6 - Paediatric periodontology

Question 1

What are the 2017 classifications of periodontal health and disease?

Answer 1

• periodontal health
• gingivitis
• gingival diseases and conditions (non-biofilm)
• necrotising periodontal diseases
• periodontitis
• periodontitis as a manifestation of systemic disease
• systemic diseases affecting periodontium
• periodontal abscesses / endodontic-perio lesions
• mucogingival deformities
• traumatic occlusal forces
• tooth and prothesis factors

Question 2

Describe healthy periodontium in children.

Answer 2

• absence of gun inflammation and calculus, no more than 1 sextant with plaque
• gingival margin several mm coronal to CEJ
• gingival sulcus 0.5-3mm deep
• (in teenagers) alveolar crest 0.4-1.9mm apical to CEJ

Question 3

What can cause gingival overgrowth?

Answer 3

• systemic and metabolic diseases
• genetic factors (hereditary gingival fibromatosis)
• local factors
• medications
• more commonly seen in puberty

Question 4

How do you treat gingival overgrowth?

Answer 4

• rigorous home care and OH
• PMPR frequently
• +/- surgery for drug induced growth

Question 5

How does mixed dentition affect the periodontal exam?

Answer 5

Be aware of false pocketing around erupting permanent dentition

Question 6

Give examples of systemic disease that manifest as periodontitis in children.

Answer 6

• papillon lefevre syndrome (PLS)
• Ehlers danlos syndrome
• down syndrome

Question 7

What should be recorded during a routine exam?

Answer 7

• gingival condition
• OH status
• calculus present?
• local risk factors

Question 8

What is BPE?

Answer 8

• basic periodontal exam
• screening tool
• does not consider historic LOA or bone loss

Question 9

What is the sBPE?

Answer 9

• simplified basic periodontal exam
• all cooperative children 7-18 years
• 6 teeth
• WHO 621 probe (one black band)

Question 10

What teeth are used in the sBPE?

Answer 10

16
11
26
36
31
46

Question 11

What sBPE codes are used for children 7-11 years?

Answer 11

0
1
2

Question 12

What sBPE codes are used for children 12-17 years?

Answer 12

0
1
2
3
4
*

Question 13

What is the O’Leary index?

Answer 13

• plaque free and marginal bleeding free chart
• used to motivate children

Question 14

What are the SDCEP plaque scores?

Answer 14

10/10 - perfectly clean tooth
8/10 - plaque at cervical margin
6/10 - plaque covering cervical third
4/10 - plaque covering middle third

Question 15

What treatment is required for sBPE 0?

Answer 15

Nil

Question 16

What treatment is required for sBPE 1?

Answer 16

OHI

Question 17

What treatment is required for sBPE 2?

Answer 17

• OHI
• PMPR
• manage plaque retentive factors

Question 18

What treatment is required for sBPE 3?

Answer 18

• OHI
• PMPR of shallow pockets
• manage plaque retentive factors

Question 19

What treatment is required for sBPE 4?

Answer 19

• full periodontal assessment including 6ppc of full mouth
• consider referral whilst completing initial therapy

Question 20

What treatment is required for sBPE *?

Answer 20

• full periodontal assessment including 6ppc of full mouth
• consider referral whilst completing initial therapy

Question 21

What is the recall policy for sBPE 0?

Answer 21

Screen at routine recall or within 1 year

Question 22

What is the recall policy for sBPE 1?

Answer 22

Screen at routine recall or within 1 year

Question 23

What is the recall policy for sBPE 2?

Answer 23

Screen at routine recall or within 6 months

Question 24

What is the recall policy for sBPE 3?

Answer 24

3 months, full periodontal assessment including 6ppc in affected sextants

Question 25

What is the recall policy for sBPE 4?

Answer 25

Refer to specialist

Question 26

When should paediatric patients be refer to a periodontitis specialist?

Answer 26

• stage 2/3 periodontitis not responding to treatment
• grade C
• stage 4
• MH that affects periodontitis treatment
• periodontitis as a manifestation of systemic disease
• surgical interventions