generalized IP attachment loss of AT LEAST 3 permanent teeth other than 1st molars and incisors |
|
|
Term
| How does type 1 inflammation GAP appear? |
|
Definition
acutely inflamed
ulcerated
fiery red
(destructive phase of disease) |
|
|
Term
| How does type 2 inflammation GAP appear? |
|
Definition
pink gingival tissues
deep pockets
(periods of disease inactivity) |
|
|
Term
| what are the 4 microorganisms associated with NPD? |
|
Definition
Treponema
Selenomonas
Fusobacterium
B. melaninogenicuss ss. intermedius (Prevotella intermedia) |
|
|
Term
| what is the term for swollen lymph nodes? |
|
Definition
|
|
Term
| Patient's experiencing NPD usually have what risk factor in common? |
|
Definition
|
|
Term
| what is the mean age for NPD in industrial countries |
|
Definition
|
|
