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4th Yr- CCD2-Clinical > Periodontal disease and adolescents and children > Flashcards

Periodontal disease and adolescents and children Flashcards

1
Q

Name a key differenence between the 1999 terminology of periodontal disease and the new 2017 upgrade

A

Chronic and aggressive periodontitis no longer exist

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2
Q

What has chronic and aggressive been replaced with

A

Necrotising periodontitis
Periodontitis as a direct manifestation of systemic disease
Periodontal staging and grading

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3
Q

Name the periodontal disease most common in children

A

Gingivitis

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4
Q

What would you expect to see in a patient with dental biofilm induced gingivitis

A
  1. False gingival pockets- 5mm deep
  2. No bone loss
  3. Inflamed gingiva
  4. Normal sulcus depth 2mm
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5
Q

What do we mean by false pocketing

A

There is no attachment loss

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6
Q

Name the 3 groups dental biofilm induced gingivitis is split into

A
  1. Associated with dental biofilm alone
  2. Mediated by systemic or local risk factors
  3. Drug influenced gingival enlargement
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7
Q

List some local contributing factors to gingivitis

A
  1. Lack of saliva
  2. Tooth anatomical features
  3. Dental restorations/ appliances
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8
Q

Talk through some local risk factors for dental biofilm induced gingivitis

A
  1. High fraenal attachment
  2. Fixed orthodontic appliance
  3. Incompetent lips, mouth breather, lack of saliva
  4. Amelogenisis imperfecta- calculus
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9
Q

List some systemic risk factors for dental biofilm induced gingivitis

A
  1. Smoking
  2. Metabolic factors (hyperglycaemia)
  3. Nutritional (vit C deficiency)
  4. Pharmacological
  5. Sex hormones eg puberty, pregnancy
  6. Haematological conditions
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10
Q

List some drugs that can contribute to gingival enlargement

A
  1. Phenytoin (epilepsy)
  2. Ciclosporin (Immunosuppresent after organ transplant)
  3. Calcium channel blocker
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11
Q

Give examples of calcium Chanel blockers

A

Nifedipine

Diltiazem for heart problems

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12
Q

What is phenytoin taken for

A

Epilepsy

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13
Q

What is cyclosporin taken for

A

It is an immunosuppressant used to prevent organ rejection following a transplant

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14
Q

What can cause non dental biofilm induced gingivitis

A
  1. Genetic/ developmental disorder
  2. Specific infections
  3. Inflammatory and immune conditions
  4. Reactive processes
  5. Neoplasms
  6. Endocrine, nutritional and metabolic disease (scurvy)
  7. Trauma
  8. Gingival pigmentation
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15
Q

Give an example fo a genetic/ developmental disorder that can lead to gingival disease

A

Hereditary gingival fibromatosis

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16
Q

Give examples of trauma that can contribute to gingival disease

A
  1. Fingernail picking

2. Cocaine induced necrosis

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17
Q

Give examples of viral condition that can lead to non dental biofilm induced gingivitis

A
  1. Herpetic gingivostomatitis
  2. Herpes simplex virus 1
  3. Molluscum contagiosa (pox virus)
  4. Chicken pox
  5. Viral wart from child finger
  6. Herpangina (coxasckie virus)
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18
Q

Give examples of fungal condition that can lead to non dental biofilm induced gingivitis

A
  1. Histoplasmosis

2. Linear gingival erythema

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19
Q

Describe histoplasmosis

A
  1. Deep mycoses seen mostly in young children following bone marrow rejection or the severely immunocompromised
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20
Q

What is histoplasmosis

A

An opportunistic infection with fungal organism histoplasma capsulatum which can lead to gingival necrosis

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21
Q

What is Linear gingival erythema associated with

A

HIV

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22
Q

Give examples of inflammatory and immune conditions that can lead to gingival lesions

A
  1. Lichen Planus (rare in children)

2. Granulomatous inflammatory

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23
Q

When does gingivitis peak in children

A

Puberty

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24
Q

In the 2013 child dental health surgery which age group had the highest levels of plaque

A

8 year olds (7 in 10 had plaque)

25
Q

Is inflammation a threat to patients

A

YES as teeth with consistent inflamed gingiva have showed greater clinical attachment loss and tooth loss over 26 yr observation

26
Q

What pattern of gingivitis is seen in children

A

Molar incisor pattern

27
Q

What is molar incisor pattern periodontitis

A

When first molar and incisors are affected by CAL and bone loss

28
Q

What is the systemic disease/ conditions affecting the periodontal supporting tissue category further split into

A
  1. Systemic disorder that have a major impact on loss of periodontal tissue (due to inflammation)
  2. Other systemic disorders that influence pathogenesis of periodontal disease
  3. Systemic disorders that can result in loss of periodontal tissue independent of periodontitis
28
Q

Give examples of systemic disorders that have a major impact on loss of periodontal tissue by influencing periodontal inflammation

