acute perio inc lateral perio abscess Flashcards
How are acute perio disorders classified?
GINGIVITIS
Non specific
Gingival abscess
Trauma (physical/chemical/thermal)
Bacterial/viral
HIV
Fungal (rare)
Allergic
PERIODONTITIS
Periodontal abscess
Traumatic periapical abscess
Necrotising
HIV
How long does it take to manage plaque induced gingivitis?
After OHI, PMPR
7-10 days
What is a gingival abscess?
Only involves gingival tissues not perio membrane
Fluctuant swelling of pus
What is primary herpes?
Painful red gingiva
Self limiting
Fluids
Systemic fever- may prescribe acyclovir
ACUTE HERPETIC GINGIVOSTOMATITIS- by herpes simplex type 1
Highly contagious
5-7 day incubation period
Many sub clinical
What are symptoms of acute herpetic gingivostomatitis?
More serious in adults
Sore painful mouth
Loss of appetite
Numerous vesicles which will soon ruptured
Ulcers (gray membrane surrounded by red mucosa)- discrete/confluent
Irritability and profuse salivation (young children)
Malaise and pyrexia
Lymphadenopathy, stomatitis, pharyngitis
Should be easy to distinguish from necrotising (can occur together however)
What is tx of AHG?
Support and tx symptoms
Fluid intake/soft diet
Analgesics
Antipyretics
Antivirals if severe (acyclovir)
Topical antiseptics (5% lignocaine Diflam)
Self limiting 10-12 days
Highly infectious- avoid contact
What are complications of AHG?
Herpetic whitlow- finger of dentist no gloves
Herpetic lesion- eye of dentist no goggles
Herpetic satellite lesions- suck finger and scratch elsewhere
Herpetic encephalomeningitis
How does reactivation of herpes occur?
Primary illness leads to infection of trigeminal ganglion
Subsequent reactivation
Herpes labialis
IO reactivation may occur following trauma (surgery/infiltration)
Sometimes complication of perio surgery
What does HIV associated gingivitis look like?
Classic red banding along gum line
What is acute fungal gingivitis?
Superinfection w Candida albicans
Often w partial dentures
Those who’ve recently finished a course of broad spectrum antibiotic therapy
Also seen in debilitated pts
Can rub off white patch leaving red underneath
What is acute allergic gingivitis?
2 types of adverse reactions
1. Systemic administration of drug/chemical
2. Direct contact w mouth eg. Mouthwash (esp Corsodyl), cosmetic
Gingival tenderness
Mild-anaphylactic shock
Should stop cause
Red shiny gingival
Loss of stippling
Oedema
What is a traumatic periapical abscess?
Can be associated w root fracture and point pocketing
What are features of necrotising perio disease?
Characterised by lack of papilla and punched out appearance
Stress related
Localised or whole mouth
Sore, painful and bleeding gingiva
Ulceration and necrosis of margin
Gray/yellow slough
Distinct halitosis- metallic taste
Sometimes lymphadenopathy
Severe- bone loss
HIV ASSOCIATED- more destructive
What is the aetiology of necrotising perio?
Opportunistic infection by anaerobes
Fuso-spirochaetal complex (eg Treponema vincentii, Fusobacterijm nucleatum)
No evidence of transmission
Lowered resistance
What are predisposing factors of necrotising perio diseases?
Compromised immune system eg. HIV, leukaemia, malnutrition
Smoking
Stress
Poor oral hygiene
