Gingival and periodontal health in children

Question 1

children with teeth with the condition of amelogensis imperfecta

Answer 1

sensitive teeth
rough/little enamel
hard to brush teeth therefore calculus builds

Question 2

consqeunes of children fed by a gastrostomy tube

Answer 2

may not have a swallow reflex
not generating as much saliva as they are not eating
therefore can develop extensive calculus

Question 3

which side is gngitivus less prevalent in

Answer 3

LHS compared to RHS

Question 4

periodontal screeing for children under 18 years

Answer 4

Code 0 ¬ healthy
Code 1 ¬ bleeding on gentle probing
Code 2 ¬ calculus present and/or plaque retention factors
Code 3 ¬ 4-5mm pocket
Code 4 ¬ 6mm or more pocket

Question 5

what is Code *

Answer 5

furcation

Question 6

what are the codes used in those 7-11 years

Answer 6

0-2

may be false pocketing as the teeth erupt

Question 7

codes used in those 12-17 years

Answer 7

0-4

Question 8

gingival disorders in children

Answer 8

chronic gingivitis
gingival hyperplasia
traumatic lesions
acute gingivitis

Question 9

chronic gingivitus

Answer 9

common
plaque indced
reversible with improved OH

Question 10

symptoms of chronic gingivitus

Answer 10

painless 
red
swelling of gingiva
no loss of function
gums bleeding due to not brushing enoug

Question 11

what is the bacteria flora in chronic gingitus in childre

Answer 11

flora similar to those in adults
gram+ rods and cocci
gram - anaerobic rods and spirochetes

Question 12

what can make chronic gingivitis worse

Answer 12

exfoliating teeth
malocclusion
presence of orthodontic applicances

Question 13

challenged to toothbrushing

Answer 13

reteroclined teeth in cleft like and palate patients
abnormalities of tooth morphology
orthodontic applicances
sensitive teeth - amelogenesis imperfect
learning disabilites
physical disabilities e.g. cerebral palsy

Question 14

what is another name for localised gingival recession

Answer 14

stilmans cleft

Question 15

localised gingival recession

Answer 15

usually labial to lower incisors

associated with misaligned teeth, self inflicted injury, tooth brushing habits

Question 16

what is gingival hyperplasia

Answer 16

gingival overgrowth

Question 17

what drugs can induce gingival hyperplastia (i.e. drug induced)

Answer 17

Pheytoin
cyclosporin
nifedepine

Question 18

pheytoin

Answer 18

anti epileptic

Question 19

cyclosporin

Answer 19

immunosuppressant
inhibits T lymphocyte proliferation
effects of fibroblasts promoting protein synthesis and collagen formation

Question 20

nifedepine

Answer 20

calcium channel blocker

Question 21

what is cylcosporin used for

Answer 21

• used mainly to prevent graft rejection

Question 22

gingival hyperplasia as a systemic disease

Answer 22

sarcoid

cyclic neutropenia

Question 23

sarcoid gingival hyperplasa

Answer 23

tubrercular cells laid down

interdental papilla overgrown

Question 24

cyclic neutropenai

Answer 24

can be inherited
very immunocomprised
leads to gingival overgrowht

Question 25

types of traumatic gingival injury (self inflicted injury)

Answer 25

type A B C

Question 26

what is type A traumatic gingival injury

Answer 26

injuries are superimposed upon a pre existing source of irritation e.g. exfoliating tooth

Question 27

type B traumatic gingival injury

Answer 27

injuries are secondary to another established habit e.g. biting nails

Question 28

Type C traumatic gingival injury

Answer 28

injuries are complex aetiology and are a physical manifestation of underlying emotions disturbance resistance to conventional treatment

Question 29

acute gingival conditions and infections

Answer 29

1) Acute herpetic gingivostomatitis 2) Necrotising ulcerative gingivitis 3) hand foot and mouth 4) Herpengina

Question 30

acute herpetic gingivostomatitis

Answer 30

HSV type I infection can present as subclinical infection i.e. under the weather 5-7 incubation period before symtoms

Question 31

sign/symtoms of AHGS

Answer 31

``` high temperature (pyrexia) lymphadenopathy malaise and irritability profuse salivation refusal to eat sore throat and mouth symtoms for 7-10days ```

Question 32

clinical features of acute herpetic gingivostomatic (AHGS)

Answer 32

``` small irregualr ulcers on gingiva tongue and palate erthyematous gingiva occasional extraoral lesions salivation lympathdenopathy ```

Question 33

what can acute herpetic gingivasomatis recurre as

Answer 33

herpes labialise in 30%

Question 34

management of AHGS

Answer 34

fluids and soft diet(don't get dehydrated) analgesics and antipyrexics isolation of drinking and eating materials OH improvement- chlorhexidine and sponges, soft toothbrish not acylovir (antivirals)unless immunocompromised

Question 35

necrotiising ulcerative gingivitis and periodontiss

Answer 35

necrosis and ulceration (interdental papilla bleed profusely, distinctive hallitosis) broad anarobic infection treatment wit OH, hydrogen peroxide mouthwash, metronidazole 3 day

Question 36

cancrum orbis

Answer 36

starts in the mouth | can necrosis soft tissues too

Question 37

systemic conditions that may present with gingival changes e.g. bleeding, ulceration

Answer 37

``` HIV chrons disease leukaemia langerhans cell histocytosis scurvy ```

Question 38

langerhams cell histocytosis

Answer 38

aggressive proliferation of histocytes multisystem condition

Question 39

periodontal disease subheadings

Answer 39

aggressive periodontitis chronic periodontits with systemic disease/gentic conditions

Question 40

clinical features of aggressive PD disease in children

Answer 40

tooth mobility/drifiting periodontal abcess rapid periodontal attatchnt loss healthy apart from periodontis

Question 41

bacteria common in aggressive PD

Answer 41

a actinomycetescomitans | p gingivalis

Question 42

body deformities with PD (Ie immune system issues)

Answer 42

phagocyte abno | hyperrepsonsive macrophage phenotype

Question 43

management of periodontal diseas

Answer 43

standard mechanical periodontal therapy systemic or local drug therapy maintenance therapy periodontal surgery

Question 44

what can be used to treat PD

Answer 44

metronidazole and amoxycillin 1 week

Question 45

systemic or genetic conditions where PD is exacerbated

Answer 45

- insulin dependant diabetes - down syndrome - papillion lefevre syndrome - enlers danlos syndrome - Langerhans cell histiocytosis - neutropenia - hypophosphatasia (abnormal cementum)