Periodontal diseases in children and adolescents part 2 Flashcards
For coxsackie virus, state:
- What it is
- Who is most commonly affected
- How it spreads
What it is
• A mild illness caused by a number of enteroviruses, including coxsackieviruses. It is usually not a serious illness
Who is most commonly affected
• It mainly occurs in children under 10 but occur in older children and adults
How it spreads
• Spread by person-to-person contact
• The virus is spread from the faeces of an infected person to the mouth of the next person by contaminated hands
• It is also spread by secretions from the mouth or respiratory system, and by direct contact with the fluid from blisters
For coxsackie virus, state:
- Incubation period
- How it presents orally
- General signs and symptoms
- When dental treatment should commence
Incubation
• It usually takes between three and five days after contact with an infected person before blisters appear
• The viruses can remain in faeces for several weeks
How it presents orally
• Begins with blisters that begin as small red dots which later become ulcers
• Appears inside the cheeks, gums, and on the sides of the tongue, as well as on the palms of the hands and soles of the feet
• Blisters last for seven 7 to 10 days
General signs and symptoms
• Children may have a low fever, irritability, sore throat, tiredness, feel off colour and may be off their food for 1-2 days
When dental treatment should commence
• Avoid treating patients unless blisters have dried-up, and any rash (if present) has gone and any fever has settled
For primary herpetic gingivostomatitis, state:
- The causes of primary herpetic gingivostomatitis
- When it is most contagious,
Explain the causes of primary herpetic gingivostomatitis:
• Primary herpetic gingivostomatitis is a painful oral condition that results from the initial infection with the herpes simplex virus (HSV) Type 1
• In most patients, the initial HSV infection produces NO noticeable clinical signs and goes undetected
• In some patients, the initial HSV infection produces very severe oral symptoms that are known as primary herpetic gingivostomatitis
When it is most contagious:
• HSV infections are contagious during the vesicular stage as the virus is contained in the clear fluid of the vesicles
• HSV-1 is spread by direct contact through kissing, contact with open sores, or contact with infected saliva
• HSV-1 can be spread from one part of the body to another, such as from saliva to fingers, then to eye
• Touching the eye can result in a dangerous infection of the cornea of the eye (herpes keratitis)
For primary herpetic gingivostomatitis, state:
- Who is most affected
- Its signs and symptoms (5)
Who is most affected:
• Initial infection is primarily seen in children or young adults
• Initial infection can occur at any age
• In most patients, the infection does not reoccur after the initial infection
• In some patients, the HSV infection reoccurs periodically throughout life in the form of herpes labialis (“cold sores of lip”).
Its signs and symptoms (5):
• Oral pain and discomfort
• Difficulty eating and drinking
• Swollen, red, bleeding gingiva
• Painful oral ulcers on lips, palate, tongue, and gingival tissues
• If severe, will also have elevated temperature, malaise, headache, swollen lymph nodes
For primary herpetic gingivostomatitis, state:
- How secondary manifestations occur, and some examples
- A recurrent herpetic episode usually occurs in individuals with a history of herpesvirus infections by dental treatment, respiratory infections, sunlight exposure, fever, trauma, exposure to chemicals, and emotional stress
- As part of the primary infection, the virus ascends through the sensory and autonomic nerves, where it persists as latent HSV in neuronal ganglia that innervate the site
- In approximately one third of the world’s population, secondary manifestations result from various stimuli, such as sunlight, trauma, fever, and stress
- These secondary manifestations include herpes labialis, herpetic stomatitis, herpes genitalis, ocular herpes etc.
For primary herpetic gingivostomatitis, state:
- Management
- Increase water/fluid intake
- Paracetamol: 4-6 hours
- Swabbing younger children with chlorhexidine or Difflam
- Mouthwashes: older children only, chlorhexidine
- Topical anaesthetics; however can be more distressing for the younger child and lead ulceration
- Antiviral medications: Acyclovir (only in vesicular stage, mainly for immunocompromised children)
- Hospital admission may be required
- Antibiotics are unhelpful, may be used in severe cases
- Regresses approximately 2 weeks
List the oral signs of down syndrome (6)
- Open bite or class III malocclusion. The tongue may protrude and appear too large. The force of tongue greater than force of teeth causing class III malocclusion
- Microdontia
- Hypoplasia and Hypocalcification
- Congenitally missing teeth
- Delay in the eruption of dentition
- Less space in oral cavity for tongue affecting speech, mastication, and natural cleansing of teeth
Describe the biological effects of down syndrome
- Higher rate of infections due to compromised immune system and decrease in number of T cells
- Dry mouth caused by mouth breathing associated with upper respiratory infections and small nasal passage
- Higher incidence of periodontal disease
- Fissuring of tongue and lips
- Aphthous ulcers, oral candida infections, and acute necrotizing ulcerative gingivitis
Explain what type of genetic disorder papillon LeFevre syndrome is and how it manifests
- Autosomal recessive condition
* Manifests as hyperkeratosis of the palms and feet
Explain the oral side effects of papillon LeFevre syndrome
- Premature tooth loss
- Severe inflammation and bone loss
- Both deciduous and permanent teeth
- Edentulous by 16 years
Explain what cyclic neutropenia is and when its onset is and cycle is
What cyclic neutropenia is:
• Hereditary and congenital disorders that affect the bone marrow
• Can be chronic, cyclic or intermittent forms
When its onset is and cycle is:
• Onset 10 years of age
• 19-21 day cycle
For cyclic neutropenia, list the 4 general side effects
- Recurrent pneumonia
- Skin and other infections
- Mouth ulcerations and fever
- Periodontal disease
Explain what acquired neutropenia is and the variety of ways it may be acquired (3 - 7)
What it is
• Neutropenia is defined as a decrease in the circulating or absolute neutrophil count
Variety of ways it may be acquired
• Drugs
• Radiotherapy
• Viral or bacterial infections - HIV, Hepatitis, Measles and Influenza
Explain self inflicted lesions as a source of damage to the periodontium
- Usually in the form of lip/ tongue piercings.
- In 47% of subjects who had tongue piercings for more than 4 years chipped lower anterior teeth were noted
- You must ensure that patients are informed of the risks associated with oral piercings and encourage recommendations for the use of plastic or rubber barbells.
List sources (4) of chemical damage to the gingiva, and describe how chemical injuries look
Sources: • Aspirin • Dental cavity varnishes • Acid etching materials • Hydrogen peroxide
How they look
• White lesions are attributable to the formation of a superficial pseudo membrane composed of a necrotic surface tissue and an inflammatory exudate
