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Flashcards in Perio Deck (79)
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1

True or false.. gingival related oral pathology is rare in children

False. It is relatively common

2

Periodontal disease, most of the time, conditions are ___ with palliative care

Self-limiting

3

What is the most difficult step in treating perio problems in pedo pts?

Management of the parent

4

What does this pt likely have?

Mom calls with report that 2 yo has been irritable, not eating, not sleeping well and slightly febrile. Gums have been red and swollen. Breath is terrible. Brushing has been exceptionally difficult last couple of days.

Primary hermetic gingivostomatitis

5

Primary herpetic gingivostomatitis is caused by ____. It occurs in children younger than ___. It is transmitted via ___. Primary infection is usually ___.

Herpes simplex virus type 1

6

Direct contact

Asymptomatic

6

What does primary herpetic gingivostomatitis look like?

Discrete spherical gray vesicles

Hard palate, attached gingiva and oral mucosa

Blisters outside of lip, excoriation, bleeding

Generalized soreness and gingival erythema

Ruptured vesicles - focal site of pain

Irritability, generalized malaise

Pain upon swallowing. Refusal to eat

Fever

Cervical lymphadenopathy

7

How long does primary herpetic gingivostomatitis typically last?

7-10 days

8

How do you treat primary herpetic gingivostomatitis?

Treatment is symptomatic and supportive

Bed rest, soft diet

Hydration is important

In severe cases, use systemic acyclovir (200mg for 5 days).


Remember that course is self limited to 7-10 days

9

What does this pt likely have?

Mom calls with report that 4yo has not been eating well. Mom cannot look in the mouth very well without it hurting. No reports of fever or swelling. Brushing has been exceptionally difficult last couple of days.

Recurrent apthous ulcer

10

What things may cause a recurrent apthous ulcer?

Genetic predisposition

Systemic disease

Stress

Mechanical injuries

Hormones

Micro element deficiencies

Viral and bacterial infections

11

True or false.. RAUs are typically asymptomatic

False they are typically very painful

12

Where do RAUs occur? What do they look like?

Buccal and labial mucosa and tongue and gingiva are commonly involved.

Discrete conquest lesions
Round to oval craterform base, raised and reddened margins.


Begin as single or multiple superficial erosion covered by grey membrane, surrounded by localized areas of erythema

13

What is the treatment of a RAU?

Symptomatic and supportive

Use topical corticosteroid trimcinolone four times a day if severe

Nutritional diet

Maintenance of oral hygiene

14

What is a specially common location of RAUs in kids?

Buccal mucosa adjacent to lower molars

15

What does this pt likely have?

Mom calls with report that 2 month old has white and red ares inside mouth. Mom thought it was just milk residue but when removed, it appeared reddish underneath. No reports of fever or swelling.

Acute candidiasis (oral thrush) (Candida albicans)

16

What are some things that can cause oral candidiasis?

Illness

Corticosteroids

Stress

Antibiotics

17

What are two different types of acute candidiasis?

Pseudomembranous

Erythematous

18

What does acute candidiasis look like?

Pearly white or bluish white plaque present on oral mucosa which may extend to circumoral tissues

Painless and noticed on careful evaluation

May be removed with little difficulty

Pt may complain of burning sensation

19

True or false... acute candidiasis is painful

False

20

What is the treatment for acute candidiasis?

Nystatin - 1ml dropped into mouth for local action four times a day for infants and very young children

Clotrimazole lozenge (this works really well when the kids get older)

Systemic fluconazole suspension

21

What does this pt likely have?

Mom calls with report that 14 month old is fussy and will not eat normally. Brushing has been difficult last couple of days. No swelling or fever reported. Mom wonders if teeth are coming in.

Eruption gingivitis

22

True or false... the erupting tooth causes gingivitis directly

False. Tooth eruption does not cause gingivitis, however there can be inflammation with plaque accumulation in the area

23

Should the pt stop brushing if it is painful in eruption gingivitis?

No. Although eruption gingivitis causes secondary discomfort and inflammation caused by brushing friable areas, they shouldnt stop

24

What is the treatment for eruption gingivitis?

Time

Improved oral hygiene

Chlorhexidine rinses in older kids

25

What does this pt likely have?

Mom calls with report that 8yo is fussy and experiences pain in the gums when eating or brushing. Child is sensitive when brushing in UL quad and bleeding noticed. The gums are swollen in sensitive area.

Acute inflammatory gingival enlargement. Could be tooth related, infection, or just gingiva related. Rule out trauma, caries, etc.

26

What is the clinical appearance of acute inflammatory gingival enlargement?

Localized, painful rapidly expanding lesion that is usually of sudden onset.

Red swelling with smooth shiny surface becoming fluctuations

Removal of substance and possible incision and drainage

27

What are some likely causes of acute inflammatory gingival enlargement?

Irritation from foreign substance embedded into gingiva

Limited to the marginal gingiva or interdental papillae

28

Although most periodontal diseases peak in their destructive stages during ___, many of them have their inception during ___.

Middl age

Childhood

29

True or false... the early detection and early treatment are important because the prevention of most periodontal diseases are relatively simple and very effective, providing lifetime benefits.

True

30

True or false.. plaque is necessary for bone loss.

True?