Perio Flashcards
How can you explain acute necrotising gingivitis to a pt?
This is a rare condition presenting as an acute form of gum disease
This means that the gum disease develops much faster and more severely than normal gum
It can be caused by a variety of reasons but it tends to cluster in people who are stressed, smokers and poorly nourished - poor OHI, stress, smoking, immunocompromised, malnourished
It can be made worse by high plaque levels due to poor brushing
What are the symptoms of acute necrotising gingivitis?
Bleeding
Painful gums
Painful ulcers
Receding gums in between your teeth
Bad breath
Metallic taste in your mouth
Excess saliva in the mouth
Difficulty speaking or swallowing
Disease can also extend away from the mouth and cause systemic symptoms like swollen LNs or fever
How is acute necrotising gingivitis managed?
Reassure as it can be managed by local measures - OHI, subgingival PMPR under LA, 0.2% CHX mouthwash
Smoking cessation
Stress reduction
Antibiotics if systemic
Recommend optimal analgesia
Advise register with GDP
Review within 10 days
Referral if no changes on review
What should be compared between pre- and post-treatment pocket charts?
Missing teeth - identify cause
Gingival margin - shows recession
Probing deaths - indicator of tx difficulty
Loss of attachment - indicator of disease severity
Bleeding on probing - indicator of disease activity
Furcation - involvement indicator of tx difficulty
Mobility - gives rise to symptoms, poorer prognosis
Reasons for failure
What are the reasons for perio tx failure?
Smoking
Pt not compliant - poor OH
Inability for pt to practice OH effectively:
- hard to reach areas - furcations, lone standing teeth
- poor manual dexterity - dementia, Parkinson’s, age
Systemic factors - stress, diabetes, pregnancy, malnutrition, poor diet
Difficulty accessing for instrumentation, inadequate instrumentation - time constraint, pt cannot tolerate, operator error
Iatrogenic factors - overhangs, poor margins
What special investigations should be carried out for a periodontal abscess?
PA radiograph
Sensibility testing
What are the signs of a periodontal abscess?
Swelling
Pocket with pus
Bone loss from radiograph
How are periodontal abscesses treated?
Irrigate through pocket
Instrumentation
Warm salt mouthwash
Only antibiotics if systemic
