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Fast Facts: Perio Edition - Dental Biofilm Induced Gingivitis - Local [Predisposing Factors]

Fast Facts

Fast Facts: Perio Edition Episode 38

[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 to Fast Facts: Perio Edition. On this week's episode, we begin looking at gingivitis, beginning by looking at dental biofilm induced gingivitis and even more specifically, looking at localized or predisposing factors. Now, to clarify, when we talk specifically about plaque induced gingivitis, I want to be very clear, this is when biofilm levels have begun to build up. And if we do not see any disruption or removal of this dental plaque accumulation over days or weeks, we're going to begin to see what's called an incipient dysbiosis.  OK, guys, that's just a fancy term for an imbalance in the concentration of bacteria within that biofilm. Essentially, the bacteria become more sophisticated and we begin to develop bacterial infiltrates that are more disease producing versus health producing or health stabilizing biofilm. So as we begin to see this biofilm not become disrupted or removed, we begin to see a movement into what's called non-resolving destructive inflammation. This is where we begin to see a release of inflammatory components. This is where we begin to see the host get involved in working to fight the presence of this biofilm.
Which is a wonderful introduction because local or predisposing factors are going to be a relatively tooth related or tooth specific factors that can allow for higher levels or higher concentrations of plaque retention, these could be, for example, patients that have orthodontia where the bands and brackets are permitting a greater accumulation of plaque biofilm. These could also be, for example, patients that have some type of a crown margin that, you know, the patient is maybe allergic to, which we can see oftentimes with a PFM margins, will see an inflammatory condition localized around a particular tooth that has a PFM on it because that porcelain fuzed to metal crown is eliciting a localized irritational or inflammatory challenge for the patient.
We could also look, for example, at other plaque retentive qualities, things like fractured teeth, where biofilm is able to adhere into those areas or even anatomical observations. These would be things, for example, like a more deep or a more pronounced mesial lingual concavity of a maxillary first premolar, for example. Keep in mind, these are localized factors. And so oftentimes from a treatment standpoint, yes, we are having the conversation about biofilm control. But in some of these arenas, controlling that inflammatory condition may also mean that we need to control the risk factor, meaning if a patient is reacting to a PFM margin perhaps biofilm control alone may not be the only way to address this challenge.
Perhaps part of our treatment plan for this patient will be not only biofilm eradication, but also addressing that localized PFM challenge. Stay tuned as we continue the conversation about gingivitis next week, looking at systemic or modifying factors that can elicit an inflammatory condition of the gingiva. Thank you for tuning in this week and have an awesome week.
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 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 We'll see you next week for another Fast Fact!

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