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AU '18 - Peds III exam III > Perio in Pediatrics > Flashcards

Perio in Pediatrics Flashcards

1
Q

gingivitis

A
  1. inflammation of gingival tissues

2. no loss of attachment or bone

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2
Q

what causes gingivitis?

A

occurs in response to plaque bacteria

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3
Q

clinical signs of gingivitis

A
  1. erythema
  2. BoP
  3. edema
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4
Q

T/F: it is common for gingivitis to occur in early primary dentition

A

false, uncommon

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5
Q

why is it uncommon to have gingivitis in early primary dentition?

A

young children have…

  1. less plaque than adults
  2. less reactive to plaque
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6
Q

50% of young children have gingivitis by what age?

A

4-5 yrs

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7
Q

what percent of children have gingivitis at puberty?

A

almost 100%

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8
Q

T/F: prevalence of gingivitis declines after puberty and stays constant into adulthood

A

true

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9
Q

T/F: some children exhibit severe gingivitis at puberty

A

true

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10
Q

what is the peak prevalence of puberty gingivitis?

A

10 yrs in girls

13 yrs in boys

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11
Q

puberty gingivitis

A

gingiva enlarged with granulomatous changes similar to pregnancy

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12
Q

what is puberty gingivitis related to?

A

increases in steroid hormones

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13
Q

local factors for gingivitis

A
  1. crowded teeth
  2. ortho appliances
  3. mouthbreathing
  4. erupting primary and permanent teeth
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14
Q

tx of gingivitis

A
  1. improve OH

2. appropriately sized toothbrush

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15
Q

T/F: gingivitis is reversible

A

true

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16
Q

why is flossing not a practical tx for children with gingivitis?

A

b/c parental assistance still needed especially under 8-10 yrs

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17
Q

longstanding gingivitis can lead to what?

A

chronic inflammatory gingival enlargement

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18
Q

common sites for chronic inflammatory gingival enlargement

A
  1. around ortho appliances

2. areas chronically dried by mouthbreathing

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19
Q

clinical features of chronic inflammatory gingival enlargement

A
  1. interdental papillae and marginal gingiva enlarged
  2. tissue usually erythematous and bleeds easily
  3. tissue may be soft, friable with a smooth, shiny surface
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20
Q

chronic inflammatory gingival enlargement may slowly resolve when what?

A

when adequate plaque control is instituted

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21
Q

chronic inflammatory gingival enlargement may require what?

A

gingivectomy

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22
Q

drugs that cause drug-induced gingival overgrowth

A
  1. phenytoin
  2. cyclosporine
  3. Ca2+ channel blockers
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23
Q

phenytoin

A

anti-convulsant

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24
Q

cyclosporine

A

immunosupressant for host rejection of transplanted organs and autoimmune diseases

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25
Q

Ca2+ channel blockers

A

cardiac drugs to control hypertension

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26
Q

clinical features of drug-induced gingival overgrowth

A
  1. fibrous, firm and pale pink w/ little tendency to bleed
  2. occurs slowly
  3. may cover and interfere w/ eruption or occlusion
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27
Q

where does drug-induced gingival overgrowth occur first and eventualyl spread to?

A

first in papilla and spreads to gingival margin

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28
Q

T/F: drug-induced gingival overgrowth may improve or resolve when med discontinued

A

true

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29
Q

T/F: there is a genetic component to susceptibility of drug-induced gingival overgrowth

A

true

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30
Q

severity of drug-induced gingival overgrowth is affected by what?

A
  1. adequacy of oral hygiene

2. gingival concentration of the med

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31
Q

T/F: if med cannot be discontinued or changed for pts with drug-induced gingival overgrowth then the overgrowth can be surgically removed but will recur

A

true

32
Q

how can tissue from drug-induced gingival overgrowth be removed?

A
  1. gingivectomy

2. flap w/ internal bevel

33
Q

when is surgery indicated for pts with drug-induced gingival overgrowth?

A
  1. appearance is unacceptable to pt
  2. overgrowth interferes with comfortable fxn’ing
  3. overgrowth has produced perio pocket that cannot be maintained
34
Q

most severe cases of gingival overgrowth seen in pts with intellectual disabilities are due to what?

A

poor OH

35
Q

teeth erupt through existing band of what?

A

keratinized gingiva

36
Q

T/F: width of band of keratinized gingiva and relationship to teeth changes very little during subsequent growth and development

A

true

37
Q

deflections in path of eruption due to crowding or over-retention of primary teeth may result in what?

A

narrowed band of attached gingiva

38
Q

when is development and defects of attached gingiva common?

