Paediatric Periodontology Flashcards
what is periodontal health?
a state
- free from inflammatory periodontal disease
- allows normal individual function
what is a healthy periodontium in children?
- absence of gum inflammation and calculus
- no more than 1 sextant with plaque
what are some features of a healthy periodontium in children?
- gingival margin several millimeters coronal to the CEJ
- Gingival sulcus 0.5mm-3mm deep on fully erupted tooth
how can a child have reduced periodontium without having periodontitis?
- crown lengthening surgery
- recession
What is clinical presentation of periodontal health?
BPE screening
less than 10% BoP
What are the types of gingival conditions? (2 types)
- Plaque biofilm-induced gingivitis
- (intact periodontium)
- (reduced periodontium) - non plaque biofilm-induced gingivitis/gingival lesions
what is plaque biofilm-induced gingivtis?
- supragingival plaque accumulation on teeth, inflammatory cell infiltrate develops
- junctional epithelium becomes disrupted
- allows apical migration of plaque and increase in gingival sulcus depth
what is non-dental biofilm-induced gingivitis/gingival lesion?
can be:
- genetic
- infective
- manifestations of systemic disease
- drug induced
what is necrotising gingivitis and what are its features?
Necrotising = death of tissues
- pain
- necrosis of interdental papillae
- ulceraction, bleeding
- fever
what are the predisposing factors (local risk factors) for periodontium health?
malocclusion (instanding/rotated teeth)
traumatic dental injury (damage to PDL etc)
dental plaque-biofilm retentive factors (overhangs, ortho appliances, teeth defects, reduced pt saliva)
what are the modifying factors (systemic risk factors) for periodontium health?
- smoking
- metabolic factors (diabetes type 1)
- pharmacological
- nutritional factors (Vit C deficiency)
- increase in sex steroids
- haematological conditions (leukaemia)
what can be some causes of gingival overgrowth?
- systemic and metabolic diseases
- genetic factors
- local factors
- some medication side effects (calcium channel blockers, cyclosporin)
what are some treatments for children with gingival overgrowth?
- rigorous home care
- frequent appointments for PMPR
- maybe surgery
what would you do in a case of gingival enlargement, inflammation, bleeding, tooth mobility where the extent of the condition is inconsistent with level of oral hygiene observed?
consider urgent referral to physician - haematinic screening
describe periodontitis
- chronic multifactorial inflammatory disease
- associated with dysbiotic (microbial imbalance) plaque biofilm
- characterised by progressive destruction of tooth supporting apparatus
what are the 4 main distinguishing features of periodontitis?
- apical migration (of junctional epithelium beyond CEJ)
- loss of attachment (of periodontal tissues to cementum)
- transformation of junctional epithelium to pocket epithelium (often thin and ulcerated)
- alveolar bone loss
what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?
- polyphyromonas gingivalis
- prevotella intermedia
what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?
- polyphyromonas gingivalis
- prevotella intermedia
what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?
- polyphyromonas gingivalis
- prevotella intermedia
what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?
- polyphyromonas gingivalis
- prevotella intermedia
how do you diagnose periodontitis?
- Staging
- Grading
- Current perio status (stable, unstable, remission)
- Risk
what are some features of molar incisor pattern perio in adolescents?
- rapid attachment loss and bone destruction
Not common however
when can a patient present with periodontitis as a manifestation of a systemic disease?
- neutropenias
- down syndrome
- hypophosphatasia
- langerhans’ cell histiocytosis (LCH)
etc
how do you record routine periodontal screening?
- Gingival condition
- Assess OH status
- Assess if any calculus present
- Local risk factors
what is a simplified BPE and its codes?
used in children on teeth
16, 11, 26, 36, 31, 46
0-2 in 7-11 yrs
0-4 in 12-17 yrs
then use BSP flowchart for what to do with each code and diagnosis
what are the benefits of bleeding/plaque charts for paeds patients?
can be motivational
in a 12-17 year old, what should you do if theres a code 3 or 4?
6PPC (localised if 3, fmpc if 4)
check alveolar bone levels (BW posterior, periapicals anterior, opg if more)
what are some oral health messages for improved periodontal health?
- affective brushing
- fluoride advice
- smoking cessation
- oral health improvement measures
what are the treatment and recall measures for simplified BPE in paeds patients?
0 - no treatment, check again after 1 year
1 - OHI, check again after 1 year
2 - OHI, PMPR, plaque retentive factors removal, check 6 months
3 - PMPR, plaque retentive factors, OHI, pocket chart. 3 months review
4 - unusual in paeds, FMPC, PMPR, possible perio referral
