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Advanced Periodontology > Ch 16 Periodontal Emergencies > Flashcards

Ch 16 Periodontal Emergencies Flashcards

1
Q

What is included in the history?

A
  • What is the chief complaint
  • Location
  • Onset
  • Other symptoms
  • Systemic factors
  • Trauma
  • Aggravating factors
  • Alleviating factors
  • Previous tx
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2
Q

What are the 3 basic type of abscesses

A
  1. ) Periodontal
  2. ) Gingival
  3. ) Periapical
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3
Q

Each type of abscess can be?

A

Acute or Chronic

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4
Q

This is a site of inflammation of microbial origin that is associated with accumulations of suppuration or purulence (pus) in the periodontal tissues

A

Periodontal

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5
Q

Pus is often referred to as what?

A

Exudate or purulent

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6
Q

Which type of abscess/infection have rapid onset and are usually characterized by pain, swelling and discomfort

A

Periodontal abscess

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7
Q

With the presence of which abscess doesn’t always mean that the tooth must be extracted

A

Periodontal

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8
Q

What is associated with pre-existing periodontal disease?

A

Acute periodontal abscess

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9
Q

What abscess may occur around any tooth in the mouth when periodontal pocket becomes occluded often as a result of a foreign object?

A

Acute periodontal abscesses

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10
Q

If the pocket can drain through a sulcus or a fistula (opening in the tissue), the infection can be stabilize and can be considered in the state?

A

Chronic State

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11
Q

What causes the pocket not to stabilizes?

A

If a object, such as a peanut skin, popcorn hull or blueberry seed remain in the pocket

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12
Q

What abscess appears as a shiny, red raised and rounded mass on the gingiva or mucosa

A

Acute periodontal

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13
Q

What is the most common symptom of acute perio abscess?

A

PAIN

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14
Q

What are some symptom of acute perio abscess?

A
  • Swelling
  • Deep red to blue discoloration of the affected tissue
  • Tooth sensitivity to pressure
  • Tooth mobility
  • Tooth feels “high” to the pt
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15
Q

What does it mean when the tooth feels “high”

A

The tooth becomes slightly extruded as a results of swelling of the perio ligaments

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16
Q

How can x-ray images of acute perio abscess be helpful?

A

Can be used to locate an area of bone loss which may be the origin of the abscess

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17
Q

The opening of a fistula or sinus along the lateral aspect of the tooth in the adult dentition is usually what?

A

Indicative of a periodontal abscess

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18
Q

Tx of acute periodontal abscess consists mainly of what?

A
  • Drainage after administering local anesthesia

- Use of antibiotics or antimicrobial agents

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19
Q

The teeth in the affected area are

A

scaled and root planed, and curettage is preformed to remove granulation tissue

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20
Q

Postoperative instructions after tx of acute perio abscess

A

rest
fluid intake
warm salt water rinses to reduce swelling

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21
Q

What are healthy gingival biota predominantly

A

Gram-positive and aerobic

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22
Q

Periodontal abscess are predominantly of what?

A

Gram-negative and anaerobic

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23
Q

The resemble acute perio abscesses, They may be indistinguishable

A

Chronic periodontal abscess

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24
Q

What abscess are usually painless, they drain into oral cavity, either through the opening of the pocket or a sinus tract

A

Chronic perio abscess

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25
Q

The tx for this is the tooth crown and root surface must be scaled and root-planed, curettage performed, local antimicrobial theraphy completed if needed, and the pt is scheduled for follow-up care to evaluate for any further periodontal tx is needed

A

Chronic perio abscess

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26
Q

This is a material such as fluid or cellular debris that has escaped from bld vessels and been deposited in or on tissue surfaces

A

Exudate

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27
Q

This abscess often occurs in disease-free areas and may be related to forceful inclusion of some forging object into the area?

A

Gingival abscess

28
Q

This abscess are found on the marginal gingiva and are not associated with any abnormality of the deeper tissue

A

Gingival

29
Q

Typically appears as a shiny, raised area of acute inflammation that may ne painful. The swelling is usually confined to the marginal gingiva.

A

Gingival abscess

30
Q

With this abscess a suppurative lesion is usually evident on the gingival tissues

A

Gingival abscess

31
Q

What is the tx for gingival abscess?

A

Drain and irrigate. Tx is usually performed by the dentist or periodontist

32
Q

After the tx of gingival abscess what should be done the next day?

A

Scaled and root-planning

33
Q

This abscess is difficult to distinguish from an acute periodontal abscess. The facial pain and tenderness to the tooth are similar in both

A

Periapical abscess

34
Q

What type of abscess is result of infection through caries, traumatic fracture of the tooth, or trauma from a dental procedure

A

Periapical

35
Q

In periapical abscess the pulpal infection to a tooth can spread to the pulp from an adjacent infected tooth through what?

A

lateral canals

36
Q

Periapical abscess often appears on x-rays as what?

