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BDS 3 - CDS - Paediatric Dentistry > Paediatric Periodontology > Flashcards

Paediatric Periodontology Flashcards

1
Q

what is periodontal health?

A

a state
- free from inflammatory periodontal disease
- allows normal individual function

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2
Q

what is a healthy periodontium in children?

A
  • absence of gum inflammation and calculus
  • no more than 1 sextant with plaque
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3
Q

what are some features of a healthy periodontium in children?

A
  • gingival margin several millimeters coronal to the CEJ
  • Gingival sulcus 0.5mm-3mm deep on fully erupted tooth
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4
Q

how can a child have reduced periodontium without having periodontitis?

A
  • crown lengthening surgery
  • recession
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5
Q

What is clinical presentation of periodontal health?

A

BPE screening
less than 10% BoP

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6
Q

What are the types of gingival conditions? (2 types)

A
  1. Plaque biofilm-induced gingivitis
    - (intact periodontium)
    - (reduced periodontium)
  2. non plaque biofilm-induced gingivitis/gingival lesions
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7
Q

what is plaque biofilm-induced gingivtis?

A
  • supragingival plaque accumulation on teeth, inflammatory cell infiltrate develops
  • junctional epithelium becomes disrupted
  • allows apical migration of plaque and increase in gingival sulcus depth
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8
Q

what is non-dental biofilm-induced gingivitis/gingival lesion?

A

can be:

  • genetic
  • infective
  • manifestations of systemic disease
  • drug induced
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9
Q

what is necrotising gingivitis and what are its features?

A

Necrotising = death of tissues

  • pain
  • necrosis of interdental papillae
  • ulceraction, bleeding
  • fever
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10
Q

what are the predisposing factors (local risk factors) for periodontium health?

A

malocclusion (instanding/rotated teeth)

traumatic dental injury (damage to PDL etc)

dental plaque-biofilm retentive factors (overhangs, ortho appliances, teeth defects, reduced pt saliva)

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11
Q

what are the modifying factors (systemic risk factors) for periodontium health?

A
  • smoking
  • metabolic factors (diabetes type 1)
  • pharmacological
  • nutritional factors (Vit C deficiency)
  • increase in sex steroids
  • haematological conditions (leukaemia)
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12
Q

what can be some causes of gingival overgrowth?

A
  • systemic and metabolic diseases
  • genetic factors
  • local factors
  • some medication side effects (calcium channel blockers, cyclosporin)
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13
Q

what are some treatments for children with gingival overgrowth?

A
  • rigorous home care
  • frequent appointments for PMPR
  • maybe surgery
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14
Q

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?

A

consider urgent referral to physician - haematinic screening

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15
Q

describe periodontitis

A
  • chronic multifactorial inflammatory disease
  • associated with dysbiotic (microbial imbalance) plaque biofilm
  • characterised by progressive destruction of tooth supporting apparatus
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16
Q

what are the 4 main distinguishing features of periodontitis?

A
  • 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
17
Q

what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?

A
  • polyphyromonas gingivalis
  • prevotella intermedia
18
Q

what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?

A
  • polyphyromonas gingivalis
  • prevotella intermedia
18
Q

what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?

A
  • polyphyromonas gingivalis
  • prevotella intermedia
19
Q

what are some of the pathogens that can be found in the subgingival microflora of patients with periodontitis?

A
  • polyphyromonas gingivalis
  • prevotella intermedia
20
Q

how do you diagnose periodontitis?

A
  1. Staging
  2. Grading
  3. Current perio status (stable, unstable, remission)
  4. Risk
21
Q

what are some features of molar incisor pattern perio in adolescents?

A
  • rapid attachment loss and bone destruction
    Not common however
22
Q

when can a patient present with periodontitis as a manifestation of a systemic disease?

A
  • neutropenias
  • down syndrome
  • hypophosphatasia
  • langerhans’ cell histiocytosis (LCH)

etc

23
Q

how do you record routine periodontal screening?

A
  1. Gingival condition
  2. Assess OH status
  3. Assess if any calculus present
  4. Local risk factors
24
Q

what is a simplified BPE and its codes?

A

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

25
Q

what are the benefits of bleeding/plaque charts for paeds patients?

A

can be motivational

26
Q

in a 12-17 year old, what should you do if theres a code 3 or 4?

A

6PPC (localised if 3, fmpc if 4)
check alveolar bone levels (BW posterior, periapicals anterior, opg if more)

27
Q

what are some oral health messages for improved periodontal health?

A
  • affective brushing
  • fluoride advice
  • smoking cessation
  • oral health improvement measures
28
Q

what are the treatment and recall measures for simplified BPE in paeds patients?

A

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

BDS 3 - CDS - Paediatric Dentistry (8 decks)

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