National Board Dental Hygiene Examination (NBDHE) Dental Hygienist Practice Test

Which signs are indicators of chronic gingival inflammation?

1. Tough, fibrous gingiva and blunted interdental papilla

2. Soft, spongy gingiva and swollen interdental papilla

3. Shallow pockets and tooth mobility

4. Ulcerations and bleeding upon probing

The correct answer is: Tough, fibrous gingiva and blunted interdental papilla

Tough, fibrous gingiva and blunted interdental papilla are classic indicators of chronic gingival inflammation. In cases of chronic gingivitis, the body reacts to ongoing inflammation by remodeling the gingival tissue, which often results in a firmer, more fibrous texture. This is a protective response of the body to the persistent irritation typically caused by plaque accumulation. The interdental papilla may appear blunted because of the loss of papillary tissue—this is a common morphological change due to chronic conditions. In contrast, other signs such as soft, spongy gingiva and swollen interdental papilla are more commonly associated with acute inflammation rather than chronic. Shallow pockets and tooth mobility may indicate periodontal disease rather than gingivitis specifically, while ulcerations and bleeding upon probing can occur in various forms of gingivitis but are usually associated with acute lesions or active disease processes rather than a chronic state. These differences highlight the characteristics of chronic gingival inflammation as primarily indicated by the tough texture and morphological changes seen in the gingiva.