Ch. 6 Periodontal Disease

Question 1

What is periodontal disease?

Answer 1

Inflammation and infection of the tissues surrounding the tooth called the periodontium

Question 2

What can be the different factors for periodontal disease?

Answer 2

Age, species, breed, chewing behavior, diet, grooming habits, orthodontic occlusion, patient health status, home care, frequency of professional care, and bacterial flora of oral cavity

Question 3

How is periodontal disease characterized?

Answer 3

By movement of the gingival margin toward the apex (exposing more crown and root) and migration of the attached gingiva with loss of the periodontal ligament and surrounding bone

Question 4

Pyorrhea definition

Answer 4

Discharge of pus from the periodontium (This term is no longer used)

Question 5

What are the systemic effects of periodontal disease?

Answer 5

Research in vet med is still ongoing. Theoretically, bacteria from infected tissues enter the bloodstream and cause an inflammatory response

Question 6

Which organs are most susceptible to infection from periodontal disease?

Answer 6

Lungs, Kidneys and Liver

Question 7

What is the glycoprotein component of saliva called?

Answer 7

Acquired pellicle

Question 8

The pellicle will begin to form on a tooth in how much time?

Answer 8

20 minutes

Question 9

What purpose does the acquired pellicle serve?

Answer 9

To help bacteria attach to the tooth surface

Question 10

How long after the formation of the pellicle will bacteria start to colonize the tooth surface?

Answer 10

6-8 hours

Question 11

What is the bacterial layer that is formed on a tooth called?

Answer 11

Plaque

Question 12

The bacteria that are attached to the tooth absorb calcium from saliva and become calcified.

What is this new calcified substance called?

Answer 12

Tartar or Calculus

Question 13

What are the types of bacteria seen with periodontal disease?

Answer 13

-Healthy gingival flora: Made up of gram-positive aerobic bacteria
-Gram-negative bacteria begin to colonize the tooth surface as periodontal disease progresses
-Spirochetes begin to colonize and the aerobic bacteria have converted to anaerobic

Question 14

Gram-positive aerobic bacteria require what to survive?

Answer 14

Oxygen

Question 15

What is biofilm?

Answer 15

Aggregate bacterial colonies protected by a polysaccharide complex. Disruption of this biofilm is most important in the control of periodontal disease

Question 16

Plaque can be found in a number of areas around the tooth. Where is the worst place for plaque to be?

Answer 16

The worst plaque is the type that infiltrates the gingiva itself

Question 17

As inflammation continues, the gingiva loosens from the tooth and creates what?

Answer 17

A pocket

If it is not treated, deeper pockets will form

Question 18

What indicates the beginning of periodontal disease?

Answer 18

When there is loss of tissue and bone support deeper in the periodontium

Question 19

What is furcation exposure?

Answer 19

The furcation is the area where the roots of a tooth join the crown and exposure happens because of gingival recession and bone loss

Question 20

How is furcation exposure classified?

Answer 20

Based on depth

Question 21

What is class 1, 2, and 3 furcation exposure?

Answer 21

Class 1: <1mm exposure
Class 2: >1mm exposure but not fully through
Class 3: Complete furcation exposure

Question 22

What are the initial signs of periodontal disease?

Answer 22

Halitosis, not eating well, occasionally drooling, bloody saliva, and pawing at the mouth

Question 23

What are the diagnostic parameters and tests available to diagnose this disease?

Answer 23

Red & inflamed gingiva, accumulation of plaque, and calculus (does not tell you the degree of the disease)

The OraStrip is a test used to test for thiols (indicates the presence of periodontal disease but does not stage it)

Question 24

How many stages/classifications of periodontal disease are there?

Answer 24

There are 4 stages of this disease

Question 25

What is stage 1 characterized by?

Answer 25

Gingivitis only—no loss of attachment

Question 26

What is stage 2 characterized by?

Answer 26

Early periodontitis —less than 25% attachment loss, stage 1 furcation exposure

Question 27

What is stage 3 characterized by?

Answer 27

Moderate periodontitis- 25% to 50% attachment loss, stage 2 furcation exposure

Question 28

What is stage 4 characterized by?

Answer 28

Advanced periodontitis- >50% attachment loss, stage 3 furcation exposure

Question 29

A dog has periodontal disease and the canines are classified as stage 3 while the premolars are stage 4. What stage would this dog be diagnosed/classified in?

Answer 29

You will take the worse tooth's grade, so this dog would be diagnosed/classified with stage 4 periodontal disease

Question 30

A dog has multiple 5 mm periodontal pockets and several Class 2 furcations. What stage of periodontal disease does this dog have?

Answer 30

Stage 3 (PD 3)

Question 31

How is Class 1 furcation index classified?

Answer 31

Periodontal probe extends less than halfway under the crown in any direction of a multirooted tooth with attachment loss

Question 32

How is Class 2 furcation index classified?

Answer 32

Periodontal probe extends greater than halfway under the crown of a multirooted tooth with attachment loss, but not through and through

Question 33

How is Class 3 furcation index classified?

Answer 33

Periodontal probe extends under the crown of a multirooted tooth

Question 34

How many stages of mobility index are there?

Answer 34

There are 3 stages

Question 35

Describe the stages of mobility index

Answer 35

Stage 0: Mobility up to 0.2mm Stage 1: Movement in any direction- 0.2mm-0.5mm Stage 2: 0.5mm-1mm Stage 3: Movement of over 1mm or any axial movement

Question 36

What does healthy gingiva look like?

Answer 36

It has a knife-like margin and is coral pink or a pigmented color and smooth gingival topography should be noted. Healthy gingival tissue is firm

Question 37

What is the topography of a tooth?

Answer 37

The surface features of the gingiva as it flows from tooth to tooth As periodontal disease progresses, the surface features become irregular and the even flow from tooth to tooth is lost

Question 38

When probing with a periodontal probe, what is a normal minimal sulcular depth in dogs and cats?

Answer 38

Dogs: 2-3mm Cats: 0.5-1mm

Question 39

How is type 1: early gingivitis described?

Answer 39

Redness of the gingiva and a mild amount of plaque, loss of visualization of blood vessels, appears 2-4 days after plaque accumulations, and is localized to the gingival sulcus, including the junctional epithelium and the most coronal part of the connective tissue (Early gingivitis is reversible)

Question 40

How is type 2: advanced gingivitis described?

Answer 40

Increased inflammation with edema, subgingival plaque development, supragingival plaque, and calculus, gingival topography has started to become irregular, but is still reversible

Question 41

How is type 3: early periodontitis described?

Answer 41

Moderate loss of attachment or moderate pocket formation with 10-30% loss of bone support, furcation exposure, inadequate gingival topography, recession, and/or hypertrophy, and may have mobility. Gingival bleeding with probing, and subgingival calculus may be visual and a rounding of the alveolar crestal bone at the cervical portion of the tooth can be seen

Question 42

How is type 4: established periodontitis described?

Answer 42

Advanced breakdown of supportive tissues, severe pocket depth, severe recession, severe inflammation, bone loss, pus, and mobility. Gingiva easily bleeds upon probing and there is a loss of gingival topography