Gingival Description

These guidelines are based on Wilkins, 2017 Ed., pp. 304-308. All terms in this reference are acceptable to use in describing a patient’s gingival condition.

After assessing the , record a brief gingival description in the section of the ODRA form. Using the following terminology, record any active disease present in the gingival tissue.

1. Distribution (generalized, localized or both) A. Generalized - involves all or nearly all teeth in dentition, or all teeth in 1 quad B. Localized - confined to the gingiva of a single tooth or group of teeth.

2. Severity - slight, moderate, severe

3. Location A. Marginal-involvement of the . The interdental papillae may be involved. B. Papillary-involves only the interdental papillae. C. Diffuse-involves the gingival margin, interdental papillae, and the attached gingiva. Frequently localized and rarely generalized.

4. Color A. Chronic inflammation: dark red, bluish red, magenta or deep blue B. Acute inflammation: bright red C. Cyanotic (Bluish red to bluish) D. Shiny Slate Gray (associated with Necrotizing Ulcerative ) E. Pink (vascularization reduced as a result of fibrosis or increased keratinization. Note this does not refer to healthy tissue which is described as "pale pink" or "coral pink”)

5. Shape (Form or Contour) A. Pointed, pyramidal, knife-edged or slightly rounded at facial and lingual usually means healthy. B. Blunted (refers to flat papillae) C. Stillman’s cleft: localized recession in V-shape, slits extending from gingival margin into the keratinized tissues for varying distances. D. Cratered- interdental necrosis with ulceration of the papillae produces crater like-defects. Associated with Necrotizing Ulcerative Gingivitis (NUG) E. McCall’s festoon: lifesaver-shaped enlargements of the gingival margin - exaggerated rolling of the free gingiva. F. Rolled - thickening of the gingival margin with inflammatory edema at the necks of the teeth. G. Bulbous - fills gingival embrasure but is no longer pyramidal shaped; swollen, rounded rather than sharp peak; covers part of facial or lingual surface of tooth.

6. Consistency A. Firm and resilient (usually healthy) B. Fibrotic, hard (resists probe pressure) C. Edema (Edematous) D. Retractable, flaccid E. Spongy, soft

j:/manual2007.ging.desc_Revised 2012; 2013; 2015 Revised Vu 10/16

Gingival Description

7. Surface Texture A. In health, free gingiva is smooth and attached gingiva is usually stippled. B. In disease: 1. Inflammatory - loss of with smooth, shiny surface 2. Hyperkeratosis - leathery, hard or nodular surface 3. Chronic disease – hard and fibrotic with normal pink color or normal to deep stippling

8. Position of the Gingival Margin A. Recession B. Hyperplasia

9. Examples A. Generalized, slight, marginal erythema and edema. B. Localized, moderate, marginal cyanotic and edematous gingival tissue on the facial and lingual of #22-#27. C. Localized, slight recession, and slight marginal erythema, and edema on the facial of #6- #8. (If recession is the only significant finding then all the student needs to record is localized slight recession on facial of #6-#8). D. Generalized, severe, papillary cyanotic and edematous tissue. E. Localized, moderate, marginal festooned tissue on facial of #4,#5,#,6 F. Generalized, moderate, marginal erythema with localized moderate shiny slated gray cratered interdental papillae located on facial of #7-#10 and #23-#26.

j:/manual2007.ging.desc_Revised 2012; 2013; 2015 Revised Vu 10/16