Periodontology in Paediatrics Flashcards
Describe the mnemonic
Please Give Greg Nine Percy Pigs Straight Past Meal Time Tonight
P - periodontal health
intact periodontium or reduced periodontium
G - Gingivitis: dental biofilm induced
intact periodontium
reduced periodontium
G - Gingival diseases and conditions that are not biofilm induced
N - Necrotising periodontal diseases
P - periodontitis
P - Periodontitis as a manifestation of systemic disease
S - systemic diseases or conditions that affect the periodontal supporting tissues
P - periodontal accesses and endodontic periodontal lesions
M - mucogingival deformities and conditions
T - traumatic occlusal forces
T - tooth and prosthesis related factors
Describe a healthy periodontium
- gingival margin may be several millimetres coronal to the CEJ
- gingival sulcus may be 0.5-3mm deep
- alveolar crest is 0.4-1.9mm apical to the CEJ in teenagers
What is the biologic width
the area/distance between the CEJ and the alveolar bone crest
What are the potential diagnosis of a healthy periodontium
intact periodontium or reduced periodontium
What to we need in order to diagnose periodontal health
- do a BPE
- <10% bleeding on probing
What are the types of gingivitis
- dental biofilm - induced (localised or generalised)
2. Non-dental biofilm induced
Outline the steps of gingivitis caused by the dental biofilm
- As supra-gingival plaque accumulates on the teeth, an inflammatory cell infiltrate develops in gingival connective tissue
- This causes the junctional epithelium to become disrupted
- This allows apical migration of plaque and an increase in the gingival sulcus depth
- This gives rise to a gingival pocket, also called a false pocked or pseudo pocket
is there loss of attachment in gingivitis
there is no periodontal loss of attachment
what is the diagnosis of 10-30% bleeding on probing
localised gingivitis
what is the diagnosis of over 30% bleeding on probing
generalised gingivitis
describe the appearance, aetiology and risk factors of Necrotising Ulcerative Gingivitis
appearance
- blunted papillae
- malodour
- painful gingivae
- no attachment loss
Aetiology
- Fusiform and spirochete bacteria
Risk factors
- smoking, stress, immunosuppression, poor diet
- HIV positive
- common in developing countries
- trench mouth
Describe pubertal gingivitis
- increased inflammatory response to plaque mediated by hormonal changes during puberty
- can progress to early periodontitis
- local and systemic factors and influence progression
when do you diagnose non-dental biofilm-induced gingivitis
when the main etiological agent for gingivitis is not plaque
Describe two drugs which can cause drug induced gingivitis
cyclosporin
- immunosuppressant used in patients with underlying immune conditions, such as crohn’s, or post organ transplants
Phenytoin
- anti epileptic medicine used in children with epilepsy
What systemic diseases can lead to gingivitis
- agranulocytosis
- cyclic neutropenia
- crohn’s
- Sarcoidosis
- Granulomatosis