Perio in Pediatrics Flashcards
(76 cards)
1
Q
gingivitis
A
- inflammation of gingival tissues
2. no loss of attachment or bone
2
Q
what causes gingivitis?
A
occurs in response to plaque bacteria
3
Q
clinical signs of gingivitis
A
- erythema
- BoP
- edema
4
Q
T/F: it is common for gingivitis to occur in early primary dentition
A
false, uncommon
5
Q
why is it uncommon to have gingivitis in early primary dentition?
A
young children have…
- less plaque than adults
- less reactive to plaque
6
Q
50% of young children have gingivitis by what age?
A
4-5 yrs
7
Q
what percent of children have gingivitis at puberty?
A
almost 100%
8
Q
T/F: prevalence of gingivitis declines after puberty and stays constant into adulthood
A
true
9
Q
T/F: some children exhibit severe gingivitis at puberty
A
true
10
Q
what is the peak prevalence of puberty gingivitis?
A
10 yrs in girls
13 yrs in boys
11
Q
puberty gingivitis
A
gingiva enlarged with granulomatous changes similar to pregnancy
12
Q
what is puberty gingivitis related to?
A
increases in steroid hormones
13
Q
local factors for gingivitis
A
- crowded teeth
- ortho appliances
- mouthbreathing
- erupting primary and permanent teeth
14
Q
tx of gingivitis
A
- improve OH
2. appropriately sized toothbrush
15
Q
T/F: gingivitis is reversible
A
true
16
Q
why is flossing not a practical tx for children with gingivitis?
A
b/c parental assistance still needed especially under 8-10 yrs
17
Q
longstanding gingivitis can lead to what?
A
chronic inflammatory gingival enlargement
18
Q
common sites for chronic inflammatory gingival enlargement
A
- around ortho appliances
2. areas chronically dried by mouthbreathing
19
Q
clinical features of chronic inflammatory gingival enlargement
A
- interdental papillae and marginal gingiva enlarged
- tissue usually erythematous and bleeds easily
- tissue may be soft, friable with a smooth, shiny surface
20
Q
chronic inflammatory gingival enlargement may slowly resolve when what?
A
when adequate plaque control is instituted
21
Q
chronic inflammatory gingival enlargement may require what?
A
gingivectomy
22
Q
drugs that cause drug-induced gingival overgrowth
A
- phenytoin
- cyclosporine
- Ca2+ channel blockers
23
Q
phenytoin
A
anti-convulsant
24
Q
cyclosporine
A
immunosupressant for host rejection of transplanted organs and autoimmune diseases
25
Ca2+ channel blockers
cardiac drugs to control hypertension
26
clinical features of drug-induced gingival overgrowth
1. fibrous, firm and pale pink w/ little tendency to bleed
2. occurs slowly
3. may cover and interfere w/ eruption or occlusion
27
where does drug-induced gingival overgrowth occur first and eventualyl spread to?
first in papilla and spreads to gingival margin
28
T/F: drug-induced gingival overgrowth may improve or resolve when med discontinued
true
29
T/F: there is a genetic component to susceptibility of drug-induced gingival overgrowth
true
30
severity of drug-induced gingival overgrowth is affected by what?
1. adequacy of oral hygiene
| 2. gingival concentration of the med
31
T/F: if med cannot be discontinued or changed for pts with drug-induced gingival overgrowth then the overgrowth can be surgically removed but will recur
true
32
how can tissue from drug-induced gingival overgrowth be removed?
1. gingivectomy
| 2. flap w/ internal bevel
33
when is surgery indicated for pts with drug-induced gingival overgrowth?
