Coast Dental Blog
Fast Facts - Perio Edition Episode 10
A Message for Coast Dental Hygienists and Doctors:
Happy New Year to our Coast Dental family of clinicians! 2020 was, for sure, a memorable year and we are hoping that 2021 will be much better and much safer for us all. Thank you so much for providing the best care possible for our patients during these past several months. Your unwavering delivery of care has had a meaningful impact on thousands of people.
A new year hopefully brings a renewed desire to reach a higher level of understanding and with this episode, I want you all to think about the importance of accurately measuring the CAL - Clinical Attachment Level (Loss depending on where you went to school). Do you have the integrity needed to diligently record all measurements to have an accurate assessment and diagnosis?
Andrew Johnston, RDH, BSBM
Director of Hygiene Coast Dental
[Andrew Johnston, RDH]
Welcome back, everyone. You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello and welcome back to another episode of Fast Facts: Perio Edition. Today's episode is a part of a continuous conversation around the anatomical considerations of the periodontium. Remember last week we talked about the gingiva. We talked about the free gingiva the free gingival groove, the attached gingiva, the Mucogingival Junction and the alveolar mucosa.
Whoo, today we're going to focus on the attached gingiva and this is an important gingiva for us to take a look at for many reasons, it's called attached not because it's not single, not on dating apps, but rather because it's not movable. It is attached, firmly bound into the bone and cementum by connective tissue fibers and it's important to note that attached gingiva is able to withstand the forces from toothbrushing and chewing. The attached gingiva provides a protective quality to the tooth structure. And so, one of the challenges that we run into is that sometimes patients can actually have a diminished amount of attached gingiva left. Think about a patient who has, for example, excessive recession on a lower anterior tooth. When you peel that lower lip back, it's almost like the recession is so involved that it moves into the vestibule. This could be a patient where that particular tooth has no attached gingiva left. So one of the things that we focus on in periodontics is measuring the width of attached gingiva. There is a very special way that we do that. What we do is we approximate where that Mucogingival Junction line is, which means that we can only really gather this information on the facial or buccal aspects of teeth. We cannot gather this for lingual or palatal surfaces.
So we're going to approximate where that Mucogingival Junction line is. Can you guys picture it?
Don't close your eyes if you're driving to work, but picture what that Mucogingival Junction line looks like. We want to measure how many millimeters is it from the gingival margin to the Mucogingival junction?
That amount of millimeters gives us the amount of free gingiva and attached gingiva, so we have to remove or subtract the amount of free gingiva from that number to give us our attached gingiva. So we probe our patient and that direct facial probing depth reading is going to give us the amount of free gingiva.
Why is this important? Well, because if our patient has recession that moves past that Mucogingival junction, there are certain tissue grafting procedures they may not be a candidate for.
We also know that if a tooth is missing attached gingiva, it is highly likely that there are protective qualities that are missing from that tooth structure and so we want to have that patient evaluated by a periodontist. Thank you so much for joining me today on our anatomy conversation around attached gingiva. Stay tuned as we chat in greater detail about additional anatomic considerations of the periodontium.
This has been another episode of Fast Facts - Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts - Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We'll see you next week for another Fast Fact!