Periodontal Diseases

Question 1

first described in the young men who fought in the trenches during WWII, thus the term trench mouth came to be. it is a MIXED bacterial infection and there is a controversial viral component

Answer 1

NUG

Question 2

what are contributing factors to NUG

Answer 2

stress, poor oral hygiene, poor diet, immune suppression, smoking

Question 3

what age group does NUG affect most?

Answer 3

young or middle aged adults

Question 4

what is the clinical presentation of NUG

Answer 4

• punched out interdental papillae
• localized or diffuse gingival involvement
• severe pain, oral malodor, spontaneous hemorrhage

Question 5

does NUG spread to the adjacent soft tissues?

Answer 5

yes occasionally

*necrotizing ulcerative mucositis / necrotizing stomatitis

Question 6

what is the tx for NUG

Answer 6

• debridement (using topical or LA)
• mild salt water or CHX
• improve oral hygiene and diet

*broad spectrum antibiotic may be helpful particularly if systemic symptoms

Question 7

clinical term used to describe sloughing of the gingival epithelium and is associated with several different immune-mediated vestibulobullbous diseases

Answer 7

desquamative gingivitis

Question 8

is desquamative gingivitis considered a diagnosis?

Answer 8

NO it is a description

Question 9

how do you manage desquamative gingivitis

Answer 9

incisional biopsy

Question 10

abnormal growth of gingival tissues secondary to use of systemic medication.

Answer 10

drug-related gingival hyperplasia

Question 11

in drug related gingival hyperplasia, what does the degree of clinical enlargement depend on?

Answer 11

pts suseptibility and level of oral hygiene

Question 12

what was the first drug to be associated with gingival enlargement

Answer 12

phenytoin (Dilantin)

Question 13

what is the tx for drug related gingival hyperplasia

Answer 13

• removal of the offending medication may result in cessation and some regression of the gingival enlargement
• home plaque control regimens and surgical therapy as needed

Question 14

slowly progressive collagenous overgrowth of the gingiva. is isolated or familial, is generalized or localized

Answer 14

gingival fibromatosis

Question 15

what is the clinical presentation of gingival fibromatosis

Answer 15

gingiva if firm and normal color

Question 16

what are three other finding associated with gingival fibromatosis?

Answer 16

• hypertrichosis (excess hair)
• epilepsy
• mental retardation

Question 17

what is the tx for gingival fibromatosis?

Answer 17

• oral hygiene instruction
• gingivectomy (ideally delayed until after complete eruption of permanent dentition)
• selective tooth extraction sometimes necessary

Question 18

rare, autosomal recessive disorder that has oral and dermatologic manifestations. leads to accelerated periodontitis, related to defects in NEUTROPHIIL function

Answer 18

papillon- Lefevre Syndrome

Question 19

what is the tx of papillon- Lefevre syndrome

Answer 19

rigorous oral hygiene, CHX rinse, freaquent dental prophylaxis, periodic appropriate antibiotic therapy may slow or halt disease progression

Question 20

what happens if you dont treat papillon Lefevre syndrome?

Answer 20

without aggressive therapy, loss of the dentition is inevitable