Drugs and Periodontium Flashcards
what type of drug is Phenytoin?
An antiepileptic
what does phenytoin affect and cause?
directly affects the gingival tissues causes hyperplasia in 50% of cases : related to fibroblast activity/OH standards
hyperplasia will improve with what?
improved OH
when is they hyperplasia side effect of phenytoin most likely to occur?
within first 3 months
worse anteriorly
begins ID and grows and coalesces
what is the side effect of phenytoin related to?
serum conc of blood and not dose of drug
some examples of immunosuppresant drugs, what can they cause?
reduce inflamm response and reduce gingivitis
corticosteroids/cyclosporin
what can cyclosporin cause?
gingival hyperplasia in 30% of cases
increased incidence of women and children
what does cyclosporin hyperplasia resemble?
phenytoin hyperplasia
what medication can cyclosporin be switched to?
tacrolimus with gingival resolution
what do corticosteroids inhibit?
inhibit early and late stages of the inflammation process
periodontally what to corticosteroids cause?
reduced inflammation response/reaction to plaque
reduced swelling
reduced bleeding
occasionally allow a better response to tx
NSAIDS inhibit the synthesis and release of?
what does this result in?
prostaglandins
increased vasodilation
increased vacular permeability
stimulate bone loss - levels of PG’s in perio disease
periodontally what do NSAIDS cause?
reduced bleeding/reduced swelling/reduced bone than age/sex matched controls
why not use NSAIDs in perio disease?
GI effects
what does osetrogen cause in the mouth?
increased keratinisation and alters composition of CT
what does progesterone cause in the mouth?
increased permeability of gingival blood vessels
at puberty what can be seen in the mouth?
increased prevalence and sensitivity to gingivitis
increased host response to presence of plaque
during pregnancy what can be seen in the mouth?
pregnancy only exacerbates any underlying conditions
gingivae may become red/swollen/sensitive/bleed spont/increased gcf’mobility
tx - elimiate plaque retentive factors/good oh
what is a pregnancy epulis?
pyogenic granuloma soft. pedunculated granuloma arising from an inflammed papilla deep red/bleeds easy usually around ants usually 3rd month
what are pregnancy epulis’s associated with?
plaque deposits and another factor:
carious cavity
poor tooth contact
overhang
only remove epulis if?
being traumatised easily
remove after birth b/c recurrence unlikely
what can the OCP cause?
increased flow of g.fluid and higher prevalence if gingival inflammation
inflammation associated with length of time and length medication taken
does not affect a healthy mouth
what are chemotheraputic agents?
used to tx malignant disease
what can chemotheraputic agents cause?
gingival haemorrhage
thrombocytopenia
lack of clotting factors
low white blood count, pt more susceptible to ?
periodontal destruction
what calcium channel blockers can cause problems orally?
nifedipine/amlodipine induced hyperplasia
amlodipine - 30% - soon after 1st dosage
contact hypersensitivity caused by?
signs?
LA/penicillin/gum/MW
gingivae sore/red/epitheloum may peel of and leave ulcerated areas
drugs causing hyperplasia?
phenytoin
cyclosporin
nifedipine
destruction inhibition caused by?
immunosuppressants
NSAIDs
increased susceptibility caused by?
sex hormones
exacerbate and cause destruction?
chemotheraputic agents
smoking
