Gingivitis And Perio In Children

Question 1

Gingival conditions in children (TRAMPSAD)

Answer 1

Simple gingivitis due to trauma

Chronic plaque associated gingivitis

ANUG

Medication induced

Desquamative

Allergic

Associated with systemic disease

Gingival recession

Question 2

Causes of simple gingivitis in children

Answer 2

Tooth brush trauma, foreign body in gum

Question 3

What is juvenile spongiosum gingival hyperplasia

Answer 3

Localised. Red bumps on gingiva, happens a lot in erupting teeth. Painless gingival swelling.

Hyperplasia of non keratinised non stratified squamous epithelium

Unclear aetiology, only happens in children

Monitor

Question 4

Etiology of ANUG

Answer 4

Poor OH, nutritional deficiencies, medical conditions

Question 5

Clinical appearance of ANUG

Answer 5

Punched out appearance due to ulcerated and necrotic papilla and gingival margins

Question 6

Medication induced gingival condition (gingival enlargement) is caused by which drugs

Answer 6

Phenytoin (anti epileptics)
Cyclosporine (post transplant)
Nefidipine (calcium channel blocker)

Question 7

Management of medication induced gingival conditions

Answer 7

Alternative drugs eg tacrolimus replace cyclosporine

Improve oral hygiene, enlargement is a reaction to plaque

Question 8

HSV affects what type of tissue in desquamative gingivitis

Answer 8

Keratinised tissue

Question 9

Systemic conditions associated with gingivitis in children

Answer 9

Leukemia
Lymphoma
Aplastic anemia (no plaque but a lot of bleeding)
HIV (linear gingival erythema)

Question 10

Causes of gingival recession in children

Answer 10

Traumatic occlusion

Orthodontic teeth movement — eg move too far forward,move to place with no bone, never clean well\

High frenal attachments

Question 11

Types of periodontal conditions in children

Answer 11

Early onset/juvenile periodontitis
Periodontitis associated with systemic disease
Unusual periodontal conditions eg hypophosphatasia, langerhan cell histiocytosis

Question 12

Characteristics of juvenile periodontal disease

Answer 12

affect incisors and molars (permanent teeth)
aggressive
6-7 years old
no systemic component (unlike periodontitis in bab teeth)

Question 13

systemic diseases associated with periodontitis

Answer 13

White blood cell conditions eg cyclic neutropenia, chronic idiopathic neutropenia, leukocyte adhesion deficiency

genetic conditions eg chediak higashi, papillon lefevre

endocrine disorders eg DM

HIV

Question 14

symptoms of papillon lefevre syndrome

Answer 14

palmar hyperkeratosis
severe early onset periodontitis
calcification of falx cerebri

Question 15

what is hypophosphatasia

Answer 15

metabolic disorder characterised by deficit of alkaline phosphatase necessary for mineralisation of tissue

cementum affected. teeth become loose and and are prematurely lost with no root resorption

Question 16

premature eruption of canine, molar in a child below age of 1 –> i might be suspicious of?

Answer 16

langerhan cell histiocytosis. abnormal proliferation of bone marrow derived histiocutes