Acute Periodontal Disorders Flashcards

1
Q

APD can affect

Two diseases caused

A

Gingivae alone
Periodontium - mechanism holding teeth in places

Gingivitis and Periodontitis

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2
Q

Gingivitis

Features , example, causes

A
Non-specific 
Gingival abscess 
Traumatic - mechanical, chemical, physical, thermal 
Bacterial and viral 
Allergic 
HIV associated 
Fungal
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3
Q

Periodontitis
Example
Types
Can be associated with?

A
Periodontal abscess
Acute generalised
Traumatic PA 
Acute necrotising 
HIV associated
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4
Q

Types of gingivitis

A

Plaque related gingivitis
Physical trauma related gingivitis
Herpes related gingivitis

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5
Q

Gingival abscess

Involves?

A

ONLY the gingival tissue

Caused by infection within gingival tissue

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6
Q

Herpes causes - which herpes? Who does it affect? Spread? Relieving factors

A
Acute herpetic gingivostomatitis 
Common in children 
Contagious and spreads from lesions with 5-7 incubation period - subclinical in many 
Cold fluids are best reliever 
Refer on if symptoms are worse
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7
Q

Herpes symptoms

A
More in adults
Sore mouth 
Loss of appetite 
Numerous vesicles which rupture 
Ulcers 
Salivation 
Moderate-severe malaise 
Lymphadenopathy, stomatitis, pharyngitis
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8
Q

Treatment of AHG

A
fluid intake
soft diet
analgesics
anti-paretics
topical antiseptic anaesthetics 
but naturally self limiting 10-12 days 
ANTIVIRALS e.g acyclovir
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9
Q

Herpetic complications

A

Herpetic WHITLOW without gloves
Herpetic lesion of eye in dentist if not wearing gloves
Satellite lesions - caused if child sucks finger and scratches elsewhere
Encephalomeningitis

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10
Q

Reactivation of virus
Primary illness
Reactivation

A

Primary leads to infection of trigeminal ganglion
Reactivation as herpes labialis
IO reactivation may occur following trauma e.g surgery or infiltration/periodontal surgery

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11
Q

HIV associated gingivitis

A

Distinct red line along gingival margin

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12
Q

Acute fungal gingivitis
Can occur due to?
Common in
Check with

A

Acute candidal gingivitis
Superinfection with superinfection with candid albicans
PD wearers, recently finished course of broad spectrum antibiotics, debilitated patients

Rub with cotton wool roll, white part will come off

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13
Q

Acute allergic gingivitis
Follows…2 types

Symptoms

Signs

What to do

A

Systemic administration of drug/chemical
Direct contact with mouth

Gingival tenderness may prevent effective cleaning
Red, shiny, gingivae, loss of stopping, oedema
Mild to anaphylactic shock

Stop and find cause

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14
Q

Traumatic periodontal disorder can be caused by?

A

Root fracture

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15
Q

ANUG
indicated by

Clinical features

A

Loss of interdental papilla
Halitosis
Localised or whole mouth
Gingivae sore and bleeding
Ulceration and necrosis of gingival margin
Ulcers covered in slough
No systemic symptoms but lymphadenopathy often present
If severe, bone and PD attachment can be lost
May be associated with HIV

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16
Q

Aetiology of (A)NUG

Pre-disposing factors

A

Opportunistic infection by anaerobes
Fuso-spirochaetal complex e.g treponema vincentii
No evidence of transmission
Lowered resistance

Compromised immune defence
Smoking
Stress
Poor oral hygiene

17
Q

Lateral periodontal abscess

A

Collection of pus in connective tissue wall of a periodontal pocked

18
Q

LPA presenting signs and symptoms

A

Pain
Tissue around teeth is painful, swollen, small localised enlargement
Tissues red or deep red blue
Lymphadenopathy and fever may be present
TTP on tooth and adjacent
Tooth usually mobile and high in occlusion
Deep pocket on charting
Sinus?

19
Q

Aetiology of LPA

A

Deep perio pocket with active inflammation and micro ulceration
Entry of microbes through pocket lining into connective tissue –> abscess
Blockage, trauma and reduction of host response

20
Q

Differential diagnosis of LPA

Things to consider

A
History 
Deep pocket
Vital tooth 
Pus in pocket
Tooth may be extruded
Radiograph confirms bone loss
21
Q

Differential diagnosis of PA abscess

A
History of pain, stopped pain 
Tooth non-vital 
Usually acute TTP 
Pus in tissues
Tooth may be extruded 
Apical changes
May show cavity/restorations
22
Q

Management of an abscess

Consider

A

extract or remain

wishes of patient
medical condition
tooth prognosis
prognosis for dentition

23
Q

Management - retaining tooth

and follow up

A
Retain the tooth (acute phase) 
Drain if fluctuant 
RSD for draining through pocket
Selective grinding to relieve pain 
Salt water mouthwashes 
Antibiotics 
Amoxicillin 5 days 
Azithromycin 3 days 

Further assessment
Scaling
Plaque control
Periodontal surgery