Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CSA SR > Gingival Recession and Dentine Hypersensitivity > Flashcards

Gingival Recession and Dentine Hypersensitivity Flashcards

(85 cards)

Start Studying
1
Q

What is gingival recession

A

A situation where you can see the CEJ and underlying gingival margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does the gingival margin lie on a tooth with gingival recession?

A

Gingival margin lies apical to the cemento enamel junction

Root surface may be exposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many adults age 30 + suffer from recession of 1mm or more?

A

58%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe generally the distribution of gingival recession

A

Maxillary 6 and mandibular 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Patients with gingival recession on their buccal surfaces have god or bad oral hygiene?

A

Good oral hygiene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Patients who have gingival recession associated with the lingual surfaces of they lower anteriors have god or bad oral hygiene?

A

Poor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the aetiology of gingival recession?

A
  1. Normal sulcus and undiseased interdental crestal bone
  2. In periodontal disease
  3. Orthodontic tooth movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Aside from periodontal disease why might a patient suffer from gingiva recession?

A
  1. Trauma
  2. Post treatment
  3. Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give some examples of trauma that may lead to gingival recession

A
  1. Foreign bodies
  2. Finger nail picking
  3. Toothbrushing (eg brushing too hard etc)
  4. Chemical trauma from topical cocaine
  5. Partial dentures that are poorly designed or painted
  6. Poor oral hygiene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of tooth brushing technique is most likely to lead to gingival recession?

A

Scrubbing instead of using a more rounded technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do we mean by the keratinised tissue?

A

Tissue above the mucogingival junction is keratinised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens to keratinised tissue I a person suffering from gingival recession ?

A

It becomes reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do we mean by gingival biotype?

A

The thickness of tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The talking about the gingival biotype are we talking about the height o thickness of keratinised tissue?

A

Thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is recession more likely in thin or thick tissue?

A

Thin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is there a minimum width you need to have to reduce your chances of getting gingival recession? If so what is it?

A

no theres not a minimum width

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe gingival hat inmost likely to suffer from gingival recession?

A

Thin fragile tissue is predisposed to recession in the precesence of plaque induced inflammation or trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give examples of some local plaque retention factors that relined to gingival recession

A
  1. High muscle attachment of the lip
  2. Frenal pull
  3. Restorative dentistry
  4. Calculus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is the frenum keratinised tissue?

A

No it is oft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why can a feral pull become a plaque retentive factor ?

A

As bushing the anteriors may resulting you talking your frenum which will then become are and resulting the patient avoiding their anterior teeth when brushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can restorative dentistry become a plaque retentive factor that may lead to gingival recession?

A

Subgingival margins on restorations may increase plaque retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why does periodontal disease sometimes lead to gingival recession?

A

As patients will get bone loss and theres apical migration f the soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How can a patient get recession post treatment?

A

If we scale enthusiastically gums may become inflammation and one the inflammation dies down patient may have recession

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where can inhaled tobacco pool in the mouth?

