Medical Conditions and the Periodontium

Question 1

what is Downs Syndrome?
oral signs?
prone to?

Answer 1

21 chromosomes.
Class III occlusion, anterior open bite, large tongue, lack of lip seal
prone to infections/perio disease

Question 2

why are downs syndrome patients susceptible to infection?

Answer 2

abnormalities in immune system. Impaired chemotaxis and phagocytosis of PMN’s

Question 3

how to treat downs syndrome patients?

Answer 3

prevention!!!

Question 4

what is hypophosphotasia?

Answer 4

Premature exfoliation of deciduous teeth because bone and cementum changes with absence of inflammation.
Loss of alveolar bone at deciduous canines and incisors.
perm dentition not affected

Question 5

what type of teeth are present in a patient with hypophospotasia?

Answer 5

shell teeth

Question 6

what is papillon levefre syndrome?

Answer 6

autosmal recessive
diffuse palmer/planter erythematous keratosis at hands/feet and premature tooth loss.
deciduous and permanent teeth affected

Question 7

in a papillon levefre patient how are the dentitions lost?

Answer 7

deciduous lost in order of eruption
permanent erupts early - progressive bone loss until teeth exfoliated - edentulous by 16
severe gingiva inflammation

Question 8

what is Ehlers-Danos syndrome?

Answer 8

inherited and affects connective tissue

excessive joint mobility/skin hyperextensibility/easy bruising and abnormal scarring.

Question 9

what could be seen orally in a patient with Ehlers Danos?

Answer 9

oral mucosa fragile and susceptible to bruising
gingival tissues bleed easily
post extraction haemorrhages
teeth fragile and fracture easily.
Type III is linked with aggressive periodontitis

Question 10

what is hereditary gingival fibromatosis?

Answer 10

singly or with other inherited conditions

autosmal dominant - affects perm dentition

Question 11

what is seen orally with hereditary gingival fibromatosis?

Answer 11

gingival tissues enlarged/hyperplasia b/c excessive collagen - localised/generalised
can completely cover crowns - may affect speech/mastication
may delay eruption

Question 12

what are mucopolysaccharides?

Answer 12

group of inherited disorders
characterised by disturbance of mucopolysaccharied production - Hunter/Hurlers syndrome
orally - teeth small/wide spaced/delayed eruption/gingival enlargement

Question 13

what may be seen in the mouth of a crohns patient?

Answer 13

apthous ulceration. Cobblestone mucosa/mucosal tags/diffuse erythematous/granular enlargement of attached gingivae

Question 14

orally what is seen with sarcoidosis?

Answer 14

swelling at parotid and cervical lymph nodes

gingivae - hyperplastic, granulomous appaearance

Question 15

oral signs of anaemia?

Answer 15

oral mucosa pallor

tongue smooth with or without apthous ulceration

Question 16

what is seen orally with aplastic anaemia?

Answer 16

gingival bleeding and infections

Question 17

what is fanconi’s anaemia?

Answer 17

aggressive periodontitis with early tooth loss

Question 18

what can be seen orally with a neutropenia?

Answer 18

oral ulceration/ severe gingivitis/profuse bleeding/rapid bone loss

Question 19

leukaemia signs in the mouth?

Answer 19

oral ulceration/petechiae/gingival enlargement/gingival bleeding/bacterial/viral/fungal infections/acute herpetic gingivostomatitis, candidiasis

Question 20

what is chedaik Higashi syndrome?

Answer 20

rare autosmal/lymphoma like, develops with a neutropenia

severe gingivitis/periodontitis, premature loss of both dentitions/not respond well to perio tx

Question 21

what is lichen planus?

Answer 21

inflammatory disease of skin and mucous membranes
oral lesions with or without skin lesions
interlacing network of white on cheeks/vestibule and gingivae

Question 22

what is erosive lichen planus?

Answer 22

seen at gingivae

most common cause of desquamative gingivitis

Question 23

what is benign mucous membrane pemphigoid?

Answer 23

disease of mucous membranes because of immunological disorder
lesion = bulla which breaks down to an ulcer - heals to scar
affects diffuse erythema/patches of desquameted epithelium

Question 24

what is pemphigus vulgaris?

Answer 24

automimmune disease
oral lesions before skin lesions
formation of bullae on any part of oral mucosa
forms in clusters
bullae - breakdown - ragged ulcers
tx - systemic corticosteroids