advanced perio disease

Question 1

who does necrotising gingivitis affect?

Answer 1

Can affect both males and females
Usually ages 18-30
Rare in the very elderly and very young
Can be very destructive

Question 2

what is the clinical picture for necrotising gingivitis?

Answer 2

redness (erythema)
Oedema
Heat, pain and loss of function
Gingivae shiny with loss of stippling
Bleeds easily or spontaneously
Tips of interdental papilla affected with ulcers
May, if left untreated involve attached gingivae
Very painful, even on gentle probing (important diagnostic sign) covered in a layer of pseudomembranous slough (necrotic tissue), underlying tissue erythematous and raw

Question 3

what is the slough called that the gingivae is covered in called?

Answer 3

pseudomembranous slough

Question 4

what are symptoms of necrotising gingivitis?

Answer 4

halitosis - due to necrotic tissue
pain
patient may complain of a metallic taste in the mouth - due to bleeding
Upon healing-interdental papillae may have “punched out” appearance
May have cervical lymphadenitis-may affect submental and submandibular lymph nodes- Pyrexia and Malaise

Question 5

how would you treat Necrotising gingivitis?

Answer 5

remove the pseudomembranous slough
SDCEP Guidelines – recommend if there is evidence of spreading infection or systemic involvement consider prescribing Metronidazole
Systemic antimicrobial treatment is sometimes indicated
Local treatment is essential

Question 6

what factors can cause Necrotising gingivitis?

Answer 6

stress
poor diet
poor oh
smoking
pre existing gingivitis

Question 7

what are some of the bacteria involved in NG?

Answer 7

gram negative

Porphyomonas Gingivalis
Prevotella Intermedium
Treponema Vincenti
Borelli Vincenti