Medical conditions

Question 1

Down’s syndrome affects the periodontium in what way? (7)

GENETIC CONDITION

Answer 1

Class 3 occlusion (bottom teeth in front)
Large tongue
Lack of lip seal
Prone to infections
Prone to destructive periodontitis (lower incisors commonly affected)
Increased susceptibility to NUG
Impaired chemotaxis & phagocytosis of PMNs

Question 2

What treatment do you use for someone with Down’s Syndrome?

GENETIC CONDITION

Answer 2

Good OH, Prevention (fluoride), frequent monitoring, frequent perio treatment likely

Question 3

Hypophosphatasia (matabolic bone disease) causes affects to the periodontium- how?
GENETIC CONDITION

Answer 3

Premature extraction of deciduous teeth
Abscence of inflammation
‘Shell teeth’
Loss of alv bone

Question 4

What effects does Papillon-Lefevre syndrome have on the periodontium?
GENETIC CONDITION

Answer 4

Premature loss of teeth
Primary and secondary dentition
Aggressive periodontitis
Severe gingival inflammation 
Treatment usually unsuccessful

Question 5

What effect does Ehlers- Danlos syndrome have on the periodontium?
GENETIC CONDITION

Answer 5

Mucosa fragile and susceptible to bruising
Easy bleeding gingiva
Teeth are fragile and fracture easily
Link with aggressive periodontitis

Question 6

What effect does Hereditary gingival fibromatosis have in the mouth?
GENETIC CONDITION

Answer 6

Doesn’t manifest till after eruption
Enlargement of gingival tissues
Gingiva can cover crowns
May delay eruption of teeth

Question 7

Mucopolysaccharidosis (Hurlers/hunters syndrome) orally?

GENETIC CONDITION

Answer 7

Small teeth
Wide spaces
Delayed eruption

Question 8

What does Crohn’s disease do to the mouth? GRANULOMATUS CONDITION

Answer 8

Ulceration
Acid erosion
Cobblestone mucosa

Question 9

What does Sarcoidosis do to the mouth? GRANULOMATUS CONDITIONS

Answer 9

May effect lymph nodes, spleen etc
Swelling of parotid gland and lymph nodes
Gingival hyperplasia

Question 10

What is Wegner’s granulomatosis?

Answer 10

Extreme sarcoidosis?

Question 11

What does Anemia do to the mouth?

HAEMATOLOGICAL CONDITION

Answer 11

Pt may feel tired and faint
Pallor oral mucosa
Tongue is smooth
With or without ulceration

Question 12

What does aplastic anaemia do to the mouth?HAEMATOLOGICAL CONDITION

Answer 12

Caused by drugs/radiation

Gingival bleeding, infections

Question 13

What is Fanconis anaemia?

Answer 13

A rare aplastic anaemia

Associated with aggressive periodontitis and early tooth loss

Question 14

What is neutropenia?

Answer 14

Decrease in PMNs

Genetic or secondary to viral disease

Question 15

What does neutropenia do to the mouth? HAEMATOLOGICAL CONDITION

Answer 15

Ulceration
Severe gingivitis with bleeding
Rapid bone loss

Question 16

What does Leukaemia do to the mouth?

HAEMATOLOGICAL CONDITION

Answer 16

Ulceration
petechia (Red/purple spot)
Gingival enlargement
Affects ability of PMNs

Question 17

hypogammaglobulinaemia is what condition?

Answer 17

IMMUNOLOGICAL CONDITION

Question 18

What is lichen planus?

Answer 18

Inflammatory disease of unclear aetiology
Itercalating network os white lines
Erosive lichen planus- can occur on gingiva

Question 19

What is an oral localised infection?

Answer 19

NUG

Question 20

How does having a vitamin C deficiency have an effect on the periodontium?

Answer 20

Severe perio destruction