1. appearance is unacceptable to pt
2. overgrowth interferes with comfortable fxn'ing
3. overgrowth has produced perio pocket that cannot be maintained
34
most severe cases of gingival overgrowth seen in pts with intellectual disabilities are due to what?
poor OH
35
teeth erupt through existing band of what?
keratinized gingiva
36
T/F: width of band of keratinized gingiva and relationship to teeth changes very little during subsequent growth and development
true
37
deflections in path of eruption due to crowding or over-retention of primary teeth may result in what?
narrowed band of attached gingiva
38
when is development and defects of attached gingiva common?
when mand incisors erupt labial to alveolar ridge
39
if band of attached gingiva narrow, small loss of attachment results in what?
mucogingival defect (pocket depth exceed width of keratinized gingiva)
40
T/F: recession may occur rapidly if there is a defect in attached gingiva
true
41
T/F: gingival architecture makes labially erupted teeth difficult to clean, even more so after recession
true
42
loss of attachment and recession sometimes termed what?
"stripping"
43
what other factors may contribute to recession?
1. use of smokeless tobacco
| 2. habit-related self-induced injury
44
tx of mucogingival defect
1. gingival graft to stabilize and replace labial keratinized gingiva
2. ortho movement of back onto alveolar ridge may produce increase in attached gingiva and place tooth in periodontally more stable position
45
when mucogingival defect not severe, best to postpone grafting after what?
ortho tx
46
maxillary frenum penetrating incisive papilla is often accompanied by what?
large midline diastema
47
maxillary frenum penetrating incisive papilla is common finding in who?
children
48
traumatic forces on the facial attached gingiva of maxillary frenum penetrating incisive papilla will cause what?
loss of papilla... LOOK FOR BLANCHING
49
tx of maxillary frenum penetrating incisive papilla should be delayed until when?
until permanent incisors and cuspids erupted to allow natural closure of diastema
older child = better cooperation
50
T/F: for pts with prominent max frenum, if ortho tx planned, postpone surgical tx until diastema has closed
true
51
normal maxillary frenum
1. diastema normal during transitional dentition
2. no blanching of papilla
3. tip of papilla will fill embrasure
52
ankyloglossia or "tongue-tie"
restricted tongue movement
53
T/F: restricted lingual frenum common in children
true
54
restrictive lingual frenum causes problems with what?
1. speech
| 2. feeding
55
tx is indicated for children with restrictive lingual frenum when tongue cannot what?
be protruded or touch the upper alveolar process
56
tx for restrictive lingual frenum
simple frenotomy
57
T/F: infant surgeries to improve latching and feeding controversial
true
58
T/F: evidence for surgery to improve speech very limited
true
59
what percent of 14-17 y.o.s have attachment loss of ≥2mm at ≥1 sites?
20%
60
when does chronic periodontitis has incipient beginning?
in adolescence
61
T/F: chronic periodontitis responds well to oral hygiene measures
true
62
when is chronic periodontitis more easily arrested?
in early stages when attachment loss is minimal and deep pockets have not formed
63
what is a major risk factor for chronic periodontitis?
smoking
64
T/F: smoking status of pts with chronic periodontitis should be determined as part of perio assessment for young pts and counseling provided
true
65
localized aggressive periodontitis (LAP)
characterized by loss of attachment and bone around permanent incisors and 1st permanent molars
66
attachment loss in children with localized aggressive periodontitis is occurring at what rate of adult onset disease?
3x
67
when is localized aggressive periodontitis (LAP) detected?
in early adolescence
68
when might localized aggressive periodontitis (LAP) be noticed?
after mild trauma luxates tooth
69
prevalence of localized aggressive periodontitis (LAP)
~1% of US
70
localized aggressive periodontitis (LAP) is most commonly seen in what population?
African-American population
71
T/F: some localized aggressive periodontitis (LAP) cases appear to be inherited as an autosomal dominant trait
true
72
what is localized aggressive periodontitis (LAP) linked to?
1. neutrophil chemotactic defect
| 2. presence of high numbers of Aggregatibacter actinomycetemcomitans (AA)
73
successful tx of localized aggressive periodontitis (LAP) is correlated with what?
eradication of bacteria
74
T/F: localized aggressive periodontitis (LAP) is self-limiting
true
75
tx for localized aggressive periodontitis (LAP)
SRP combined w/ systemic abx therapy and monitoring
76
systemic abx choices for tx'ing localized aggressive periodontitis (LAP)
1. tetracyclines
2. metronidazole alone or in combo w/ amoxicillin appears to be more effective
3. newest therapy azithromycin
