Paediatrics: Periodontology Flashcards
(39 cards)
What are features of periodontal health in children?
- absence of gum inflammation and calculus
- no more than one sextant with plaque
- gingival margin several mm coronal to the CEJ
- gingival sulcus 0.5-3mm on a fully erupted tooth
- in teenagers the alveolar crest is situated 0.4-1.9mm apical to CEJ
- BOP <10%
What occurs to the gingivae during gingivitis?
- plaque accumulates on teeth (large number of bacteria) and inflammatory cells accumulate
- this causes inflammation of the gingivae and the junctional epithelium is disrupted
- allows apical migration of plaque and an increase in gingival sulcus depth
When can gingivitis occur in a reduced periodontium patient?
- successfully treated periodontitis patient
- root lengthening
Name the sub-classifications of gingival diseases and conditions that are non-dental biofilm induced?
Genetic/Developmental disorders
Specific infections
Inflammatory and immune conditions and lesions
Reactive processes
Neoplasms
Endocrine
Nutritional and metabolic diseases
Traumatic lesions
Gingival pigmentation.
What is the microbial aetiology of necrotising gingivitis?
fusiform spirochaetal
What is the socioeconomic factors of necrotising gingivitis?
developing countries
what are the modifiable risk factors of necrotising gingivitis?
- smoking
- immunosuppression
- stress
- malnourishment
- poor diet
- diabetes
- pharmaceutical drugs (cyclosporin, calcium channel blockers)
What are the local risk factors of necrotising gingivitis?
- root proximity
- tooth malposition
- dental trauma
- orthodontic appliances
- overhangs
- tooth anatomy
- incompetent lip seal
What are the systemic non -modifiable risk factors of necrotising gingivitis?
- HIV positive
- underlying undiagnosed pathology in a immunosuppressed host
- haematological conditions (leukaemia)
- increase in sex steroids (period/pregnacy)
- genetics, age
What are the features of necrotising gingivitis?
- pain
- punch out gingivae
- ulceration
- spontaneous bleeding
- halitosis
- pseudomembrane may be present
- fever
What are the treatment options for gingival overgrowth?
- rigorous home care
- frequent appointments for professional mechanical plaque removal (PMPR)
- +/- surgery, especially with drug-induced gingival overgrowth
If an extent of a patients condition is inconsistent with level of oral hygiene observed and have unexplained bleeding, gingival enlargement, inflammation and tooth mobility what should you do?
consider urgent referral to a physician and haematinic screening
What are the 4 main distinguishing features of periodontitis?
- apical migration of the junctional epithelium
- loss of attachment of PDL to bone
- transformation of junctional epithelium to pocket epithelium
- alveolar bone loss
What is early clinical signs of periodontitis in teenagers classified as?
1mm loss of attachment
What pathogens can be found in the subgingival flora of teenagers with periodontitis?
- similar to adults
- p. gingivalis, p. intermedia, T. forsythia
What do you need to consider when taking BPE around erupting permanent dentition?
false pocketing
What are the features of molar-incisor periodontitis in adolescents?
- rapid attachment loss and bone destruction
- patient is otherwise healthy
- onset at puberty
- family history
- Caucasians and African ancestry
What teeth does localised molar-incisor periodontitis usually effect?
incisors and first permanent molars
What teeth does generalised molar-incisor periodontitis usually effect
- Traditionally > or = 3 permanent teeth other than the incisors and first molars
What things are you looking for when assessing gingival condition?
- contour
- recession
- bleeding
- suppuration
- swelling
- gingival colour
- inflammation
How would you asses oral Hygiene status on a patient?
- look for visible plaque or plaque on probing
- score (modified plaque and bleeding chart)
What 4 things would you look at when recording and diagnosing periodontal disease?
- gingival condition
- oral hygiene (plaque)
- calculus present
- local risk factors
What type of tool is a BPE?
screening tool- helps to aid in diagnosis and any special test/further investigations needed
What does a BPE not consider?
- bone levels
- historical attachment loss
