Necrotising Periodontal Disease Flashcards
If a patient has necrotising periodontitis, what are their usual complaints?
Painful Gums
Bleeding Gums
Bad Breath
Unpleasant Taste
What are the characteristics of necrotising periodontitis?
- Ulceration of papillae which may extend to the gingival margin
- Necrotising (Dead) fibrinous slough covering ulcers
- Gingival bleeding under gentle probing
- Redness around margin of lesions
- Presence of plaque
Is necrotising periodontitis contagious?
Yes
What are the predisposing conditions to getting necrotising periodontitis?
1) Moderate plaque and a reduced host response
2) Certain bacteria present e.g. fusobacterium and sprirocheates
3) Acute inflammatory cells, plasma cells and lymphocytes
What are the risk factors that a patient may have to getting necrotising periodontitis?
- Pre-existing periodontal inflammation
- Frequently young people
- Reduced host defence: smokers, stress
- Immunocompromised (leukaemia, HIV infection)
- Malnutrition
What are the two main complications of NPD?
Candrum oris: highly destructive due to infection out of the gingiva
HIV: more frequent and show faster progression with necrotising periodontitis, NPD may be the first sign of AIDS,
What are the main complications that can occur with HIV patients with periodontal disease?
Increase in chances of malignant lesion including T cell lymphoma and Kapsosis sarcoma.
Can in combination with other conditions lead to Atrophic candidasis or black hair tongue
How do we manage a patient with NPD?
History: look for any smoking or immune compromising conditions
Examination: look for disease extent, any local factors, other oral diseases such as candidiasis, check for lymph node swellings
Treatment: antibiotics (metrondiazole 400mg 3-5 days except in pregnant women, alcoholics or liver disease patients), advice patient abut smoking, use chlorhexidine mouthwash to reduce plaque, do debridement if comfortable, regularly review this patient