A

when mand incisors erupt labial to alveolar ridge

39
Q

if band of attached gingiva narrow, small loss of attachment results in what?

A

mucogingival defect (pocket depth exceed width of keratinized gingiva)

40
Q

T/F: recession may occur rapidly if there is a defect in attached gingiva

A

true

41
Q

T/F: gingival architecture makes labially erupted teeth difficult to clean, even more so after recession

A

true

42
Q

loss of attachment and recession sometimes termed what?

A

“stripping”

43
Q

what other factors may contribute to recession?

A
  1. use of smokeless tobacco

2. habit-related self-induced injury

44
Q

tx of mucogingival defect

A
  1. gingival graft to stabilize and replace labial keratinized gingiva
  2. ortho movement of back onto alveolar ridge may produce increase in attached gingiva and place tooth in periodontally more stable position
45
Q

when mucogingival defect not severe, best to postpone grafting after what?

A

ortho tx

46
Q

maxillary frenum penetrating incisive papilla is often accompanied by what?

A

large midline diastema

47
Q

maxillary frenum penetrating incisive papilla is common finding in who?

A

children

48
Q

traumatic forces on the facial attached gingiva of maxillary frenum penetrating incisive papilla will cause what?

A

loss of papilla… LOOK FOR BLANCHING

49
Q

tx of maxillary frenum penetrating incisive papilla should be delayed until when?

A

until permanent incisors and cuspids erupted to allow natural closure of diastema

older child = better cooperation

50
Q

T/F: for pts with prominent max frenum, if ortho tx planned, postpone surgical tx until diastema has closed

A

true

51
Q

normal maxillary frenum

A
  1. diastema normal during transitional dentition
  2. no blanching of papilla
  3. tip of papilla will fill embrasure
52
Q

ankyloglossia or “tongue-tie”

A

restricted tongue movement

53
Q

T/F: restricted lingual frenum common in children

A

true

54
Q

restrictive lingual frenum causes problems with what?

A
  1. speech

2. feeding

55
Q

tx is indicated for children with restrictive lingual frenum when tongue cannot what?

A

be protruded or touch the upper alveolar process

56
Q

tx for restrictive lingual frenum

A

simple frenotomy

57
Q

T/F: infant surgeries to improve latching and feeding controversial

A

true

58
Q

T/F: evidence for surgery to improve speech very limited

A

true

59
Q

what percent of 14-17 y.o.s have attachment loss of ≥2mm at ≥1 sites?

A

20%

60
Q

when does chronic periodontitis has incipient beginning?

A

in adolescence

61
Q

T/F: chronic periodontitis responds well to oral hygiene measures

A

true

62
Q

when is chronic periodontitis more easily arrested?

A

in early stages when attachment loss is minimal and deep pockets have not formed

63
Q

what is a major risk factor for chronic periodontitis?

A

smoking

64
Q

T/F: smoking status of pts with chronic periodontitis should be determined as part of perio assessment for young pts and counseling provided

A

true

65
Q

localized aggressive periodontitis (LAP)

A

characterized by loss of attachment and bone around permanent incisors and 1st permanent molars

66
Q

attachment loss in children with localized aggressive periodontitis is occurring at what rate of adult onset disease?

A

3x

67
Q

when is localized aggressive periodontitis (LAP) detected?

A

in early adolescence

68
Q

when might localized aggressive periodontitis (LAP) be noticed?

A

after mild trauma luxates tooth

69
Q

prevalence of localized aggressive periodontitis (LAP)

A

~1% of US

70
Q

localized aggressive periodontitis (LAP) is most commonly seen in what population?

A

African-American population

71
Q

T/F: some localized aggressive periodontitis (LAP) cases appear to be inherited as an autosomal dominant trait

A

true

72
Q

what is localized aggressive periodontitis (LAP) linked to?

A
  1. neutrophil chemotactic defect

2. presence of high numbers of Aggregatibacter actinomycetemcomitans (AA)

73
Q

successful tx of localized aggressive periodontitis (LAP) is correlated with what?

A

eradication of bacteria

74
Q

T/F: localized aggressive periodontitis (LAP) is self-limiting

A

true

75
Q

tx for localized aggressive periodontitis (LAP)

A

SRP combined w/ systemic abx therapy and monitoring

76
Q

systemic abx choices for tx’ing localized aggressive periodontitis (LAP)

A
  1. tetracyclines
  2. metronidazole alone or in combo w/ amoxicillin appears to be more effective
  3. newest therapy azithromycin

AU '18 - Peds III exam III (12 decks)

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