A

Rounded radiolucency at the apex of the tooth

37
Q

To determine whether an abscess is periodontal or periapical, consider the following:

A
  • 85% of the tooth pain is pulpal and 15% periodontal
  • Periapically the teeth test nonvital
  • Periapical pain is sharp, severe, intermittent and difficult to localize
  • Periodontal pain is constant, localized and less severe
38
Q

Tx of periapical abscesses requires what?

A

Endodontic therapy or the extraction of the tooth

39
Q

Untreated periapical abscess can lead to what?

A

Abscess of the brain or swelling of the fascial planes

40
Q

Extensions of infection into deeper tissues can be life threatening

A

Ludwigs angina

41
Q

When an abscess spreads from the pulp to the periodontium or from the periodontal pocket to the pulp what is it considered?

A

Combination of periapical and periodontal abscess

42
Q

What is the flap of tissue called that covers or partly covers a tooth

A

Operculum

43
Q

What abscess is associated with a partially or fully erupted tooth that is covered completely or partly by a flap of tissue called operculum

A

Pericoronitits

44
Q

Pericoronitis abscess commonly effect what tooth and age?

A

Mandibular third molar and in young adults

45
Q

What are symptoms of acute pericoronitis

A

-Swelling of the operculum
-Gingiva redness and extreme pain
-Trismus (muscle spasm)
-Fever
Purulent exudate

46
Q

Tx of Pericoronitis is:

A
  • Initial therapy involves debridement of the infected area and flushing it with warm water or chlorhexidine
  • Pt should rest, use warm salt water rinses and drink fluids
  • Antibiotics of fever
  • After acute condition has resolved, the operculum can be removed
47
Q

This is an opportunistic infection of the gingiva that is associate with stress, lifestyle, and some chronic illnesses and conditions such as bld dyscrasias, human immunodeficiency virus infection and down syndrome

A

Necrotizing ulcerative gingivitis (NUG)

48
Q

NUG is primarily observed in who?

A

Young adults who are under severe stress and individuals who are immunocompromised

49
Q

Is NUG communicable

A

NO

50
Q

Nug is a recurring disease with a complex bacteriologic structure that consists of a large proportion of what?

A

Spirochetes and gram-negative organism

51
Q

When NUG reoccurs, the name for the disease

A

Necrotizing ulcerative periodontitis (NUP)

52
Q

What are clinical characteristics that distinguish NUG from other forms of acute oral infections:

A
  • Papillary gingiva becomes necrotic and appears cratered or “punched out”
  • Surface of the gingiva has a pseudomembranous coating made up of necrotic bacteria and tissue
  • Gingiva is red and painful
  • Lesions (localized or generalized)
  • Bad breath described as fetid (fetor oris)
53
Q

Tx for NUG requires the following approaches

A
  1. ) Alleviation of acute inflammation and tx of chronic conditions
  2. ) Alleviation of systemic symptoms such as fever and malaise
  3. ) Correction of condition that contribute to the initation or progress of the disease
54
Q

How many visits to tx NUG

A

Several

55
Q

On the first visit of NUG what should be done?

A
  • Limited amount of debridement, only what the pt can tolerate
  • Use of ultrasonic and topical or local anesthetics may be helpful
  • Don’t subgingival scaling or root planning bec increase the possibility of extending the infection into deeper tissue and causing bacteremia
  • Dentist may prescribe systemic antibiotics if fever
56
Q

What should be done in your second tx for NUG

A
  • Should occur 1 or 2 days later

- Subgingival scaling if pts sensitivity permits

57
Q

What should be done in the pts third visit for NUG?

A

Occurs 3-5 days after 1st visit

-Complete debridment

58
Q

What is the pt instructed to do after the tx of NUG

A
  • Rest
  • Drink plenty of fluids
  • Avoid spicy foods
  • Rinse with warm salt water
  • Refain from smoking
59
Q

Oral manifestation of primary infection with the herpes virus, usually herpes simplex virus 1 (HSV1)

A

Acute herpetic gingivostomatitis

60
Q

Acute herpetic gingivostomatitis is commonly found in

A

Young adults, possibly representing primary infection with genital herpes virus herpes simplex virus ll (HSVll)

61
Q

Acute herpetic gingivostomaitis disease is?

A
  • Highly infectious

- Dental and dental hygiene care should be postponed until the condition has subsided

62
Q

Acute herpetic gingivostomatitis is commonly associated with symptoms such as

A
  • Fever
  • Malaise
  • Headache
  • Irritability
  • Lymphadenopathy
63
Q

What does the acute herpetic gingivostomatitis lesions begin out as:

A

Small yellow vesicles that coalesce to form larger round ulcers with gray centers and bright red borders.

64
Q

Where are the acute herpetic lesions found at?

A

May be found on any of the oral mucous membranes. Pts may have serious, even extreme pain

65
Q

After the primary infection has accrued the herpes virus travels through the nerves to reside in neuronal ganglia, there the virus can become what?

A

Active again and recur most commonly in the form of herpes labialis

Advanced Periodontology (6 decks)

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