A

Palatal side of the central incisors

not every smoker will have this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the possible consequences of gingival recession?
1. Fear of tooth loss 2. Plaque retention/ bleeding gingivae 3. Aesthetics 4. Root caries 5. Abrasion 6. pain due to dentine hypersensitivity
26
How is dentine hypersensitivity characterised?
Characterised by short, sharp pain
27
What causes the short sharp pain patients experience when they have dentine hypersensitivity?
Due to exposed dentine which becomes sensitive in response to a certain stimuli
28
What can dentine hypersensitivity manifest as?
May manifest as a dull ache beyond the duration of the stimulus, possibly as an altered plural response
29
In what age does dentine hypersensitive peak?
20-40 year olds
30
Is there a gender bias to dentine hypersensitivity? If so to which gender?
YES there is more female are seen to get it than males
31
What is a suggested reason why more females get hypersensitivity than men?
Could be due to better oral hygiene and some attend to use dental services more so their dentine hypersensitive would be diagnosed
32
On which SURFACES of the teeth is dentine hypersensitivity more frequent?
The buccal/ labial cervical areas of the teeth
33
List, from most to least, which teeth are affected by dentine hypersensitivity?
1. First molars 2. Canines 3. Incisors 4. Second premolars 5. Molars
34
What does the distribution of dentine hypersensitivity correspond to?
1. Areas of gingival recession 2. Areas of thinning enamel 3. Areas of cementum loss
35
Does every area of gingival recession have dentine hypersensitivity?
NO but every case of dentine hypersensitivity usually stems from gingival recession
36
What are the 3 key factors that lead to a hypersensitive lesion?
1. Dentine exposure (lesions localisation) 2. Tubules made patent/open (lesion initiation) 3. STIMULUS
37
Is the pulp vital or non vital in a patent suffering from detente hypersensitivity?
Pulp will be vital
38
Give example of stimuli that can trigger a dentine hypersensitivity response
1. Thermal (Hot or cold) 2. Osmotic hypertonic solutions (Sweet, spicy or acidic) 3. Desiccation (drying of lesions may stimulate pain) 4. Electrical (galvanic reactions and EPT) 5. Tactile (touching probing or tooth brushing)
39
Name the 3 proposed theories of sensitivity conduction
1. Odontoblast as receptors 2. Nerves in dentine 3. Hydrodynamic mechanism
40
Which of the 3 mechanism is the currently accepted one?
Hydrodynamic theory
41
What has research shown about dentine having nerves and that causing sensitivity/
Only seen in 1% of tubules in the cervical margin, however electrical Curren and cold stimulate nerves directly
42
Explain Brännströms hydrodynamic hypothesis
1. Dentine hypersensitivity is caused by the movement of dentinal tubule contents 2. Increased outward fluid low causes a pressure change across the dentine 3. Distortion of A- delta fibre causes pain
43
Where are the A delta fibres found?
Near the pulp
44
Give the steps in the hydrodynamic mechanism of pulp nerve activation
1. Stimulus 2. Causes fluid flow 3. Distorts and stimulates fibres
45
What affects the severity of pain a dentine hypersensitivity patient may feel in response to a stimulus?
Width of the tubules
46
What does the rate of fluid flow depend on?
Depends o the 4th power of the radius | So if a tubule is twice the width fluid flow is 16 times greater
47
Does dentine hypersensitivity increase or decrease with age? Why?
Decreases as the size of the tubules decreases
48
What does a slide of sensitive dentine show under a microscope?
1. A distrusted smear layer 2. Many more dentinal tubules at the surface 3. Tubules not occluded by deposits 4. Tubule diameter is wider
49
What debates are going on surrounding the affect of the pulp in a patent with dentine hypersensitivity
1. Does the pulp react to modify the sensitivity over time ? | 2. With resolution of pulpal inflammation is there regression of sensitivity?
50
What does dentine exposure result from?
Results from loss of enamel
51
What can cause enamel loss?
1. Removal of enamel by restorative treatment 2. Attrition 3. Abrasion 4. Erosion 5. Combined erosion and abrasion
52
Does tooth brushing alone have a significant effect on hard tissues?
no
53
How can toothbrushing slightly affect the teeth?
Toothpaste has the potential to abrade dentine considerably | Toothbrush bristles may indirectly contribute to abrasion
54
How can tooth paste cause abrasion?
1. Abrasive particles might remove the smear layer and open tubules 2. Detergents might help to remove the smear layer 3. Tubulents could be occluded with particulate matter from the paste
55
What causes erosion?
Intrinsic or extrinsic sources of acid
56
What is erosion?
It is the loss of enamel and dentine which can lead to surface softening
57
How is tooth surface lost increased if the patients intra oral environment is acidic
By toothpaste abrasion if the intra oral environment is acidic
58
What factors affect erosion?
1. pH of the acid 2. Type of acid 3. Chemical strength 4. Exposure time and frequency
59
If a patient comes to you complaining of short sharp pains when they eat anything hot/cold/sugary what might they suffer from?
Dentine hypersensitivity BUT it could be other things too
60
When carrying out the history, exam and diagnosis phase what must you note down?
1. Record extent of recession 2. Description of the mouth 3. Record periodontal indexes 4. Identify aetiological factors
61
Do you need to record every mm of recession you see in your patients mouth?
No as a rule of thumb record any pockets/ recession over 3mm
62
How is dentine hypersensitivity characterised?
Sharp pain that lasts as long as the stimulus is present
63
What should your treatment plan be when you have a patient with dentine hypersensitivity
1. Pain management 2, Prevent progression 3. Periodontal screening and early treatment
64
Give the two ways we can manage dentine hypersensitivity
1. Tubule occlusion | 2. Blocking pulpal nerve response
65
What does blocking tubule occlusion do?
It promotes the formation of new tissues (eg smear layer, intratubular dentine etc ) in response to a stimulus or trauma
66
How can we block tubule occlusion?
By applying a artificial barrier eg a varnish, dentine bonding agents, composite resin, GIC and toothpaste
67
out of the 2 methods of reducing hypersensitivity which one is more commonly carried out?
Tubule occlusion
68
Why is blocking pulpal nerve response not a common way to treat dentine hypersensitivity?
As it is unproven in humans | Clinically it is unlikely that ions will diffuse into tubules against the flow of dentinal fluid
69
List some ideal qualities of barrier materials for blocking tubule occlusion?
1. Retentive 2. Insoluble 3. Penetrate tubules 4. Form mechanical tags from tubules 5. Must seal the tubules
70
Give some home use products that can be used by patients to manage hypersensitivity
toothpastes, gels ad mouthwashes that contain potassium, strontium, oxalate and fluoride salts
71
What must you tell patients when you recommend to them a home use product?
It requires long term use before results are apparent
72
Why is it hard to evaluate the efficacy of dentine hypersensitivity products
1. Pain perception is subjective and open to individual interpretation 2. Psychological, medical, gender and cultural issues abound 3. Stimulus varies 4. The response is often complex 5. We are unable to examine effects o subjects tissues 6. Placebo effect
73
What is percentage of the placebo effect on some of the toothpastes used to treat hypersensitivity?
40%
74
What is good about strontium acetate ?
It withstands immersion in acid well
75
Give examples of some in surgery products that are used to manage hypersensitivity
1. Varnish 2. 1-3 layers of adhesive resin bonding system 3. Desensitising polishing paste 4. Reinforced GIC where there is a cavity progression
76
Give examples of varnish we use in surgery to manage hypersensitivity
1. Duraphat | 2. Clinpro
77
What is duraphat made up of?
5% NaF
78
What is clinpro made up of?
5% NaF and tricalcium phosphate
79
Give examples of resin bonding systems we use in surgery to manage hypersensitivity
1. Seal and protect 2. Optibond solo 3. Scothbond
80
What do desensitising polishing pastes we use in surgery to manage hypersensitivity contain?
Calcium carbonate and arginine
81
Describe the efficacy of fluoride varnish
Reasonable efficacy but dissolution over time
82
Describe the efficacy of resins
Good if film thickness is adequate
83
Describe the efficacy of GIC
Good at occlusion tubules where indicated for use
84
Give some preventative advice can give to patients
1. Change from damaging brushing techniques to modified bass technique or using an electric toothbrush 2. Smoking cessation 3. Try and eliminate traumatic habits 4. Reduce risk factors associated with diet
85
Why might we treat gingival recession surgically?
1. Aesthetics 2. Hypersensitivity 3. Shallow root caries and abrasions

CSA SR (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions