Gingival and periodontal health in children Flashcards
children with teeth with the condition of amelogensis imperfecta
sensitive teeth
rough/little enamel
hard to brush teeth therefore calculus builds
consqeunes of children fed by a gastrostomy tube
may not have a swallow reflex
not generating as much saliva as they are not eating
therefore can develop extensive calculus
which side is gngitivus less prevalent in
LHS compared to RHS
periodontal screeing for children under 18 years
Code 0 ¬ healthy Code 1 ¬ bleeding on gentle probing Code 2 ¬ calculus present and/or plaque retention factors Code 3 ¬ 4-5mm pocket Code 4 ¬ 6mm or more pocket
what is Code *
furcation
what are the codes used in those 7-11 years
0-2
may be false pocketing as the teeth erupt
codes used in those 12-17 years
0-4
gingival disorders in children
chronic gingivitis
gingival hyperplasia
traumatic lesions
acute gingivitis
chronic gingivitus
common
plaque indced
reversible with improved OH
symptoms of chronic gingivitus
painless red swelling of gingiva no loss of function gums bleeding due to not brushing enoug
what is the bacteria flora in chronic gingitus in childre
flora similar to those in adults
gram+ rods and cocci
gram - anaerobic rods and spirochetes
what can make chronic gingivitis worse
exfoliating teeth
malocclusion
presence of orthodontic applicances
challenged to toothbrushing
reteroclined teeth in cleft like and palate patients
abnormalities of tooth morphology
orthodontic applicances
sensitive teeth - amelogenesis imperfect
learning disabilites
physical disabilities e.g. cerebral palsy
what is another name for localised gingival recession
stilmans cleft
localised gingival recession
usually labial to lower incisors
associated with misaligned teeth, self inflicted injury, tooth brushing habits
what is gingival hyperplasia
gingival overgrowth
what drugs can induce gingival hyperplastia (i.e. drug induced)
Pheytoin
cyclosporin
nifedepine
pheytoin
anti epileptic
cyclosporin
immunosuppressant
inhibits T lymphocyte proliferation
effects of fibroblasts promoting protein synthesis and collagen formation
nifedepine
calcium channel blocker
what is cylcosporin used for
- used mainly to prevent graft rejection
gingival hyperplasia as a systemic disease
sarcoid
cyclic neutropenia
sarcoid gingival hyperplasa
tubrercular cells laid down
interdental papilla overgrown
cyclic neutropenai
can be inherited
very immunocomprised
leads to gingival overgrowht
types of traumatic gingival injury (self inflicted injury)
type A
B
C
what is type A traumatic gingival injury
injuries are superimposed upon a pre existing source of irritation e.g. exfoliating tooth
type B traumatic gingival injury
injuries are secondary to another established habit e.g. biting nails
Type C traumatic gingival injury
injuries are complex aetiology and are a physical manifestation of underlying emotions disturbance
resistance to conventional treatment
acute gingival conditions and infections
1) Acute herpetic gingivostomatitis
2) Necrotising ulcerative gingivitis
3) hand foot and mouth
4) Herpengina
acute herpetic gingivostomatitis
HSV type I infection
can present as subclinical infection i.e. under the weather
5-7 incubation period before symtoms
sign/symtoms of AHGS
high temperature (pyrexia) lymphadenopathy malaise and irritability profuse salivation refusal to eat sore throat and mouth symtoms for 7-10days
clinical features of acute herpetic gingivostomatic (AHGS)
small irregualr ulcers on gingiva tongue and palate erthyematous gingiva occasional extraoral lesions salivation lympathdenopathy
what can acute herpetic gingivasomatis recurre as
herpes labialise in 30%
management of AHGS
fluids and soft diet(don’t get dehydrated)
analgesics and antipyrexics
isolation of drinking and eating materials
OH improvement- chlorhexidine and sponges, soft toothbrish
not acylovir (antivirals)unless immunocompromised
necrotiising ulcerative gingivitis and periodontiss
necrosis and ulceration (interdental papilla bleed profusely, distinctive hallitosis)
broad anarobic infection
treatment wit OH, hydrogen peroxide mouthwash, metronidazole 3 day
cancrum orbis
starts in the mouth
can necrosis soft tissues too
systemic conditions that may present with gingival changes e.g. bleeding, ulceration
HIV chrons disease leukaemia langerhans cell histocytosis scurvy
langerhams cell histocytosis
aggressive
proliferation of histocytes
multisystem condition
periodontal disease subheadings
aggressive periodontitis
chronic periodontits
with systemic disease/gentic conditions
clinical features of aggressive PD disease in children
tooth mobility/drifiting
periodontal abcess
rapid periodontal attatchnt loss
healthy apart from periodontis
bacteria common in aggressive PD
a actinomycetescomitans
p gingivalis
body deformities with PD (Ie immune system issues)
phagocyte abno
hyperrepsonsive macrophage phenotype
management of periodontal diseas
standard mechanical periodontal therapy
systemic or local drug therapy
maintenance therapy
periodontal surgery
what can be used to treat PD
metronidazole and amoxycillin 1 week
systemic or genetic conditions where PD is exacerbated
- insulin dependant diabetes
- down syndrome
- papillion lefevre syndrome
- enlers danlos syndrome
- Langerhans cell histiocytosis
- neutropenia
- hypophosphatasia (abnormal cementum)
