Perio in children Flashcards
How does periodontium differ in children?
Marginal gingival tissue sore vascular Fewer connective tissue fibres Thinner epithelia Less keratinisation Redder - often mistaken for inflammation
How can tooth eruption effect periodontium?
Localised hyperaemia (Increased blood flow) = persistent swollen papillae Eruption of permanent teeth accompanies migration of JE
What should be considered around gingival stability in children?
Gingival margin and JE continue to shift after eruption - mistaken for gingival recession
at 12 years - 1,2,3,5,6 stable
at 16 - should be stable
Effect of alveolar bone being more vascular and fewer trabecular?
Enhanced rate of progression of Periodontal disease in primary dentition
Effect of puberty in gingivitis in girls?
Oestrogen - increases cellularity of tissues
Progesterone - increase permeability of gingival vasculature
Oestradiol - supports growth of BP microbes
Drugs causing gingival enlargement?
Anti convulsants e.g. phenytoin (epilepsy)
Immunosuppressant - ciclosporin (prevent organ transplantation)
Calcium channel blocker - Nifedipine (post-transplant to reduce nephrotoxicity in ciclosporin)
How does phenytoin cause gingival enlargement?
Overproduction of collagen
How does ciclosporin cause gingival enlargement?
Unknown - stimulation of fibroblasts, increased collagen production
Management of gingival enlargement?
OH, debridement
Gingevectomy
Change medication
How can width of keratinised gingival effect health?
Narrow zone of KG = cause of recession?
Wider zone may be better to withstand inflammation and trauma
How can gingival recession effect tooth position?
In permanent incisors - may be displaced labially
When is modified BPE used?
Children under 18 years
What is modified BPE?
Uses 6’s and 1’s only
Local risks factors for Perio?
Malocclusion, trauma
plaque retentive factors
General risk factors for Perio?
Inherited condition - Ehlers danlos, papillon-lefevre syndrome
Diabetes
Smoking
How does diabetes effect perio?
Diabetes and period both inflammatory condition
upregualtion of cytokines = local damage
Treatment of periodontitis in primary dentition?
Debridement (amoxicillin)
If general rather than local may extract primary dentition to remove aggressive pathogens before secondary teeth erupt
Genetic factors contributing to aggressive Perio?
Ethnic groups
Family history
Inherited condition with leukocyte defects
List 3 systemic disorders with periodontal fetaures
Papillon-lefevre syndrome
Neutropenias
Ehlers-Danlos
Describe Papillon-lefevre syndrome
Affects immune and inflammatory response
Keratosis of plasma and gingiva