A
  1. Genetic disorders
  2. Diseases affecting oral mucosa and gingival tissue
  3. Disease affective connective tissue
  4. Metabolic and endocrine tissues
29
Q

Give examples of GENETIC DISORDERS systemic disorders that have a major impact on loss of periodontal tissue by influencing periodontal inflammation

A
  1. Downs syndrome
  2. Leukocyte adhesion deficiency syndrome
  3. Papllion lefevre syndrome
  4. Severe neutropenia
30
Q

What causes downs syndrome

A

Trisomy of chromosome 21

31
Q

Describe how periostitis might present in a patient with downs syndrome

A
  1. Destructive periodontitis
  2. Primary and permanent dentition affected
  3. Tendency for shorter roots and early tooth loss
  4. Neutrophil defects affecting host immune response
32
Q

What is pavilion lefevre syndrome

A

Rare condition characterised by palmar plantar hyperkeratosis

33
Q

What is neutropenia

A

Low number of neutrophils

34
Q

Give an examples of a disease that affects the oral mucosa and gingival tissue leading to gingival inflammation

A

Epidermolysis bullosa

35
Q

Give an examples of a disease that affects the connective leading to gingival inflammation

A
  1. Ehlers danlos
  2. Angioedema
  3. Systemic lupus erythematous
36
Q

Give an examples of a metabolic or endocrine disorder leading to gingival inflammation

A
  1. Glycogen storage disease

2. Hypophosphatasia

37
Q

Give examples of conditions that can lead to periodontitis as a manifestation of systemic disease

A
  1. Hypophosphatasia (childhood)
38
Q

What is hypophosphatasia

A

A rare hereditary enzymopathy that leads to defective mineralisation of skeletal and dental tissue, lower serum alkaline phophatase and early exfoliation of teeth

39
Q

What are necrotising periodontal diseases split into

A
  1. Necrotising periodontal diseases in chronically, severely compromised patients
  2. Necrotising periodontal disease in temporary and or moderately compromised patients
40
Q

Describe necrotising periodntla disease

A
  1. Caused by fusiform spirochaetes
  2. Painful, bleeding gingiva
  3. Punched out papillae
41
Q

What is gingivitis in children associated with

A

Severely immunocompromised and/or malnutrition

42
Q

What are abscesses of the periodontium split into

A
  1. Periodontal abscess in a periodontitis patient

2. Periodontal abscess in a non periodontitis patient

43
Q

What can periodontal abscess be caused by

A
  1. Periodontitis
  2. Orthodontic factors
  3. Impaction
  4. Harmful habits or tough toothbrush bristles
44
Q

What is recession

A

Apical migration of gingival tissues

45
Q

What does gingival recession with a normal sulcus relate to

A
  1. Anatomy
  2. Tooth positon
  3. Orthodontic tooth movement
  4. Trauma
  5. Plaque retenions factors
46
Q

What does gingival recession with pockets relate to

A
  1. Periodontal disease

2. Smoking

47
Q

Before coming up with a treatment plan what steps do we go through

A
  1. History
  2. Examination including special tests
  3. Diagnosis
  4. Treatment plan
48
Q

What is treatment plan split into

A
  1. Initial
  2. Corrective
  3. Supportive
49
Q

Name a common periodontal screening tooth

A

Basic periodontal Examination (BPE)

50
Q

In children what type of BPE do we carry out

A

Simplified BPE

51
Q

Talk through the simplified BPE

A
  1. Only index teeth recorded
  2. BPE codes of 0,1,2 used in 7-11
  3. Full range BPEs used in 12+
52
Q

Which teeth are the index teeth in. simplified BPE

A

UR6 UR1, UL6

LR6, LR1, LL6

53
Q

What does initial therapy include

A
  1. OHI
  2. Smoking cessation
  3. Professional cleaning
  4. Extract teeth with hopeless diagnosis
  5. Monitor response
54
Q

Talk through what corrective therapy can include

A
  1. More non-surgical periodontal therapy
  2. Periodontal surgery
  3. Adjunctive antibiotics
  4. Restorative work
  5. Orthodontics
  6. Restore function and aesthetics
55
Q

What can supportive therapy include

A
  1. Recall at appropriate intervals
  2. Monitor periodontal status
  3. Re motivate/ re educate child and parent
  4. Repeat OHI
  5. Re treat
  6. Monitor
55
Q

What can supportive therapy include

A
  1. Recall at appropriate intervals
  2. Monitor periodontal status
  3. Re motivate/ re educate child and parent
  4. Repeat OHI
  5. Re treat
  6. Monitor
56
Q

When can children start brushing their teeth independently

A

After age of 7

Under this parents should help

57
Q

List factors that help us decide if we should treat or refer

A
  1. Dentist factors
  2. Patient factors
  3. Complexity of case

4th Yr- CCD2-Clinical (6 decks)

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