Periodontal Considerations Flashcards
During Puberty:
Levels of Prevotella intermedia _____________
Occurs during age _____ to _______
Estrogen/Progesterone levels ______
Gingivitis levels _________________
INCREASE
Age 11 to 14
INCREASE
INCREASE
How to manage puberty gingivitis?
1) OHI (frequent reinforcement)
2) Scaling & polishing
3) Antimicrobial mouth rinses (CHX)
4) Local/systemic antimicrobials if severe & medical history indicates need
During Pregnancy, estrogen levels are _____________, and progesterone levels are ___________
DECREASED (estrogen)
INCREASE (progesterone)
What are the adverse pregnancy outcomes (4) ?
1) Pre-term Birth
2) Low Birth Weight
3) Preeclampsia
4) Fetal Growth Restriction & Development
Menadione is an essential nutrient for ___________
P. intermedia
Menadione =
Methyl-naphthalenedione
Progesterone =
Naphthoquione
P. intermedia can substitute naphthoquione for _____________________
methyl-naphthalenedione.
Elevated progesterone levels will facilitate ________ and _________ of ____________
Growth
colonization
P. intermedia
P. Intermedia is tissue invasive and associated with _______________ and ____________ formation
Gingival inflammation
Pyogenic granuloma formation
What are the inflammatory mediators for pregnancy?
IL1, IL 6 TNF-alpha, and PGE 2
What are the Acute Phase Responses ?
1) C-reactive protein
2) Haptoglobin
3) Fibrinogen
4) Amyloid A
What are the Periodontal pathogens associated with pregnancy?
1) P. gingivalis
2) T. forsythia
3) Campylobacter rectus
4) Provetella intermedia
5) Treponema denticola
* *Endotoxins
Periodontal disease + P. i, Fusobacterium, &
Campylobacter recta —–>
Placental invasion w/ fetal exposure to bacterium, LPS, and bacterial antigens
Periodontal disease can lead to increased levels of ?
1) Inflammatory mediators (IL 1, 6, TNF-a and PGE2)
PGE2 can lead to ____________ contraction
Pre-mature uterine
Premature uterine contraction leads to what?
Pre-term low birth weight delivery
What are the primary objectives for managing periodontal disease in pregnancy ?
1) Achieve a health oral environment
2) Maintain optimal oral hygiene (patient education)
What is the effective Dental Treatment for the 1st Trimester?
No treatment/Emergency only
What is the effective Dental Treatment for the 2nd Trimester?
Safest time frame for treatment
- control active disease
- eliminate potential problems
- postpone periodontal surgery
Last month of 3rd Trimester_________________
Selective treatment
Dental radiographs in Pregnancy?
1) Lead apron
2) High speed film
3) safety established but desirable not to have irradiation during 1st trimester
4) 2008 ADA guidelines: ONLY required to aid in establishing a definitive diagnosis
Medications in Pregnancy?
1) Consult FDA classification system
2) 1-2% of material drug dose is excreted in breast milk
Avoid which drugs during pregnancy?
1) Lidocaine
2) Bupivacaine
3) Procaine
* *Use all these with caution
4) ASPIRIN (AVOID in 3rd trimester)
5) Ibuprofen (AVOID in 3rd trimester)
6) Codeine
7) Oxycodone
8) Hydrocodone
* **AVOID PROLONGED USE