Periodontitis + gingivitis

Question 1

What is periodontitis?

Answer 1

the inflammation of the supporting structures of the tooth

Question 2

What is gingivitis?

Answer 2

the inflammation of the gingival tissue at the neck to the tooth

Question 3

What are the causes?

Answer 3

consistently poor oral hygiene, along with contributory factors such as smoking + genetic predisposition of periodontal problems

Question 4

Control build up of plaque

Answer 4

practise regular removal by using good oral hygiene techniques

Question 5

Modify contributory factors

Answer 5

such as give advice on smoking cessation

Question 6

Control host response

Answer 6

in pts predisposed to periodontal infection, by more frequency dental attendance for monitoring + evaluation + intervention where necessary

Question 7

Causative factors

Answer 7

poor oral hygiene allows accumulation of dental plaque, specifically in gingival crevice + periodontal pockets + on any pre-existing surface of tartar

stagnation areas including gingival crevice which allows plaque to accumulate around necks of the teeth against gingiva

failure to treat + eradicate subsequent gingivitis allows inflammation of the periodontal supporting structures, leading to periodontitis

Question 8

Modify contributory factors examples

Answer 8

smoking, unbalanced masticatory stress (teeth erupted out of alignment),
excessive masticatory stress (such as posterior teeth missing + pt nibbles with anterior teeth resulting in excessive chewing force on them
-hormonal imbalances affect reaction of gingival tissues to normal events such as plaque build up
-open lip posture that allows gingival tissues to dry out readily

Question 9

More contributory factors

Answer 9

• medicines that effect saliva production so pts suffers from xerostomia (dry mouth) - diuretics used to trt heart conditions, antidepressants, hypertensives
• plaque retention factors - tooth crowding, iatrogenic factors -history of radiography in head + neck will experience reduced saliva flow
• immunocompromised pts (diabetes, blood disorders, vitamin C deficiency, AIDS)
• medicines resulting in tissue overgrowth gingival hyperplasia (Phyenytoin for epilepsy, Antihypertensive agents like nifedipine, immune supressants to prevent transplant rejection like ciclosporin, cytotoxic drugs to treat cancers)

Question 10

Treatments

Answer 10

• scaling + sub gingival debridement
• advice given on oral health products that act specifically to control calculus formation
• gingivectomy for those with gingival hyperplasia
• once debrided, periodontal pockets may have antibiotic gel inserted
• extraction
• referral to periodontal specialist