 Hello everybody Andrea Trouse here with dental tutoring. Let's talk about the first signs I guess the first clinical signs of gingival disease. So gingivitis. So what does it start to look like in the early stages? And as a new student or even a new dental hygienist or a new dental assistant this might be a little bit hard for you to determine because you think that everything looks Either healthy or not healthy, but it's a little bit harder to determine if it's in the early stages or the more advanced So think of your early stages of gingival disease as just pretty much the gums look a lot larger They're likely a dark pink or a red at this point They do not have to look so red where it's like whoa like something's happening there because I have seen that where their Gums to me actually look healthy They are a darker pink maybe but that could be normal for that person So I don't necessarily think the color means that things aren't healthy because somebody could have a dark pink Look to it, but then as soon as you go to clean your teeth their gums are bleeding everywhere So then that tells you that okay gingivitis is happening here things look okay from the outside But as soon as you start a cleaning the teeth or probing or polishing just things just start bleeding everywhere Then that tells you and the patient that things aren't as healthy as it could be but typically the gums do look more red But again, they don't have to it depends on the person And if you're new at this a dark pink and a red may look almost the same When I was a student this was hard for me because I never felt That people's gums looked red Necessarily unless it was really really obvious So if it's harder for you to determine the color that's okay The next things to look for are the gums looking pretty shiny because if they look shiny That's actually not healthy if they're puffy. That's not healthy if the gums are bleeding That's not healthy either. Those are kind of the main things to look at Think of the outside of an orange peel. Okay, if the gums are stippled, that's that's pretty healthy That's how you want them to look but I have seen it where the gums are stippled, but they're also red So red means not healthy. So then you might be saying okay So if the gums are stippled, they're healthy if it's red, it's not healthy But the patient has red stipple gums. So which is it? So they're they're obviously not healthy if the gums are that red or if they're bleeding So you might have to look at a couple other things Always ask the patient if their gums bleed when they're brushing or flossing if they're flossing then obviously They have to be doing it more and that's why the gums are bleeding because they're not healthy But if the gums are bleeding as they're brushing then they're really not healthy because that's not normal at all For the gums to bleed when they're brushing because that's that's a pretty hard thing to do Meaning their gums have to be very unhealthy for that to happen If the gums are bleeding when they're flossing, yes, things aren't healthy But that's more Normal than if the gums are bleeding when they're brushing because when I have a patient tell me that the gums are bleeding When they're brushing I think oh like you must have a lot happening there when I start to clean your teeth They will probably bleed everywhere. It's going to be harder to see it's going to take me longer There's probably a lot of plaque and tartar underneath the gum lines like I think all all kinds of things But when I hear that the gums are bleeding when the patients flossing well, I just simply say It's probably because you need to floss more and if you ask the questions the patients will usually say to you Well, I haven't been flossing for months. I just started flossing last night So I kind of expected the gums to bleed and that makes sense because even after you clean the teeth Tell the patient of course To floss every day, but also let them know that if they floss every day the gums will still bleed Probably for a good week or two because the gums have to get used to it So make sure to tell them that because if you don't tell them that then they might start to floss And then they might say oh wow the gums are bleeding so I'm going to stop flossing But you don't want that you want them to keep up with it because if they have gingivitis of any kind the best thing to do is To floss because that's where it starts is in between the teeth and even if they brush Five times a day if they're not flossing then that will not help them. It helps them, but it won't completely cure The gingivitis and the nice thing about that though is that if they're brushing and flossing It takes maybe two weeks or so and then things are perfect again Things are healthy, but they have to keep up with it. So that's the nice thing about that is you can actually Show them, you know show them That their gums are bleeding a lot But let them know that if you start to floss every day this won't happen, but then also tell them It's not normal. It's not a good thing for their gums to bleed if they're if they had a cut on their arm and It started to bleed they would be concerned right yet a lot of patients aren't concerned when it's bleeding inside the mouth But that's not a good thing. So let them know that that's not healthy. It's not a good thing But it's also curable But if they leave it alone then things can get a lot worse and then their gingivitis can advance to periodontitis and Then they have had other issues things can become painful. They can start to lose Bone around the teeth and nobody wants to hear that. So I will always say that and they will go Oh my gosh, I don't have that to happen, but that's how it happens. So if they're not paying attention If they're not brushing and flossing properly, then that's what can happen. So start them off simple Try to be firm obviously but not mean because if you're yelling at the patients And that's not that will not help them right and then they're not going to brush and floss to begin with If your patients flossing maybe say once a month, then it might be hard for them to floss every day But start them off small say well, you do have to floss Every day is ideal, but let's do it at least four times a week to start and If you notice that that's not helping then please do it every single day Okay, they will likely notice that it's not helping but then that's putting onus on them that they have to pay Attention to if their gums are getting healthy or not So that's what I'd like to do is to put the onus on them to well Let them know that it can be curable. It's just they have to work at it at home So simply having their teeth cleaned isn't enough. They have to work on it at home So then that way their gingivitis does not advance into perio So I hope this helped you guys if you guys have any questions Let me know and I will see you guys in the next one